Laryngeal Cancer - Causes, Symptoms, Diagnosis, and Treatment

Creator: Dr. Ruchika Raj
Published: 2022-11-23T17:42:02

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Laryngeal cancer is the cancer of a voice box (larynx). The larynx is a part of the throat present above the windpipe that helps to breathe, swallow, and talk.

Written by

Dr. Ruchika Raj

Medically reviewed by

Dr. Syed Peerzada Tehmid Ul Haque

November 23, 2022

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Contents

What Is the Prevalence of Laryngeal Cancer?
What Is the Incidence of Laryngeal Cancer?
What Are the Causes of Laryngeal Cancer?
What Are the Signs and Symptoms of Laryngeal Cancer?
How To Diagnose Laryngeal Cancers?
What Are the Types of Laryngeal Cancer?
What Is the Treatment for Laryngeal Cancers?
How To Prevent Laryngeal Cancer?

Introduction:

The larynx contains vocal cords, so it is also called a voice box, as it helps in the production of speech. The larynx is a framework of cartilage and is divided into three parts that are supraglottis (upper part), glottis (middle part), and subglottis (lower part). The larynx serves important functions of the body like breathing by the opening of vocal folds, swallowing by covering the larynx by epiglottis (part of supraglottis) to prevent the entry of food in the windpipe/lungs, and talking by the vibration of vocal cords after the air passes through vocal cords producing a sound of a speech.

What Is the Prevalence of Laryngeal Cancer?

Cancer associated with the larynx accounts for one-third of all head and neck cancers. The prevalence of cancer for different parts of the larynx are:

Supraglottis (Upper Part): It involves 30 to 35 % of all laryngeal cancers.
Glottis (Middle Part): More than half of laryngeal cancer ranging from 55 to 60 %, starts from here.
Subglottis (Lower Part): Five percent of laryngeal cancer starts from the lower part of the larynx.

What Is the Incidence of Laryngeal Cancer?

Laryngeal mostly affects people in the age group above 55 to 65 years of age.
It is more common in males than females.

What Are the Causes of Laryngeal Cancer?

Risk factors for laryngeal cancers are:

Long-standing throat infections.
Smoking.
Tobacco consumption.
Viral infections like human papillomavirus (HPV) infection.
Excessive use of alcohol.
Exposure to industrial chemicals like asbestos, gasoline fumes, and paint.

What Are the Signs and Symptoms of Laryngeal Cancer?

Signs and symptoms related to laryngeal cancer are:

Hemoptysis (coughing of blood).
Mass or lump in the neck.
Pain in swallowing.
Difficulty in breathing.
Sore throat.
Pain in ears.
Hoarseness of voice.
Weight loss.
Difficulty in speaking.
Feeling the presence of a foreign body in the throat.
Noisy breathing.
Change in the pitch of voice.

How To Diagnose Laryngeal Cancers?

Different diagnostic techniques for laryngeal cancers are:

Clinical Examination and History: Complete habit history of the patient should be recorded, like the frequency of alcohol, tobacco, and smoking. A history of the presence of a sore throat and pain in swallowing should be noted. Clinical examination is done using a laryngoscope (an apparatus with a light on the tip used to visualize the entire throat) to check for the location, size, and extent of the tumor.

Biopsy: A small piece of abnormal tissue can be cut from the mass and sent to the lab to rule out cancer. It can be done by direct laryngoscopy.
Fine Needle Aspiration (FNA): It uses a small needle and inserts it into the mass to aspirate the cells and is sent for investigations.
Computed Tomography (CT) Scan: These scans are done to rule out the size and extent of the tumor. It also helps to evaluate the spread of cancer to the lymph nodes of the neck, lungs, and other organs.
Magnetic Resonance Imaging (MRI): Contrast magnetic resonance imaging can be done by injecting contrast material like gadolinium through the intravenous route before taking scans. It helps to check the spread of cancer in the neck and other areas of the body.
Positron Emission Tomography (PET) Scan: It is done by injecting radioactive material into the vein, and then three-dimensional image scans are taken by the machines. It is used to assess the involved lymph nodes of the neck and the spread of cancer.
Blood Test: A complete blood count examination is done to check for any reduction in the number of RBCs, WBCs, and platelets.

What Are the Types of Laryngeal Cancer?

Types of vocal cancer are:

Early Laryngeal Cancer: Cancer is not spread beyond the larynx, and the tumor is small.
Advanced Laryngeal Cancer: The tumor is larger in size, and the cancer is spread to the complete throat, lymph nodes of the neck, lungs, and other areas of the body.

What Is the Treatment for Laryngeal Cancers?

