Laryngeal Cancer

The most common form of laryngeal cancer is squamous cell carcinoma (95%); rare forms include adenocarcinoma, sarcoma, and others. Such cancer may be intrinsic or extrinsic

Causes

In laryngeal cancer, major predisposing factors include smoking and alcoholism; minor factors include chronic inhalation of noxious fumes and familial tendency.

Laryngeal cancer is classified according to its location:

• supraglottis (false vocal cords)
• glottis (true vocal cords)
• sub glottis (downward extension from the vocal cords [rare]).

Signs and symptoms

The following are the most common symptoms of laryngeal cancer. However, each individual may experience symptoms differently. Symptoms may include:

• a cough that lasts
• a sore throat that lasts
• feeling of a lump in the throat
• trouble swallowing
• frequent choking on food
• pain when swallowing
• trouble breathing
• noisy breathing
• ear pain that lasts
• a lump in the neck
• unplanned weight loss
• bad breath

The symptoms of laryngeal cancer may resemble other conditions or medical problems. Always consult your physician for a diagnosis.

Diagnosis

If laryngeal cancer is suspected, the throat with be examined with a small long-handled mirror or a fibre-optic light called a laryngoscope. If abnormal areas are seen, a biopsy will be taken under local or general anaesthetic. This is the only way of accurately diagnosing laryngeal cancer.

If cancer is detected, x-rays , a CT scan (or CAT scan) or magnetic resonance scan (MRI) may be used to establish the size of the tumour and whether the cancer has spread.

Treatment

Early lesions are treated with surgery or radiation; advanced lesions with surgery, radiation, and chemotherapy. The chemotherapeutic agents may include methotrexate, cisplatin, bleomycin, fluorouracil, and vincristine.

The treatment goal is to eliminate the cancer and preserve speech. If speech preservation isn't possible, speech rehabilitation may include esophageal speech or prosthetic devices; surgical techniques to construct a new voice box are still experimental. Surgical procedures vary with tumor size and can include cordectomy, partial or total laryngectomy, supraglottic laryngectomy, or total laryngectomy with laryngoplasty.