Do you have any of these throat problems? Let's learn about Laryngeal Cancer!

Do you feel like your voice is slowly changing? Or do you feel like something is stuck in your throat, making it difficult to swallow? Sometimes we think these are just a cold or a throat infection, but sometimes they can be a sign of something a little more serious. That's why today we thought we would talk about this thing called laryngeal cancer. Don't be afraid, it's very important to be aware of this.

What is Laryngeal Cancer?

Simply put, laryngeal cancer is cancer that develops in your larynx . The larynx is a very important part of our throat. Some people also call it the "voice box." Because we speak, breathe, and swallow with the help of this larynx. Our vocal cords are also located inside this larynx.

Now, what is cancer? Cancer occurs when cells in our body start to divide and multiply rapidly and uncontrollably. The abnormal cells that form in this way can gather together and form a tumor. This is what happens in laryngeal cancer. As these cancer cells multiply, they invade the healthy tissues around them and damage our body.

Imagine, our larynx can be divided into three parts:

1. Supraglottis (upper part): About 35% of laryngeal cancers, or more than a third, start in this part.

2. Glottis (middle part): The vocal cords are located here. About 60%, or more than half, of laryngeal cancers start in this important part.

3. Subglottis (lower part): About 5% of laryngeal cancers, or about one in 20, start in this part.

How common is Laryngeal Cancer?

Laryngeal cancer is a type of cancer that belongs to the category of Head and Neck Cancers . There are statistics from some countries in the world, for example, in the United States, it is said that about 12,500 people are diagnosed with this disease every year, and about 4,000 die from it. Such cancers are also seen in Sri Lanka, so it is very important to be aware of this.

What are the symptoms of laryngeal cancer?

The biggest problem with this is that early symptoms can be easily confused with those of other common illnesses . The most common symptom is hoarseness . If it doesn't improve after a few weeks, you should be suspicious. Many people think it's just a cold. However, if you have any of the following symptoms, it's best to see a doctor for a proper diagnosis:

• Persistent sore throat or cough.
• Voice changes (e.g., hoarseness) that persist for more than two weeks.
• Feeling pain or other discomfort when swallowing food or drink .
• Catching something in the hand, such as a lump in the neck or throat .
• Difficulty in producing voice `(Dysphonia)` .
• Ear pain (especially on one side).

Important: If you have these symptoms, it is very important to seek medical advice immediately.

Also, if you experience the following symptoms, you should seek medical attention immediately :

• Difficulty breathing (Dyspnea) .
• A high-pitched, harsh sound (Stridor) when breathing .
• Frequent feeling of something stuck in the throat (Globus Sensation) .
• Coughing up blood (Hemoptysis) .

What are the causes of laryngeal cancer?

There are several main causes that contribute to the development of this cancer.

• Some types of HPV (Human Papillomavirus) , a sexually transmitted infection (STI), can cause laryngeal cancer.
• Additionally, tobacco use (including smoking) and heavy alcohol consumption significantly increase the risk of developing this cancer. If you do both together, the risk is even higher.

What are the risk factors for laryngeal cancer?

There are several other risk factors that can affect the development of this cancer. It is important to be aware of these, because some of them are things we can control.

• Smoking or using other tobacco products: This is the main risk factor . People who smoke are much more likely to develop this cancer.
• Alcohol consumption: The risk increases, especially if you drink more than one drink per day . The risk is even higher for someone who both smokes and drinks alcohol.
• Age: This cancer is most common in people over the age of 55.
• Gender: Men are about five times more likely to develop this cancer than women. This may be due to the higher prevalence of smoking and heavy alcohol use among men.
• Having had a previous head or neck cancer: About one in four people (25%) who have had this type of cancer before will develop cancer in this area again.
• Occupation: Some occupations also increase the risk due to exposure to substances. For example:
• Sulfuric Acid Mist
• Wood Dust
• Nickel
• Asbestos
• Working in factories that produce mustard gas.
• People who work with machinery are also at increased risk of developing laryngeal cancer.

How is Laryngeal Cancer diagnosed?

If you have symptoms, your doctor will first ask you about your symptoms and your medical history. Then they will do a physical exam and examine your throat and neck. After this initial exam, they will likely do several more tests to confirm the diagnosis.

What tests help in diagnosis?

