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Laryngeal cancer is a subset of cancer that develops within the tissues of the larynx. The larynx contains the three different regions of the throat’s vocal cords: the supraglottis, subglottis, and glottis. Roughly 60% of laryngeal cancer cases originate in the glottis – the vocal cords themselves.
Laryngeal cancer can metastasize and spread to surrounding structures such as the lymph nodes, the chest, and the spinal column, eventually traveling to further parts of the body if left untreated. Nearly 3,760 individuals develop laryngeal cancers each year. This statistic decreases each year as more individuals become educated about the consequences of smoking tobacco.
Who Is at Risk for Laryngeal Cancer?
Laryngeal cancer is not an extremely common form of cancer, but its likelihood of developing within any individual is increased based on multiple risk factors:
- Excess alcohol consumption
- Smoking
- Tobacco consumption – non-smoking variations (i.e. chewing tobacco)
- Genetic predisposition, or gene mutations
- Poor dietary habits that diminish immune response
- Occurrence of Human papillomavirus (HPV)
- Age – Individuals who are aged 65 and older have an increased risk of developing laryngeal cancer
Laryngeal cancer is most commonly caused by a combination of both smoking tobacco and excessive alcohol consumption combined. This combination increases the risk of laryngeal cancer development by 90%.
Laryngeal Cancer Types
Nearly all instances of laryngeal cancer are squamous cell carcinomas. This type of cancer impacts the surface cells of the skin. Tumors in laryngeal cancer cases develop above, below, or directly in line with an individual’s vocal folds. They are referred to as supraglottic tumors, subglottic tumors, and glottic tumors, respectively.
Common Symptoms
Laryngeal cancer develops over time and impacts older individuals most commonly as a result of chronic smoking, or a combination of smoking and drinking. The following presents symptoms that may indicate the development of laryngeal cancer:
- Hoarseness of voice when speaking
- Difficulty swallowing
- Painful swallowing
- Wheezing
- Labored breathing
- Ear pain
- Recurring swelling, pain, and/or infection of the lymph nodes
One key symptom that may indicate tumor development is chronic ear pain. When accompanied by smoking, and no other symptoms of ear disease are present, this can indicate the presence of early stage laryngeal cancer.
Diagnosing Laryngeal Cancer
Any patients that display several symptoms associated with laryngeal cancer should promptly seek professional examination. A doctor will initially assess the status of the patient via a head and neck examination consisting of the following:
- Oral examination – The doctor examines the patient’s oral cavity for the presence of tumors and/or a poor state of dental health. This examination will indicate whether the presented symptoms are the product of a simple infection or inflammation of the tonsils.
- Palpation – Palpation, or light pressing, of the neck will be conducted next. The doctor will check for abnormal lymph node characteristics and tenderness in the neck.
- Laryngoscopy – Dependent on the previous two tests, the doctor may use either a flexible laryngoscopy tool (a tube with a camera) or a mirror laryngoscopy tool in order to gain a visual confirmation of what is occurring within the throat.
Diagnostic exams are required if an individual’s doctor discovers any alarming or abnormal data via the preliminary physical tests that were conducted.
- X-rays – X-rays are taken dependent on the presented symptoms and whether the doctor suspects potential malignancy. In older, chronic smokers, this could involve a chest x-ray even though the cancer originated within the larynx.
- Laryngoscopy – Further, detailed laryngoscopy by a trained ENT will be conducted to detect potential lesions or tumors on/around the vocal flaps.
- Computed Tomography (CT) Scans – CT scans will be done to determine tumor size, location, and shape
- Biopsy – A professional will perform a biopsy, or removal of a small of tissue, of any masses that are found through the previous examinations. This is done to directly test the tissue cells for cancer.
After laryngeal cancer is diagnosed, the stage of the cancer is determined to establish a treatment plan and prognosis for the patient.
Stage 0 – In this stage the cancer is present only within the larynx’s inner lining
Early Stage – This stage involves the cancer spreading to part of the supraglottis (Stage 1) and/or spreading to the vocal cords as well (Stage 2).
Locally Advanced – In this stage, the cancer has prevented the vocal cords from moving due to its growth. It may also have spread to a surrounding lymph node.
Advanced Stage – Advanced stage laryngeal cancer implies malignancy, impacting several lymph nodes and other parts of the body as the cancer travels.
Treating the Condition
Treating laryngeal cancer promptly is essential after determining the areas of the body that it has impacted. To prevent further spread of the cancer, the following treatments are considered:
- Surgery – Microsurgery is a minimally-invasive technique used to remove intermediate tumors in the glottis and supraglottis that have not yet spread. Total laryngectomy involves removing the vocal cords/larynx altogether.
- Chemotherapy/Radiotherapy – Radiotherapy used with chemotherapy (radiation and cytotoxic drugs combined) are used to kill the malignant cells of the tumors that have multiplied. Targeted chemotherapy drugs also exist that achieve the same goal.
- Speech Therapy – Speech therapy is given to individuals who undergo surgery to treat laryngeal cancer. This is achieved by teaching patients how to control airflow and tonal vibrations that occur in the throat. Essentially, the patient is taught how it feels to create speech within their physical body. Through speech therapy, patients are able to regain some or all communication through speech.
- Speech Devices – Simple electrical devices that control air flow, such as the electrolarynx, are used to aid in speech therapy. Prosthetic speech devices are used in more complex cases. These devices are surgically placed within the throat and simulate the airflow of the original larynx.
Prognosis
After a diagnosis of laryngeal cancer, 50% of the patients survive up to ten years. Keeping in mind that most patients are of old age, this is an impressive statistic. Advanced stage cancer is associated with a lower rate of survival. This makes it crucial to either catch laryngeal cancer in its early stages, or to avoid the controllable risk factors that contribute to its development altogether.
