Laryngeal Cancer - Causes, Symptoms, Treatment

Laryngeal cancer refers to the cancer of the larynx and is more commonly called cancer of the throat. The larynx is the person's voice box located just below the pharynx or throat and at the top of the windpipe or trachea in the neck area. Because the larynx contains the vocal cords which are responsible for the production of a person's voice, laryngeal cancer is also sometimes referred to as vocal cord cancer.

In most cases of laryngeal cancer, the cancer cells begin in the glottis. The glottis is the middle part of the three main parts of the larynx where the vocal cords are found. Thus, this type of cancer is sometimes also called cancer of the glottis. The other two parts are the supraglottis (upper part) and the subglottis (lower part).

As with any other type of cancer, there is the possibility that laryngeal cancer will spread or metastasize. Usually, the cancer cells spread to the nearby lymph nodes in the neck, to the back of the tongue, other parts of the throat and neck, the lungs and other parts of the body. Thus, it is of utmost importance that laryngeal cancer be detected as early as possible.

If detected early, 90% of patients can be cured. If it has spread to surrounding tissues or lymph nodes in the neck, 50 - 60% of patients can be cured. If it has metastasized to body parts outside the head and neck, the patient is no longer curable and treatment are administered just to prolong life.

Causes  of Laryngeal Cancer

Knowing some of the causes or risk factors associated with laryngeal cancer will help us be watchful about our health.

• Laryngeal cancer is the second type of cancer commonly caused by smoking cigarette or tobacco. The first is lung cancer.
• Combining smoking with excessive drinking of alcohol further increases the risk of developing laryngeal cancer. 
• Four times more men than women develop laryngeal cancer and most of them are within the age range of 50-55.
• People who are African Americans and have a personal history of head and neck cancer are more likely to be diagnosed with cancer of the larynx. 
• Occupations which expose workers to sulfuric acid mist, nickel or asbestos increase the risk of laryngeal cancer.
• Other factors that may increase the risk of getting laryngeal cancer include contacting certain viruses, having a diet low in vitamin A and having gastroesophageal reflux disease (GERD).

Symptoms of Laryngeal Cancer

The following symptoms may or may not be caused by laryngeal cancer. If you are feeling any of the following, you should consult a doctor for proper diagnosis.

• Abnormal (high-pitched) breathing sounds or problems breathing
• Cough, sore throat, or hoarseness that does not get better in 1-2 weeks, even with antibiotics.
• Coughing up blood
• Difficulty or pain when swallowing
• Pain, swelling or lumps in the neck or throat
• Ear pain
• Unintentional weight loss

Diagnosis of Laryngeal Cancer

Upon consultation with a doctor, he may perform a physical examination of the throat and neck. He will feel for swollen lymph nodes or lumps in the neck and check the throat using a small, long-handled mirror for abnormalities.  Further tests to confirm and stage laryngeal cancer may be required such as

• Laryngoscopy - a test using a laryngoscope (a thin, lighted tube) to examine the larynx.
• Endoscopy - a test where an endoscope is inserted into the skin through a cut or an opening such as the mouth to examine the larynx. Tissue samples may be taken for biopsy.
• Biopsy -  cells or tissues are taken and viewed under a microscope to check for cancer cells.
• Cranial CT scan - a procedure using a computer linked to an x-ray machine which takes detailed pictures of the area under study. A dye may be injected into the vein or swallowed to highlight the organs or tissues.
• MRI - is also called magnetic resonance imaging. It uses magnet, radio waves and a computer to take detailed pictures of the area under study.
• Barium swallow - a procedure where the patient drinks a liquid containing barium. Afterwards, a series of x-rays of the esophagus and stomach are taken.

Treatment of Laryngeal Cancer

There are three common options employed in cancer treatment: surgery, radiation therapy and chemotherapy. The options that a particular cancer patient undergoes depends largely on his age, general health, the location and size of the tumor, and the stage of the cancer or whether it has recurred. Whatever treatment is made use of, studies show that the treatment is more likely to be effective and successful if the laryngeal cancer patient do not smoke nor drink.

When the tumor is still small, surgery or radiation therapy may be employed to remove the tumor and prevent it from spreading to the other parts of the body. But when the tumor has grown larger or has metastasized, both radiation and chemotherapy are used as treatment. Sometimes, a surgery removing the tumor including all of the vocal cords (total laryngectomy) or part of it (partial laryngectomy) is necessary.

After undergoing laryngeal cancer treatment, some of the side effects or complications that the patient may have include airway obstruction, dry mouth, sore throat or mouth, dental problems like tooth decay or delayed healing after dental care, changes in the sense of taste and smell, difficulty swallowing, loss of appetite, loss of voice and speaking ability, skin changes in the neck, disfigurement of the neck or face, hair loss, pain, weakness, numbness or stiffness, nausea and vomiting, diarrhea and others.

Swallowing therapy and speech therapy are generally needed by the patient to help them cope with the changes that came with the treatment. Some who undergo surgery and radiation therapy would need feeding tubes until they are able to return to a regular diet. However, about 5% of patients can no longer swallow and would continue to feed through feeding tubes. Speaking ability is also affected after laryngectomy. Some will be able to talk again in the usual way, but those who had total laryngectomy would need to learn to speak in a new way with the help of a speech pathologist.

To address the breathing condition of patients after larynx cancer surgery, patients need to undergo a tracheostomy or a surgical procedure wherein a tube is inserted through an incision (stoma) in the neck to allow a person to breathe without the use of his or her nose or mouth. For partial laryngectomy, this tube is temporary but for total laryngectomy, this tube is no longer an option but a necessity.

To know more about Laryngeal Cancer and its treatment, check out the following reading resources.