There are several main tests performed for this:

• Imaging Scans:
• CT scan or MRI scan: These can take detailed pictures of the inside of the body. They can show things like the size of the cancerous tumor and its location.
• Chest X-ray: This helps to see if the cancer has spread to the lungs.
• Laryngoscopy: In this procedure, the doctor inserts a thin, flexible tube called an endoscope , which is equipped with a camera and light, through the mouth or nose and down the throat. This allows the doctor to see directly inside the larynx.
• PET Scan: In this, a very small, safe dose of a radioactive substance is injected into a vein. This substance clearly shows where cancer cells are located.
• Biopsy: This is the most important test to confirm cancer . A small piece of abnormal tissue is taken from the larynx and examined under a microscope. A pathologist , a tissue scientist, examines these cells. Some cancer treatments only work if the cancer cells have certain protein markers. So this biopsy also checks for these markers.

What are the stages of laryngeal cancer?

As part of the diagnosis, the stage of the cancer is determined. This means determining how severe the cancer is, how far the tumor has grown, and whether it has spread to other parts of the body.

The stages of laryngeal cancer are simply as follows:

• Early Laryngeal Cancer: In stages 0, 1, and 2, the tumor is small. The cancer has not spread beyond the larynx.
• Advanced Laryngeal Cancer: In stages 3 and 4, the tumor has grown larger. It may have affected the vocal cords, or it may have spread to the lymph nodes or other parts of the body.

Where does laryngeal cancer first spread?

Cancer that spreads beyond the larynx can spread to the thyroid gland, trachea, esophagus, tongue, lungs, liver, and bones .

What are the treatments for laryngeal cancer?

Fortunately, there are several treatments for laryngeal cancer. Depending on your condition, your medical team will choose the treatment that is best for you.

• Radiation Therapy: In this treatment , radiation oncologists use high-energy beams of radiation to destroy cancer cells. Since the radiation is directed only at the cancerous tumor, damage to surrounding healthy tissue is minimized.
• Chemotherapy: Medical oncologists use drugs to kill cancer cells or slow their growth. Chemotherapy is often given through a vein. This treatment can cause side effects, but doctors can help manage them.
• Immunotherapy: This involves stimulating your body's own natural defense system, the immune system, to fight cancer. This is also called biologic therapy .
• Targeted Therapy: This treatment targets specific proteins in cancer cells, thereby preventing them from multiplying.
• Surgery:
• In early-stage cancer , surgery can be performed to remove only the cancerous tumor while preserving the larynx (that is, preserving the ability to speak and swallow).
• In advanced cases of cancer , surgeons may have to perform a laryngectomy , which is a surgery to remove the entire larynx.

Sometimes more than one treatment is needed. For example, chemotherapy or radiation therapy may be used to kill any remaining cancer cells after surgery.

What types of laryngeal surgery are there?

Surgery is used to remove the cancer. The primary goal of laryngeal cancer surgery is to remove the cancerous tumor while preserving the function of the larynx. However, sometimes it may be necessary to remove part of the larynx or the entire larynx. There are several main types of surgery:

• Cordectomy: Removal of part or all of a vocal cord. This is often done through the mouth.
• Supraglottic Laryngectomy: Removal of the upper part of the larynx (supraglottis). This can be done through the neck or through the mouth.
• Hemilaryngectomy: Removal of half of the larynx. This can help preserve your voice.
• Partial Laryngectomy: Removal of part of the larynx. This can also preserve the ability to speak.
• Total Laryngectomy: Removal of the entire larynx through the neck.
• Thyroidectomy: Removal of all or part of the thyroid gland (if the cancer has spread).
• Laser Surgery: Using a laser beam to remove the tumor without bleeding.

How to choose the best treatment?

For early-stage laryngeal cancer, the medical team will most likely recommend surgery or radiation therapy. Research has shown that both are effective. When deciding on treatment, the medical team will consider several factors, including:

• What is the best treatment to preserve your ability to speak and swallow ?
• Your ability to follow your wishes, hopes, and treatment plan.
• your age.
• Other illnesses you have.
• The demand for your voice (e.g. for your job).
• The nature of your voice.
• Whether you currently smoke or have you done so in the past.
• Your ability to breathe.
• Support from your loved ones.

Can you protect yourself from laryngeal cancer?

While it is not possible to completely protect against all cancers, there are things we can do to reduce our risk of developing many cancers, including laryngeal cancer. That includes adopting a healthy lifestyle:

• Quit smoking completely and avoid using other tobacco products. This is the most important thing.
• Limit your alcohol consumption. If you are addicted to alcohol, seek treatment.
• Eat a healthy diet . Eat more vegetables and fruits.

"Quit smoking today. It can protect you from not only laryngeal cancer, but many other diseases."

Is there any screening for laryngectomy?

