Laryngeal Cancer
What is it?
Laryngeal cancer is the growth of malignant cells in the larynx (also known as the voice box), an organ composed of the vocal cords and a structure known as the epiglottis, a flap of tissue that prevents food from entering the airway while you swallow. The larynx is located between the pharynx, or throat, and the trachea (the windpipe). Laryngeal cancer can almost always be cured if detected early enough. Thus, it is essential to be alert to persistent hoarseness—the disease's cardinal and often only symptom.
Treatment is most successful when the tumor is restricted to the vocal cords. The outlook is less optimistic for cancers that have spread from the larynx to nearby lymph nodes or through the bloodstream to other parts of the body. Some 11,000 cases of laryngeal cancer are diagnosed each year, mostly in those over age 50, and nearly 4,000 people die from it annually. Men are affected far more often than women—accounting for about 9,300 annual cases.
What Causes It?
- Like other cancers of the oral and respiratory system, the risk of laryngeal cancer is higher among those who smoke or otherwise use tobacco.
- Heavy use of alcohol is also associated with laryngeal cancer. The combination of drinking and smoking significantly increases risk.
Prevention
- Avoid tobacco use as well as excessive alcohol consumption.
Diagnosis
- Patient history (including alcohol and tobacco habits) and physical examination are needed.
- You may be sent to an otolaryngologist (ear, nose, and throat specialist), who will do an indirect laryngoscopy (examination of the throat using a bright light and a head mirror). A direct laryngoscopy (use of a flexible lighted scope to inspect the larynx) may be done if the visual exam is suspicious (usually performed under sedation or general anesthesia).
- A biopsy (microscopic examination of a tissue sample) may be taken to confirm the diagnosis when cancer is suspected.
- CT (computed tomography) scans or MRI (magnetic resonance imaging) may be done to determine the extent of a tumor.
How to Treat It
- Early tumors confined to the vocal cords can be treated successfully with radiation, which can destroy the tumor while leaving the voice intact.
- Laser surgery can also treat some early tumors and preserve voice quality.
- More advanced cancers often require a laryngectomy—removal of the larynx.Most often, this will cure the cancer but will result in the loss of normal speaking ability. In such cases a speech therapist can teach the patient alternate means of speaking, such as using the esophagus (the tube through which food passes) as a substitute for the vocal cords, sometimes with the assistance of a surgically placed valve. Speech may also be synthesized with vibrating electromechanical aids placed against the throat.
- Surgery is often followed by radiation.
- Chemotherapy, sometimes in combination with radiation, may be tried in advanced cases to prevent or arrest the spread of cancer and to ease symptoms.
- Administration of isotretinoin may reduce the likelihood of recurrence.
- Cure of laryngeal cancer is unlikely if the patient continues to smoke.
When to Call a Doctor
- Call a doctor if hoarseness persists for more than a week or recurs frequently.
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Copyright © 2008 Medletter Associates, LLC
Content excerpted from Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference.