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Laryngeal cancer: Treatment, symptoms, advice and help

About laryngeal cancer

Laryngeal cancer is a cancerous condition of the larynx or the ‘voice box’. The larynx is located in the throat and consists of the vocal cords, which are responsible for the production of voice. The larynx also plays an important role in breathing and swallowing. Cancer is defined as the uncontrolled growth of cells, and it may either be benign or malignant. Laryngeal cancer mostly arises from the squamous cells, lining the larynx and is usually malignant in nature. It is known to spread to other parts of the body. This phenomenon is also termed as ‘metastasis’.

Laryngeal cancer: Incidence, age and sex

The incidence of laryngeal cancer is usually low in the general population, exhibiting that it is a rare kind of cancer. Laryngeal cancer mostly affects individuals of 50 years of age or more. Its frequency is more in men as compared with women.

Signs and symptoms of laryngeal cancer: Diagnosis

The clinical features of laryngeal cancer include hoarseness of voice, sore throat or persistent cough. Sometimes, this hoarseness may be severe enough to cause temporary loss of voice. Some individuals may also complain of a scratchy sensation or something stuck in the throat. Other associated features include low-grade fever, fatigue, or unexplained weight loss. The physician, on physical examination may find a lump or a swelling or an enlarged lymph node in the neck.

Investigations like direct and indirect laryngoscopy may be done to visualize the larynx and neighbouring areas. Radiological investigation including a CT scan of the neck may help in detecting the cancer. The physician may also want to perform a biopsy (microscopic examination of a specimen of the affected tissue) which helps not only in establishing the diagnosis of the cancer but also in assessing the extent and stage of the cancer.

Causes and prevention of laryngeal cancer

The exact cause of laryngeal cancer is not known. However certain factors like persistent smoking and chronic alcoholism may increase the risk of developing cancer, many times over Moreover, in individuals with gastro-oesophageal reflux disease, the gastric juices corrode the tissue lining of the vocal cords, thus leading to their inflammation. This persistent or recurrent inflammation of the larynx may damage it and lead to development of laryngeal cancer in such individuals. Individuals who have a history of head and neck cancer are more predisposed to developing laryngeal cancer in the future.

Cessation of smoking and alcohol and avoidance of constant exposure to toxic metals like nickel may help in preventing the development of laryngeal cancer.

Laryngeal cancer: Complications

Laryngeal cancer, if not detected and treated timely, may spread locally to the neighbouring areas like the base of the tongue or the lymph nodes of the neck. The cancer may also spread to distant areas by the blood stream during the advanced stage. This phenomenon is termed as metastasis and most common organ involved in laryngeal cancer is the lung. Spread of the cancer to the lungs may lead to potentially life-threatening complications like respiratory failure or even death.

Laryngeal cancer: Treatment

The treatment modalities of laryngeal cancer include surgery, chemotherapy and radiotherapy, in combination or alone. The treatment requires a multi-disciplinary approach involving the expertise of an oncologist and an otolaryngologist. It is essential to assess the extent and stage of laryngeal cancer before deciding the treatment plan. Small cancers which are localised may be treated with radiotherapy alone, or in combination with chemotherapy. Radiotherapy involves the use of high-energy X-rays to kill the cancer cells whereas chemotherapy involves the use of potent medications to destroy cancer cells. Surgical modality may be used in adjunct to radiotherapy and chemotherapy. Surgical methods involve total (removal of the entire larynx) or partial laryngectomy (surgical resection of a part of larynx), depending upon the health of patient and extent and stage of cancer. It is advisable to keep a routine follow-up of the individual to detect any recurrence of the cancer.