What do you need to know about laryngeal cancer?
The laryngeal cancer accounts for 1-2% of all cancers, or in 2-10 cases of 100 000 inhabitants. Men are diagnosed with this type of cancer 4-10 times more often than women. According to Dr. Ljirim Demiri, an ENT physician, it usually occurs after the fiftieth year of life, and the biggest risk factor for its occurrence is smoking. The risk of this type of cancer is 5-25 times higher for smokers. Consuming alcohol, especially when combined with smoking , increases the risk of developing the disease by up to 40 times. Gastro reflux, irritation by chemicals, asbestos and so on, are also taken into account as risk factors.
First symptom, hoarseness
The tumor is usually located on the chords and the first sign is the change of the voice quality and hoarseness. If hoarseness lasts more than two weeks, you should consult an ear, nose and throat specialist. Other symptoms are ear or throat ache. In advanced cases difficulty breathing, pain when swallowing, as well as bloody sputum can also be noticed. If the cancer spreads to the lymph nodes, a swelling appears on the neck.
The laryngeal cancer is diagnosed by an ENT specialist on the basis of several diagnostic procedures. First through a conversation with the patient about his/her symptoms and the period when they occurred, the physician receives important information about the patient's disease (history). The clinical examination implies a range of diagnostic procedures such as examination of the pharynx (oropharyngeal screening), examination of the larynx and vocal cords with rigid or flexible endoscope (laryngoscopy), palpation of the neck and radiological examinations of the neck (ultrasound, computed tomography and magnetic resonance imaging). If an occurrence of laryngeal cancer is suspected, because of the histopathological diagnosis of change, in short-term anesthesia and biopsy, a direct laryngoscopy with video laryngoscope or operating microscope is recommended. Depending on the results of the histological analysis, the patient is advised for further treatment.
Surgery and radiotherapy
There are two treatment approaches for the laryngeal cancer: surgery and radiotherapy. Chemotherapy is often used as a complement to the surgery and the treatment with radiotherapy. The type and the scope of surgery depends on the position and the size of the cancer, as well as the progression of the disease. Depending on the size and location of the tumor, the surgery can be functional by removing only the tumor with part or all of the vocal cord (chordectomia). There are functional laryngectomies in which the tumor and a part of the larynx is removed (partial horizontal and vertical laryngectomy).
If the tumor is big and is detected too late, it will be necessary to remove the entire larynx (total laryngectomy). It is necessary to emphasize that, in order to provide breathing, in most surgical interventions it is necessary to create temporary or permanent tracheostomy, an aperture in the neck and trachea through which the patient can breathe postoperatively.
If there are metastases in the lymph nodes in the neck, it is necessary to make selective or radical neck dissection and to remove the lymph nodes of one or both sides of the neck. The surgery is followed by oncology examinations and assessment for further treatment (radiotherapy, chemotherapy). Sometimes the tumor may be so big that it does not allow a surgical treatment and in those cases the only way of treatment is radiotherapy and chemotherapy.