Laryngeal cancer

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at March 22, 2016
StartDiseasesLaryngeal cancer

Laryngeal cancer, sometimes referred to as throat cancer, occurs when cancer cells form in the larynx. This type of cancer affects approximately 13,000 Americans with men being affected at a higher rate than women. In most cases, the cancer develops in the thin, flat, squamous cells that line the larynx.

Contents

Definition & Facts

The larynx is located between the trachea and the base of the tongue. The larynx houses the vocal cords, which vibrate when air is forced against them. These vibrations echo through the mouth, nose, and pharynx to create a person’s voice.

The larynx is divided into three sections. The supraglottis is the upper portion situated above the vocal cords. The middle section, which contains the vocal cords, is called the glottis. The lowest section, the subglottis, is located between the trachea and vocal cords. Laryngeal cancer can develop at any point along the larynx.

Symptoms & Complaints

One of the earliest symptoms of laryngeal cancer is persistent voice hoarseness. It is important to bear in mind that hoarseness can be caused by a number of factors, including allergies and laryngitis; however, any hoarseness that does not improve within two weeks should be reported to a physician.

The size and location of the tumor are factors impacting what symptoms a person with laryngeal cancer may experience. Typical symptoms include:

Anyone experiencing these symptoms on a persistent basis should contact their doctor for a referral to an ear, nose, and throat specialist for further evaluation.

Causes

Cancer is the result of genetic mutations that allow cells to proliferate uncontrollably to form tumors and spread to others parts of the body. Smoking, heavy alcohol consumption, exposure to toxic substances, and infections, such as human papillomavirus, are factors in triggering the genetic mutations that can lead to laryngeal cancer. Other risk factors or commonly affected groups include:

Having a risk factor does not mean that an individual will develop laryngeal cancer. They should discuss their risk with their primary care physician, take steps to eliminate lifestyle factors that can increase the risk, and seek prompt medical attention if they develop any symptoms.

Diagnosis & Tests

Laryngeal cancer is frequently diagnosed when an individual seeks treatment for a chronic sore throat and hoarseness. The doctor will typically start with a routine physical examination to rule out common illnesses that may present with the same symptoms. The doctor will also check the throat area for lumps or abnormalities. This may be followed by X-rays or barium swallow studies to check for abnormalities within the larynx itself. If cancer is suspected, the patient will likely be referred to an ENT specialist for further evaluation.

A laryngoscopy or endoscopy may be performed to allow the doctor to check the larynx for any abnormal areas. The procedure involves inserting a lighted scope into the mouth and larynx. A small sample of tissue may also be removed during the procedure and submitted for biopsy. CT scans or MRIs may be ordered to provide detailed images of the larynx and surrounding structures.

In some cases, a small amount of radioactive dye may be injected or swallowed to make organs and tissues more visible in the images. A PET scan or bone scan may be requested if the doctor suspects that the cancer may have metastasized to other parts of the body.

During these procedures, a small amount of radioactive material is injected into the patient. This material collects in tumors or the bones so that cancerous areas can be detected during the scan. If cancer is found, it is staged according to the TNM system. The T stands for the tumor and the extent to which it has spread within the pharynx, larynx, and adjacent tissues.

The N looks at whether the cancer is present in nearby lymph nodes, and M looks at whether the cancer has spread to distant organs. Stage 0 cancer is very localized while Stage IV indicates an advanced form of cancer.

Treatment & Therapy

The patient’s age, overall health, as well as the location and stage of cancer are taken into consideration in determining the appropriate course of treatment. Standard treatments for laryngeal cancer include surgery and radiation therapy. Surgery is frequently used to treat all stages of the disease.

Simple laser surgery is often effective in removing cancerous tissue in the earliest stages. Advanced laryngeal cancer may require more aggressive techniques, including removal of the larynx. Surgery is often followed by radiation therapy in order to destroy any cancerous cells or tissues that may remain following surgery.

In some cases, chemotherapy may be used in combination with other treatment methods. Chemotherapy combined with radiation may help some patients avoid a laryngectomy, which would allow them to maintain their ability to speak. Chemotherapy is also frequently recommended in cases where the cancer has spread too far or is too large to be removed surgically.

Prevention & Prophylaxis

The prognosis and long-term outcome for individuals with laryngeal cancer depend on the type and stage of cancer. Five-year survival rates vary from 53 percent to 90 percent depending on the location. In all cases, the best outcomes are achieved with early diagnosis. People who are at higher risk for cancer should be aware of the symptoms and see their doctor immediately if they develop these symptoms.

Individuals who smoke can significantly reduce their risk of developing laryngeal cancer by quitting smoking. Anyone at increased risk should limit their exposure to hazardous substances, such as asbestos and nickel or sulfuric acid fumes. Young men and women can reduce their risk of laryngeal and other squamous cell cancers by getting vaccinated against the HPV virus.