Laryngeal Cancer: Treatment, Procedure, Cost and Side Effects

Laryngeal cancer is also known as Cancer of larynx, cancer of voice box, larynx cancer, throat cancer.

Cancer can develop in any part of the larynx, but the cure rate is affected by the location of the tumour. For the purposes of tumour staging, the larynx is divided into three anatomical regions: the glottis (true vocal cords, anterior and posterior commissures); the supraglottis (epiglottis, arytenoids and aryepiglottic folds, and false cords); and the subglottis.Most laryngeal cancers originate in the glottis. Supraglottic cancers are less common, and subglottic tumours are least frequent.Laryngeal cancer may spread by direct extension to adjacent structures, by metastasis to regional cervical lymph nodes, or more distantly, through the blood stream. Specific treatment depends on the location, type, and stage of the tumour. Healthcare professionals use a system called the TNM system to stage laryngeal cancer.

T describes the size of the tumour,and describes whether cancer has spread to the lymph nodes and M gives an indication of whether the cancer has spread to other parts of the body.The T stage is given as a number from 1-4 – Small tumours confined to one part of the larynx are described as T1 tumours and large tumours that have grown into tissues outside the larynx are described as T4.The N stage is given as a number from 0-3 – N0 means the lymph nodes are not affected, whereas stages N2 to N3 mean that one or more lymph nodes are affected.The M stage is given as either M0 or M1 – M0 means the cancer has not spread to other parts of the body and M1 means that it has.Treatment may involve surgery, radiotherapy, or chemotherapy, alone or in combination. This is a specialised area which requires the coordinated expertise of ear, nose and throat (ENT) surgeons (Otorhinolaryngologists) and Oncologists.

If you have early-stage laryngeal cancer, it may be possible to remove the cancer using surgery (endoscopic resection) or radiotherapy alone. This may also be the case with slightly larger cancers, although a combination of surgery and radiotherapy is sometimes required.In later-stage laryngeal cancer, more extensive surgery may be needed. Radiotherapy and chemotherapy will probably be used in combination. In some cases, the entire larynx may have to be removed.A medication called cetuximab may be used in cases where chemotherapy is not suitable.Radiotherapy or surgery to remove the cancerous cells from the larynx can often cure laryngeal cancer if it's diagnosed early.

If the cancer is advanced, a combination of surgery to remove part or all of the larynx, radiotherapy and chemotherapy can be used.If you have surgery to remove your larynx, you'll no longer be able to speak or breathe in the usual way. Instead, you will breathe through a permanent hole in your neck (stoma) and you will need additional treatment to help restore your voice.This may include an implant in your throat, or an electrical device you hold against your throat to produce sound.A severely affected patient may require a laryngectomy, the complete or partial removal of the vocal cords.

The symptoms of cancer of the larynx depend mainly on the size and location of the tumor.Most cancers of the larynx begin on the vocal cords. These tumors are seldom painful, but they almost always cause hoarseness or other changes in the voice.Tumors in the area above the vocal cords may cause a lump on the neck, a sore throat or an earache.Tumors that begin in the area below the vocal cords are rare and can make it hard to breathe. Your breathing may become noisy.A cough that doesn't go away or the feeling of a lump in the throat may also be warning signs of cancer of the larynx. As the tumor grows, it may cause pain, weight loss, bad breath, and choking on food. In some cases, a tumor in the larynx can make it hard to swallow.

Most cases of cancer of the larynx occur in people aged over 60. The common early symptom is a persistent hoarse voice. Many cases are diagnosed at an early stage when there is a good chance of a cure. In general, the more advanced the cancer (the more it has grown and spread), the less chance that treatment will be curative.If you do not have these symptoms or your age is less than specified or the tests show normal results then you do not have laryngeal cancer.

Many people treated with radiation to the neck and throat area have painful sores in the mouth and throat that can make it very hard to eat and drink. This can lead to weight loss and malnutrition. The sores heal with time after the radiation ends, but some people continue to have problems swallowing long after treatment ends. Ask about swallowing exercises you can do to help keep those muscles working and increase your chance of eating normally after treatment.Other side effects of radiation therapy may include:Skin problems in the area being treated, ranging from redness to blistering and peeling,Dry mouth,Worsening of hoarseness,Trouble swallowing,Loss of taste,Possible breathing trouble from swelling,Tiredness,Hearing problems.Most of these side effects slowly go away when treatment is over. Side effects of radiation tend to be worse if chemotherapy is given at the same time. Tell your doctor about any side effects you have because there are often ways to help.

Post treatment of Laryngeal Cancer you have to be careful and Avoiding tobacco products, cutting down on how much alcohol you drink and having a healthy diet are particularly important in reducing your chances of developing the condition.Using tobacco products increases your chances of developing several different types of cancer, including laryngeal cancer.Staying within the recommended guidelines for alcohol consumption will also reduce your risk of developing laryngeal and liver cancers.Men and women are advised not to regularly drink more than 14 units a week spread your drinking over three days or more if you drink as much as 14 units a week.Studies have found that your risk of developing laryngeal cancer reduces significantly within 5-10 years of not drinking, and after 20-30 years your risk is about the same as someone who has never drunk alcohol.

Research shows a diet that contains plenty of fresh fruits and vegetables, particularly tomatoes, citrus fruit (such as oranges, grapefruits and lemons), olive oil and fish oil, may reduce your risk of getting laryngeal cancer. This type of diet is sometimes known as a "Mediterranean diet".Eating plenty of fruit and vegetables each day may help to reduce your chances of developing many types of cancer, including laryngeal cancer.

If you've had some or all of your larynx removed (laryngectomy), it's likely that you'll need to spend one or two days in an intensive care unit until you've recovered.You won't be able to eat until your throat has healed, which for most people takes at least a week or two. While your throat heals, you'll need to be fed through a tube that's passed through your nose and into your stomach.If you've had all of your larynx removed (total laryngectomy), you won't be able to speak normally, because you will no longer have vocal cords.

It can cost anywhere between Rs1.5 lakhs - 1.7 lakhs

The prognosis or outcome for patients with throat cancer varies with the stage and location of the cancer. Most prognostic indicators are based on a 5-year relative survival rate that varies with the type of cancer and its stage. The best survival is in cancer of the glottis (90%) and worst is in cancer of the hypopharynx (53%), both beginning at stage I over a 5-year period. Unfortunately, in all individuals with throat cancer, the 5-year survival rate declines as the stages progress from 1 to IV. Consequently, the earlier the cancer is diagnosed and treated the better the potential outcome