Treatment modalities to treat laryngeal cancers are:

Radiotherapy: Radiation therapy is given to the patient in the areas confined to the tumor mass to destroy the cancer cells and prevent damage to the normal surrounding structures.

Immunotherapy / Biologic Therapy: It is given to boost the immune system of the patient to fight against cancer cells by using some targeted and immunotherapy drugs like Cetuximab (target cancer drug- called monoclonal antibody).

Chemotherapy: Chemotherapeutic agents (anti-cancer drugs) like Cisplatin and Carboplatin are used to kill or reduce the growth of cancer cells. It is given by intravenous route.
Surgical Removal of the Tumor: In the early stage of laryngeal cancer, when the tumor size is small, it can be removed surgically under general anesthesia by the surgeons without causing much damage to the larynx.
Partial Laryngectomy: It is done in the early stage of laryngeal cancer, which has recurred. In this surgery, a part of the vocal cord that is affected is removed surgically under general anesthesia. Voice is preserved because of the presence of some parts of the vocal cords but is quite weak and low-pitched.
Total Laryngectomy (Surgical Removal of the Larynx): In advanced stages of laryngeal cancer, the tumor mass is larger, and lymph nodes of the neck are also involved, so complete removal of the larynx along with the tumor is recommended by the surgeons.
Laser Surgery: Photodynamic laser therapy is used to remove the cancer tissue mass without much bleeding. It is used in the early stages of laryngeal cancers.

How To Prevent Laryngeal Cancer?

Avoid smoking.
Avoid excessive consumption of alcohol.
Avoid tobacco products.
Early treatment of underlying causes like viral infection (human papillomavirus) and long-standing sore throat.

Conclusion:

Laryngeal cancers are rare but can affect anyone. It affects the quality of life significantly by causing difficulty or pain in swallowing, voice damage, and breathing difficulties. Any of these underlying symptoms, if noted, should be reported to the doctor immediately for early diagnosis and management of cancer. Diagnosis of laryngeal cancer in the early stages is very crucial to achieve a favorable outcome of the treatment, like preservation of speech, compared to that of advanced cases of laryngeal cancer where the treatment becomes complex and the outcome is not satisfactory. Post-surgical follow-up for radiotherapy and chemotherapy is important and should be done as recommended by the doctor.

Frequently Asked Questions

1. Is Laryngeal Cancer Treatable?

Yes, It is possible to treat laryngeal cancer. Chemotherapy, radiation therapy, and surgery are available as treatment options. The patient's general health, cancer stage, location, and treatment option are all factors. A mix of therapies may be applied in certain circumstances. Chances of success can be increased with early identification and treatment.

2. What Is the Laryngeal Cancer Survival Rate?

Several variables, including the stage of the disease at diagnosis, the patient's general condition, and the type of therapy received, might affect the laryngeal cancer survivability rate. It is vital to remember that survival rates are estimated and based on information from sizable populations. There may be variations in the patient's real chance of survival. It is always preferable to speak with a doctor for a precise and individualized prognosis.

3. Is Laryngeal Cancer a Life-Threatening Condition?

The voice box, or larynx, is essential for speaking, swallowing, and breathing. Laryngeal tumors can affect these processes, making talking, eating, and breathing challenging. Cancer can spread to other organs, such as the lungs, as it becomes worse, worsening the illness if laryngeal cancer is not identified and treated promptly. Early identification and treatment can increase the likelihood of a positive result.

4. How Does Laryngeal Cancer Feel in the Throat?

Hoarseness or other voice changes, a lump or sore in the throat that does not go away, trouble swallowing, pain or discomfort in the throat, and a persistent cough are all signs of laryngeal cancer. However, it is essential to remember that similar symptoms can also be brought on by other illnesses, and visiting the doctor is necessary for a correct diagnosis.

5. What Age Is the Onset of Laryngeal Cancer?

Although laryngeal cancer can develop at any age, it is often detected in patients over 55. Smoking, drinking excessive amounts of alcohol, and exposure to certain chemicals and pollutants are risk factors for laryngeal cancer. People with specific hereditary disorders or a history of head and neck cancer may also be more vulnerable.

6. What Is the Primary Factor That Causes Laryngeal Cancer?

The leading causes of laryngeal cancer are excessive alcohol use and tobacco use. History of specific kinds of HPV (Human papillomavirus) infections and exposure to specific chemicals, such as those familiar with particular professions, are additional risk factors.

7. How Is Laryngeal Cancer Identified?

Laryngeal cancer is often detected using various techniques, some of which may include:
- Physical Examination: A doctor may check the throat and neck for any lumps or other abnormalities.
- Endoscopy: To inspect the larynx, a small, flexible tube called an endoscope is inserted through the mouth or nose.
- Biopsy: To find out if cancer cells are present, tissue samples from the suspect region are examined under a microscope.
- Imaging Tests: To determine a tumor's size, location, and if it has spread to other body areas, doctors may utilize X-rays, CT scans, and MRI scans.