There is currently no specific, regular screening test for laryngeal cancer. However, if you have symptoms such as hoarseness, other changes, or a persistent cough, you should definitely see a doctor. Early detection can catch cancer at an early stage. Then it is easier to treat and the chances of recovery are higher.

What happens after laryngeal cancer treatment?

After treatment, you will need to continue to see your doctor for follow-up appointments to see if you are getting better. The doctor will pay attention to these things:

• Treatment for any pain.
• Helping to control swallowing difficulties or sores in the mouth and esophagus (mucositis) .
• Discuss your eating habits and make sure you can eat and swallow without any problems.
• Physical therapy may be prescribed for neck scarring or difficulty opening the mouth.

What is the outlook for people with laryngeal cancer?

Your outlook depends on several factors. For example, the stage of the cancer, your age, and your overall health. In general, early-stage laryngeal cancer has a higher chance of survival . For advanced cancer that has spread to other parts of the body, the chances of survival are slightly lower.

However, even advanced laryngeal cancer can be cured . If the cancer does come back, it usually happens within the first two to three years after treatment. The risk of the cancer coming back after five years is very low. However, if you smoke or drink alcohol and do not stop, you are at higher risk of developing new cancer in this area.

Will I have to have a stoma?

If you have a total laryngectomy , your surgeon will create a new airway in your neck for you to breathe. This is called a stoma . It can be permanent or temporary. Here are some things you can do to care for your stoma:

• Check it daily to make sure it is clean and free of mucus.
• Remove the mucus from the stoma using either saline spray or a cloth.
• Keep it moist with saline spray.
• Clean the area around the stoma using mild soap and water.
• Do not immerse the stoma in water.
• Keep your stoma covered (with a scarf or a special stoma cover) to prevent dust from getting in. Keep it covered when shaving and bathing.

How do I take care of myself if my entire larynx is removed?

If you smoke, it is extremely important to quit . Stay away from tobacco completely before, during, and after treatment. People who smoke after treatment have a higher risk of developing other types of cancer. However, people who quit smoking have a much lower risk of cancer. Smoking can delay your recovery and make the side effects of treatment worse.

Will I be able to speak after laryngeal cancer treatment?

This is a problem for many people.

• If you have a total laryngectomy (which means the entire larynx is removed), you will have to learn a new way to speak. A speech therapist will help you with this.
• If the surgeon removed only part of your larynx, your voice may be hoarse at first, but you will most likely get your voice back. However, it may feel and sound different than it did before.
• Other treatments, such as radiation therapy, can temporarily cause you to lose your voice. However, your voice usually returns once your larynx heals.

What questions should I ask my doctor?

If you are diagnosed with laryngeal cancer, ask your doctor these questions:

• What stage is the cancer in?
• What treatment options do I have?
• How will the treatment affect my speaking, breathing, and swallowing?
• Will I need rehabilitation after treatment?
• Can cancer recur?
• How am I healthy?

Who helps diagnose and treat laryngeal cancer?

The laryngeal cancer care team usually consists of several specialists and health professionals from different fields:

• Head and Neck Surgeons: These are Otolaryngologists who are specially trained to remove cancers in the head and neck area.
• Radiation Oncologists: Treat cancer with radiation therapy.
• Medical Oncologists: Treat cancer with drugs such as chemotherapy.
• Dentists and Oral Surgeons: Provide services such as X-rays and treat oral cancers.
• Speech Therapists / Speech-Language Pathologists (SLPs): Evaluate and treat speech, language, voice, thinking, and swallowing disorders.
• Registered Dietitians: Help find a nutritious diet based on the patient's health condition, illness, or injury.
• Social Workers: Work to solve problems and provide information to patients and families. They provide counseling, referrals to local and national resources, information about support groups, and information about financial assistance.
• Primary Care Providers: Oversee general medical care during cancer treatment.

Summary and things to remember

If you have symptoms of laryngeal cancer, such as hoarseness or other changes in your voice, a persistent cough, or difficulty swallowing, please see a doctor . Stages 0 and 1 laryngeal cancer have a very high cure rate if treated early. Also, treating the cancer early can help preserve your ability to speak and eat. Ask your doctor about the treatment options available depending on the stage of your cancer.

Remember, smoking and excessive alcohol consumption are the main causes of laryngeal cancer. The best thing you can do is stay away from these bad habits. Stay healthy!

` Laryngeal cancer, Throat cancer, Voice cancer, Laryngeal Cancer, Cancer symptoms, Cancer treatment, Smoking cancer