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Oncology

Laryngeal cancer

Laryngeal cancer is relatively uncommon worldwide, but it represents a significant percentage of head and neck cancers.
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What is laryngeal cancer? 

Laryngeal cancer is a type of cancer that originates in the larynx, the voice organ located in the neck. 

The larynx, also known as the voice box, is a hollow organ located in the neck that contains the vocal cords and is crucial for breathing, speech, and swallowing. Laryngeal cancer develops when cells in the larynx grow uncontrollably and form a tumor. This abnormal growth can affect the vocal cords, the epiglottis (a flap of tissue that covers the trachea when swallowing to prevent food from entering the lungs), or the subglottis (the lower part of the larynx), interfering with the vital functions of the larynx. The larynx, in addition to being essential for the voice, also protects the lower respiratory tract by preventing food and liquids from entering the trachea.  

Laryngeal cancer can be treated, and early detection significantly increases the chances of successful treatment. 

Médico en un chequeo de garganta de su paciente.

Symptoms of laryngeal cancer

The symptoms of laryngeal cancer can vary depending on the location and size of the tumor. Some patients may experience mild symptoms at first, while others may present with more severe symptoms.

Early symptoms:

persistent hoarseness (more than two weeks) is often the first sign of laryngeal cancer. Other early symptoms may include changes in the voice, persistent sore throat, persistent cough, difficulty swallowing, a feeling of a lump in the throat, and ear pain. 

Late symptoms:

as the cancer progresses, the symptoms may become more severe. These may include difficulty breathing, a palpable lump in the neck, unexplained weight loss, persistent bad breath, and pain that spreads to the ear. 

It is important to remember that these symptoms can be caused by other, less serious conditions. However, if you experience any of these symptoms, especially if they persist, it is essential to consult a doctor for an accurate diagnosis. 

Classification of laryngeal cancer 

Laryngeal cancer is classified according to its anatomical location and the stage of the disease. Classification by location helps determine the type of treatment and the prognosis. Staging, on the other hand, describes the size of the tumor and whether it has spread to other parts of the body. 

  • Glottic cancer: it develops in the vocal cords, which are responsible for voice production. This type of cancer is usually detected in the early stages due to noticeable changes in the voice. 
  • Supraglottic cancer: it originates in the upper part of the larynx, above the vocal cords, including the epiglottis. Symptoms may be less obvious at first, such as a sore throat or difficulty swallowing. 
  • Subglottic cancer: it originates in the lower part of the larynx, below the vocal cords. This type is less common and can cause difficulty breathing. 

Staging of laryngeal cancer is carried out using the TNM system, which evaluates the size of the tumor (T), lymph node involvement (N), and the presence of metastasis (M). 

Causes and risk factors of laryngeal cancer 

Although the exact cause of laryngeal cancer is not always known, there are several factors that significantly increase the risk of developing it. Understanding these factors can help in making informed decisions about lifestyle and prevention. 

Tobacco and alcohol consumption are the main causes of laryngeal cancer, being responsible for the vast majority of cases. The risk increases even more when both habits are combined. Other risk factors include exposure to certain chemicals, chronic gastroesophageal reflux, and a family history of head and neck cancer. astroesofágico crónico y antecedentes familiares de cáncer de cabeza y cuello.

Complications of laryngeal cancer 

Laryngeal cancer can cause a series of complications that can affect the patient’s quality of life: 

  • Loss of voice (aphonia or dysphonia): laryngeal cancer can affect the ability to speak, causing hoarseness, changes in voice, or even loss of voice. 
  • Dysphagia (difficulty swallowing): tumors in the larynx can make swallowing difficult, which can lead to malnutrition and dehydration. 
  • Breathing problems (dyspnea): large tumors can obstruct the airways, causing difficulty breathing. 
  • Metastasis: mouth cancer can spread to other parts of the body, such as the lymph nodes, lungs, and bones. 

Diagnosis of laryngeal cancer 

The diagnosis of laryngeal cancer begins with a complete medical evaluation by an otolaryngologist (ear, nose and throat specialist). 

  • Medical history and physical examination: the doctor will review symptoms, medical and family history, and lifestyle habits, such as tobacco and alcohol consumption. Next, the doctor will perform a physical examination of your throat and neck, which may include palpating the larynx and lymph nodes. 
  • Laryngoscopy: a laryngoscope (a thin, flexible instrument with a light and camera), is used to examine the larynx and vocal cords. There are two types of laryngoscopy: indirect, which is done with a small mirror at the back of the throat, and direct, which is done with a rigid or flexible laryngoscope that is inserted through the nose or mouth. Direct laryngoscopy allows for the taking of biopsies. 
  • Biopsy: if an abnormality is found during laryngoscopy, a small tissue sample (biopsy) is taken and examined under a microscope. This is the only method to confirm a cancer diagnosis. 
  • Imaging tests: imaging tests such as computed tomography (CT) scans, magnetic resonance imaging (MRI), and positron emission tomography (PET) scans are used to determine the extent of the cancer and whether it has spread to other parts of the body. Ultrasound uses sound waves to create images of the larynx and neck. Ultrasound can help evaluate the lymph nodes and determine if there is fluid in the larynx. 

These tests help doctors determine the stage of the cancer, which is crucial for planning treatment. 

Laryngeal cancer treatment 

Treatment for laryngeal cancer is individualized for each patient and depends on several factors, including the stage of the cancer, the location of the tumor, the patient’s overall health, and their personal preferences. 

  • Supportive therapy: supportive therapy, such as speech and swallowing therapy, can help patients manage the side effects of treatment and improve their quality of life. This therapy is important for patients who have undergone a laryngectomy, as it helps them learn new ways of speaking and swallowing. 
  • Nutrition: proper nutritional assessment and support are essential during the treatment of laryngeal cancer.  
  • Radiotherapy: it uses high-energy radiation to destroy tumor cells. It can be used alone or in combination with chemotherapy. External radiotherapy is used. 
  • Chemotherapy: it uses medications to destroy cancer cells. It can be used alone or in combination with radiotherapy or surgery. There are different combinations of chemotherapy drugs used to treat laryngeal cancer. 
  • Targeted therapy: it uses drugs that specifically target cancer cells, minimizing damage to healthy cells. This type of treatment is newer than traditional chemotherapy and may be an option for some patients with advanced laryngeal cancer. 
  • Surgery: it is a common treatment for laryngeal cancer and may involve removal of the tumor, part of the larynx, or the entire larynx (total laryngectomy). There are different types of surgery, such as partial laryngectomy, cordectomy (removal of a vocal cord), and laser surgery. In some cases, reconstructive surgery can be performed to restore laryngeal function.  

Remember that this article is for informational purposes only and does not replace professional medical advice. If you suspect you have laryngeal cancer, consult a specialist to obtain an accurate diagnosis and a treatment plan tailored to your needs. 

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