Laryngeal Cancer: Symptoms, Causes, Treatment

What are the symptoms of laryngeal cancer?

Laryngeal cancer, also known as cancer of the larynx or throat cancer, can present with various symptoms, which may include:

1. Hoarseness or Change in Voice: Persistent hoarseness or a change in voice quality that does not resolve over several weeks can be a common early symptom.
2. Sore Throat or Pain: Persistent sore throat or pain in the throat that does not improve with usual treatments.
3. Difficulty Swallowing (Dysphagia): Difficulty in swallowing, which may progress over time.
4. Ear Pain: Unexplained ear pain, especially on one side, which may radiate from the throat.
5. Persistent Cough: A persistent or nagging cough that does not go away, accompanied by blood-tinged sputum in some cases.
6. Breathing Difficulties: Shortness of breath or noisy breathing, which can occur if the cancer obstructs the airway.
7. Lump or Mass in the Neck: A visible or palpable lump or mass in the neck, often caused by enlarged lymph nodes due to cancer spread.
8. Weight Loss: Unexplained weight loss, which can occur as a result of difficulty swallowing or due to the metabolic effects of cancer.
9. Fatigue: Persistent tiredness or weakness that is not relieved by rest.

It’s important to note that these symptoms can also be caused by other conditions, such as infections or benign growths. However, if any of these symptoms persist for more than a few weeks or are accompanied by other concerning signs, it’s essential to consult a healthcare provider for further evaluation and appropriate testing. Early detection and treatment of laryngeal cancer can significantly improve outcomes, so prompt medical attention is crucial if symptoms suggestive of laryngeal cancer are present.

What are the causes of laryngeal cancer?

Laryngeal cancer typically develops when normal cells in the larynx (voice box) undergo genetic mutations that cause them to grow uncontrollably and form a mass or tumor. The exact cause of these mutations is not always clear, but several factors can increase the risk of developing laryngeal cancer:

1. Tobacco Use: Smoking cigarettes, cigars, pipes, or using smokeless tobacco (such as snuff or chewing tobacco) significantly increases the risk of developing laryngeal cancer. Tobacco contains numerous carcinogens (cancer-causing substances) that can damage the cells lining the larynx.
2. Alcohol Consumption: Heavy and long-term alcohol consumption is a significant risk factor for laryngeal cancer. Alcohol can irritate and damage the cells of the larynx, making them more susceptible to carcinogens from tobacco.
3. Combined Tobacco and Alcohol Use: The risk of developing laryngeal cancer is greatly increased when tobacco use and alcohol consumption are combined. The two substances have a synergistic effect, further increasing the risk beyond the individual risks associated with each.
4. Human Papillomavirus (HPV) Infection: Infection with certain types of HPV, particularly HPV types 16 and 18, has been associated with an increased risk of developing laryngeal cancer. HPV-related laryngeal cancers often occur in younger individuals and may have a better prognosis than non-HPV-related cases.
5. Age and Gender: Laryngeal cancer occurs most commonly in individuals over the age of 55, and it is more common in men than in women.
6. Occupational Exposure: Prolonged exposure to certain workplace substances, such as asbestos, diesel exhaust, coal dust, or certain chemicals used in the metalworking and textile industries, may increase the risk of developing laryngeal cancer.
7. Poor Nutrition: Diets low in fruits and vegetables, which are rich in vitamins and antioxidants that help protect against cancer, may contribute to an increased risk of laryngeal cancer.
8. Genetic Factors: Although rare, certain genetic syndromes or family history of head and neck cancers may increase the risk of developing laryngeal cancer.

It’s important to note that while these factors can increase the likelihood of developing laryngeal cancer, not everyone with these risk factors will develop the disease. Conversely, some individuals may develop laryngeal cancer without any known risk factors. Early detection and prompt treatment can improve outcomes, so awareness of risk factors and regular health check-ups are crucial for identifying and managing laryngeal cancer at an early stage.

How is the diagnosis of laryngeal cancer made?