8. Does Laryngeal Cancer Develop Quickly?

Laryngeal cancer can grow gradually, and depending on the particular situation, the rate at which it advances might change. Laryngeal cancer occasionally has a sluggish growth rate and may go for a long time without showing any signs. In other instances, it could develop more swiftly and prompt the onset of symptoms earlier. Laryngeal cancer's early stages might go undetected or present with minor symptoms that are simple to confuse with other conditions, such as a cold or sore throat. Hoarseness, trouble swallowing, and a lump or mass in the neck are some of the symptoms that might worsen as the disease spreads. Laryngeal cancer's prognosis can be improved by early discovery and timely treatment.

9. What Can Be Confused for Laryngeal Cancer?

Several illnesses can be mistaken for laryngeal cancer due to their propensity to produce symptoms, including hoarseness, swallowing difficulties, and a lump or mass in the neck. These conditions include, among others:
- Laryngitis: Larynx inflammation, which can result in hoarseness, a painful throat, and trouble speaking.
- Benign Vocal Cord Tumors: Vocal cord non-cancerous growths that can exhibit symptoms like laryngeal cancer but are not fatal.
- Gastroesophageal Reflux Disease (Gerd): A disorder where stomach acid rushes back into the esophagus, irritating and inflaming the larynx.
- Thyroid Nodules: A neck growth or lump resembling a laryngeal tumor.

10. Is Laryngeal Cancer Visible to an ENT?

During a physical examination of the neck and throat, an ENT physician may be able to identify laryngeal carcinoma. They could carry out a process known as laryngoscopy, which entails passing an endoscope, a small, flexible tube with a camera and light on the end that may be sent into the mouth or nose to examine the larynx. The doctor can check for any indications of tumors or other abnormalities in the larynx during laryngoscopy. In order to check for the presence of cancer cells, they can also extract tissue samples (biopsy) for inspection under a microscope. It may only sometimes be visible during the examination. It may be necessary to do imaging tests, including X-rays, CT scans, and MRI scans, to establish the size and a tumor's size, location, and if it has spread to other bodily regions. Anyhow, if an ENT physician suspects laryngeal cancer, they will probably send the patient to a specialist for further testing and care.

11. Who Is Most Susceptible to Laryngeal Cancer?

Laryngeal cancer is more likely to affect specific categories than others:
- Men: Compared to women, men are more prone to get laryngeal cancer.
- Smokers: The most significant risk factor for laryngeal cancer is smoking.
- Heavy Smokers: Older Adults: The risk increases as a smoker's cigarette consumption and length of habit increase.
- Occupational Exposures: Laryngeal cancer risk is increased by heavy alcohol use, especially when combined with smoking. As people become older, their chance of laryngeal cancer rises. For example, work in the chemical, mining, or construction sectors can expose workers to compounds that raise their chance of developing laryngeal cancer.
- HPV: Laryngeal cancer has been linked to persistent HPV (human papillomavirus) infection in some cases.
- Family History: A history of the disease or other head and neck malignancies may increase a person's chance of acquiring laryngeal cancer.

12. How Does Laryngoscopy Find Cancer in the Larynx?

An ENT specialist performs a short laryngoscopy to examine the larynx, a flexible tube with a light and camera at one end is placed into the mouth or nose. The endoscope lets the medical professional view the larynx's inside in great detail and search for any tumors or other abnormalities. During the surgery, the doctor might check the vocal cords, epiglottis, and different laryngeal sections to look for any worrisome spots. They could do a biopsy, which entails taking a tiny tissue sample to be examined under a microscope if they notice any abnormal areas. Laryngeal cancer can only be definitively diagnosed with a biopsy, which enables the physician to check the tissue for the presence of cancer cells. The doctor can use the endoscope to inspect the cancer's size, the extent of its dissemination, and the depth of its tissue invasion. The planning of the treatment and the staging of the malignancy depends on this information.

13. Is Laryngeal Cancer Possible Among Non-smokers?

Yes, even non-smokers can get laryngeal cancer, but smoking is the most significant risk factor. Other variables include heavy alcohol use, exposure to certain chemicals, such as those present in particular occupations, and a history of specific types of HPV infections that can still cause laryngeal cancer in non-smokers. It is also crucial to remember that persons who smoke and drink excessively may have an elevated chance of developing laryngeal cancer since these vices work in concert to raise the disease's risk.

Sources

Dr. Syed Peerzada Tehmid Ul Haque

Otolaryngology (E.N.T)

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