It develops seventeen times more often in men than in women, most often between the ages of 50 and 60. It belongs to the group of tobacco-dependent tumors, i.e. those that develop as a result of smoking. This also means that they are less common in non-smokers.
Laryngeal cancer accounts for about 40 percent of all head and neck cancers. It is favored by smoking (also passive smoking). The risk of developing the disease for smokers is 30 times higher than for non-smokers. And if someone smokes and drinks high-percentage alcohol, the risk of developing the disease increases 330 times. The most common malignant neoplasm of the larynx is squamous cell carcinoma, which occurs in approximately 95 percent of patients.
The first symptoms
The most common symptoms of developing cancer of the larynx is hoarseness, which lasts more than two weeks and does not go away with usual anti-inflammatory treatment. Another symptom is the feeling of a foreign body, pain in the throat which often radiates to the ear, shortness of breath, dysphagia, choking, coughing, and haemoptysis. Sometimes the first and only symptom of cancer is metastasis in the local lymph nodes.
Anyone who is concerned about the condition of their larynx or pharynx should consult an ENT specialist.
What are the symptoms?
Hoarseness occurs when the vocal cords, or the glottis are damaged, is an early symptom of cancer in this area. The hoarseness appears relatively late, when the cancer develops in the epiglottis or subglottis. It is a symptom of the tumor infiltrating other structures of the larynx. * Swallowing disorders are most common in tumors of the epiglottis and lower pharynx. Initially, they are discreet and can easily be ignored by the patient. Great difficulty in swallowing is usually associated with an advanced cancer process. Choking when swallowing food may be a symptom of a tumor in the lower throat area.
Ear pain is a characteristic symptom of cancers of the epiglottis and lower pharynx.
Dyspnoea indicates a significant narrowing of the inside of the larynx and occurs in very advanced tumors.
Lymph node metastases usually appear in supraglottic cancer in about 50-60%, and in the subglottic region in 10-20%. sick, and the least frequently in glottic cancers 4-10 percent. The appearance of metastases reduces the patient’s chance of being cured by about 50 percent.
Also read: Tumors of the larynx
What research?
Diagnosis of laryngeal cancer is possible only after an ENT examination. The location, size of the tumor and mobility of the vocal cords are assessed. The examination must also include a thorough palpation of the lymphatic system. Diagnostics is supplemented with direct laryngoscopy, i.e. a specialized examination performed under general or local anesthesia. The examination enables a detailed assessment of the larynx, including the areas that are not visible during the examination with the laryngeal mirror. Another advantage of the examination is the possibility of taking a specimen for histopathological evaluation. The test involves the insertion of a rigid endoscope into the larynx. Under local anesthesia, only the extent and type of lesions are assessed and a biopsy is performed. General anesthesia enables some operations to be performed intra-laryngeally.
An ultrasound scan of the neck is also an important part of the tests to assess the health condition. During the examination, the doctor assesses the lymphatic system. Another examination is computed tomography (CT, CT) or magnetic resonance imaging (MR), which allow to determine the depth of the tumor infiltration.
The stages of the cancer are classified according to four stages, of which stage IV is further divided into stages marked with the letters A, B, and C
Treatment
It usually involves radiation therapy, surgery, or a combination of both. The type of therapy depends on the stage and location of the tumor. The doctor also takes into account the degree of tumor maturity, the general condition of the patient and his acceptance of the proposed method of treatment. Early laryngeal cancers (grade I and II) can be treated with radiotherapy or surgery. It is possible to use a laser, remove a fragment of the larynx, which allows you to maintain the voice and proper breathing. Radiation therapy as a stand-alone treatment is reserved for early glottic carcinomas, in the remaining cases the therapy of choice is surgery, often involving the removal of local lymph nodes.
Advanced laryngeal cancers (stage III and IV) are most often treated with a combination method – surgery (complete removal of the larynx) and postoperative radiotherapy. When surgery is impossible, chemoradiotherapy is used. Currently, this method is still in the research phase, but its use in inoperable cases is approximately 70%. cases, leads to tumor shrinkage, which gives hope for surgery. Such a medical procedure significantly extends the patient’s life.
The laryngectomy, that is, the complete removal of the larynx, is a mutilating procedure because the patient cannot speak and his nose and mouth are excluded from the breathing process. This results in a loss of smell and an inability to moisturize and heat the inhaled air.
Education is needed
Since 1965, the European Confederation of Laryngectomes has existed and has been active. This social organization brings together associations from 18 Member States. The Confederation provides social and legal protection to laryngectomes, i.e. people living without a larynx. It publishes magazines and guides, provides patients with the necessary auxiliary items, organizes help for the sick before surgery and newly operated patients, and coordinates the work of national organizations. Using the patterns of the Confederation, in 1991, the Polish Society of Laryngectomy was established with the headquarters of the main board in Bydgoszcz. Field branches have been organized throughout the country. During the meetings, problems bothering participants are discussed, as well as an instructional group for learning replacement speech. Doctors, psychologists, rehabilitation specialists and speech therapists as well as nurses working in the ward in ENT departments provide practical guidance to people without a larynx.
There are more and more people without laryngectomy in Europe. They are more and more often young people. They are connected by common problems and difficulties they encounter in everyday life. They also share the goal of alleviating the consequences of the disease and surgical treatment as quickly as possible.
Text: Anna Jarosz