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Among malignant neoplasms of the larynx, cancer is the most common, mainly in men, mostly over 60 years of age. Permanent cure is achieved in approximately 70% of all patients, with cure rates in the early stage of cancer growth reaching 96–98%. That is why early diagnosis of the disease is so important.
What are malignant neoplasms of the larynx?
Laryngeal cancer develops as a result of the development of cells within it that our body is unable to control. Cancer usually occurs over the age of 60 and occurs around the head and neck. Men are sick more often than women, but in recent years this has started to gradually change as more and more women start smoking. Most neoplasms (in Poland) are diagnosed in the epiglottis, which carries a bad prognosis, as a large number of lymph vessels in the neck are located from the epiglottis, which in turn causes early metastasis to this area. Laryngeal cancer initially manifests as inconspicuous hoarseness, which, despite the use of anti-inflammatory treatment, does not disappear. The number of people suffering from laryngeal cancer accounts for about 2% of all cancer cases in our country.
Laryngeal cancer – factors contributing to development
Among the factors contributing to the development of laryngeal cancer, the most common are:
- smoking,
- drinking a lot of alcohol
- male gender (women suffer from cancer about four times less often),
- black race,
- age (most often after the age of 60),
- exposure to long-term contact with chemical agents (e.g. asbestos, coal dust or sulfuric acid),
- HPV (human papillomavirus) infection – especially affects the development of squamous cell cancer of the larynx,
- vitamin A deficiency,
- laryngeal burn,
- mechanical trauma of the larynx.
Laryngeal cancer symptoms
Symptoms can be easily seen. These are:
- hoarseness,
- voice change,
- cough,
- sore throat,
- feeling of an obstacle when swallowing,
- difficulty swallowing
- pain radiating to the ear,
Later appear:
- dyspnoea,
- blood plucking,
- enlarged lymph nodes in the neck
- loss of appetite and weight loss
- trouble breathing
In addition, patients with laryngeal cancer may experience an unpleasant smell from the mouth, pale skin, and a general feeling of being unwell and tired.
A characteristic feature of these symptoms is their constant worsening and no improvement despite the use of anti-inflammatory treatment. It is worth mentioning that the disease may not cause any symptoms in the initial stage, therefore the diagnosis is often made too late. So, if you experience prolonged hoarseness or a change in timbre – do not wait and see a doctor, as these may be the first symptoms of cancer.
The most common localization of laryngeal cancer is:
a) in the epiglottis – here the tumor grows relatively quickly
b) in the glottis – in this case the cancer develops more slowly;
c) in the subglottis – this is the rarest location of the tumor.
Laryngeal cancer diagnosis
The diagnosis of cancer is based on the collection of a fragment of a laryngeal tumor for examination, which is then analyzed under a microscope. Laryngoscopy helps to assess the severity of the disease. In addition, the doctor performs an endoscopy (the so-called fibroscopy) to accurately assess the inside of the larynx. Additionally, cytology is performed using a needle and a syringe from a material taken from a tumor in the neck (this is evidence of metastasis). A less frequently performed test is with the use of a contrast agent intended to be drunk by the patient.
Imaging tests that help to assess the stage of the cancer are also of great importance. For this purpose, computer tomography of the neck and ultrasound of the cervical lymph nodes are usually recommended. In addition, an important element is a chest X-ray or a chest CT scan.
Treatment of laryngeal cancer
The type of treatment is selected based on the severity of the disease. It could be:
1. Surgical treatment – based on resection of the entire or half of the larynx or endoscopic excision of the lesion. Endoscopic surgery is performed in patients whose cancer is at an early stage. Endoscopy uses a laser to locally destroy the tumor. However, in the case of advanced disease, complete or partial excision of the larynx is necessary, which very often ends with the loss of the ability to speak and breathe through the mouth. In such patients, a tracheotomy is performed, which allows free breathing (in patients with a completely dissected larynx, this opening remains for life).
Important! There are electronic devices available on the market that modulate the air flow flowing through the tracheotomy opening, thanks to which the patient gives a voice that is understandable to the environment.
2. Chemotherapy – is an adjuvant treatment after surgery that destroys the tissues of laryngeal cancer (especially in patients with very advanced cancer).
3. Radiotherapy – uses radiation for treatment, which contains a large amount of energy. Irradiation is aimed at (like chemotherapy) destroying cancer cells. This type of therapy carries the risk of damaging neighboring healthy cells, so some methods are used to counteract the adverse effects of radiation therapy. One of the methods is to make a special mask made of plastic, which is to keep the patient’s head in the correct position during irradiation. Then the risk of damaging healthy tissues is significantly reduced.