The diagnosis of laryngeal cancer typically involves a combination of physical examination, imaging studies, and biopsy. Here are the steps involved in making a diagnosis of laryngeal cancer:

1. Symptom assessment: A thorough medical history is taken to identify symptoms such as hoarseness, coughing, difficulty swallowing, or difficulty speaking.
2. Physical examination: A physical examination is performed to assess the throat, neck, and vocal cords.
3. Indirect laryngoscopy: An indirect laryngoscopy is performed to visualize the larynx and vocal cords using a mirror or fiberscope.
4. Direct laryngoscopy: A direct laryngoscopy is performed to visualize the larynx and vocal cords using a flexible or rigid scope.
5. Imaging studies: Imaging studies such as CT scans, MRI scans, or PET scans are used to evaluate the extent of the tumor and detect any lymph node involvement.
6. Biopsy: A biopsy is performed to collect a sample of tissue from the suspected tumor site. This can be done through a variety of methods, including:
   • Fine-needle aspiration biopsy: A thin needle is inserted into the tumor site to collect cells.
   • Core biopsy: A larger sample of tissue is removed from the tumor site using a specialized instrument.
   • Endoscopic biopsy: A flexible scope is inserted through the mouth or nose to collect a sample of tissue from the larynx.
7. Pathological examination: The biopsy sample is examined by a pathologist to identify the type of cancer cells present, their aggressiveness, and any signs of invasion or metastasis.

The diagnosis of laryngeal cancer is typically made based on a combination of these tests, and it may require consultation with multiple specialists, including ear, nose, and throat (ENT) surgeons, radiation oncologists, and medical oncologists.

It’s essential to note that early detection and diagnosis are critical for successful treatment and improved outcomes in laryngeal cancer. If you experience any unusual symptoms or concerns about your throat or voice, consult with a healthcare provider promptly.

What is the treatment for laryngeal cancer?

The treatment for laryngeal cancer typically depends on the stage and location of the tumor, as well as the patient’s overall health and age. The main goals of treatment are to cure the cancer, preserve the patient’s voice, and improve quality of life. Here are some common treatment options for laryngeal cancer:

1. Surgery: Surgery is often used to remove the tumor and affected tissues. There are several types of surgery that may be used, including:
   • Laryngectomy: removal of the entire larynx (voice box)
   • Partial laryngectomy: removal of a portion of the larynx
   • Supracricoid partial laryngectomy: removal of the lower part of the larynx
2. Radiation therapy: Radiation therapy uses high-energy beams to kill cancer cells. It can be used alone or in combination with surgery. There are several types of radiation therapy that may be used, including:
   • External beam radiation therapy (EBRT): external radiation beams are directed at the tumor site
   • Intensity-modulated radiation therapy (IMRT): uses advanced technology to shape the radiation beams
   • Stereotactic body radiation therapy (SBRT): delivers high-dose radiation in a few fractions
3. Chemotherapy: Chemotherapy uses drugs to kill cancer cells. It can be used alone or in combination with surgery and/or radiation therapy.
4. Immunotherapy: Immunotherapy uses the body’s immune system to fight cancer. It can be used in combination with other treatments.
5. Targeted therapy: Targeted therapy uses medications that target specific molecules or proteins on cancer cells.
6. Palliative care: Palliative care is focused on relieving symptoms and improving quality of life, rather than curing the cancer.
7. Laser therapy: Laser therapy uses a laser to remove tumors or reduce bleeding.
8. Cryotherapy: Cryotherapy uses extreme cold to freeze and destroy cancer cells.

It’s essential to note that each patient’s treatment plan is unique and may involve a combination of these options. Consultation with a multidisciplinary team of healthcare professionals, including ear, nose, and throat (ENT) surgeons, radiation oncologists, medical oncologists, and palliative care specialists, is crucial for developing an effective treatment plan.

In addition to these treatments, patients with laryngeal cancer may also receive supportive care measures such as speech therapy, nutrition counseling, and pain management to help manage symptoms and improve quality of life.