What Is Laryngeal Cancer (Cancer Of The Larynx)? What Causes Laryngeal Cancer?

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Main Category: Cancer / Oncology
Also Included In: Ear, Nose and Throat
Article Date: 20 Nov 2009 - 0:00 PDT

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Laryngeal Cancer is a disease in which cancer cells grow in the larynx. The larynx, also called the voice box, is a short passageway shaped like a triangle that lies just below the pharynx in the neck. The pharynx is a hollow tube about five inches long that starts behind the nose and goes down to the neck to become part of the esophagus.

There are three main parts of the larynx: the glottis, the middle part of the larynx where the vocal cords are located, the supraglottis, the tissue above the glottis, and the subglottis, the tissue below the glottis. The subglottis connects to the trachea, which takes air to the lungs.

Cancer of the larynx, can also be called laryngeal cancer, can develop in any part of the larynx, but most begins in the glottis. The inner walls of the larynx are lined with cells called squamous cells. Almost all laryngeal cancers begin in these cells.

If cancer of the larynx spreads, the cancer cells often spread to nearby lymph nodes in the neck. The cancer cells can also spread to the back of the tongue, other parts of the throat and neck, the lungs, and other parts of the body. When this happens, the new tumor has the same kind of abnormal cells as the primary tumor in the larynx.

The American Cancer Society estimates that 9,510 men and women (7,700 men and 1,810 women) will be diagnosed with and 3,740 men and women will die of laryngeal cancer annually. Most cancers of the throat develop in adults older than 50. Men are 10 times more likely than women to develop throat cancers.

In addition, laryngeal cancer is listed as a "rare disease" by the Office of Rare Diseases (ORD) of the National Institutes of Health (NIH). This means that laryngeal cancer affects fewer than 200,000 people in the U.S.

What are the symptoms of Laryngeal Cancer?

A symptom is something the patient senses and describes, while a sign is something other people, such as the doctor notice. For example, drowsiness may be a symptom while dilated pupils may be a sign.

Symptoms of laryngeal cancer may include the following: persistent cough, hoarseness, sore throat, an abnormal lump in the throat or neck, difficulty or pain when swallowing, frequent choking on food, difficulty or noisy breathing, persistent ear pain or an unusual ear fullness or sensation in and around the skin of the ear, unplanned, significant weight loss persistent bad breath.

What are the causes of Laryngeal Cancer?

Cancer occurs when cells in the body (in this case laryngeal cells) divide without control or order. Normally, cells divide in a regulated manner. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms, called a growth or tumor.

The term cancer refers to malignant tumors, which can invade nearby tissues and can spread to other parts of the body. A benign tumor does not invade or spread.

Smoking is the most important risk factor for laryngeal cancer. Death from laryngeal cancer is 20 times more likely for heaviest smokers than for nonsmokers. Heavy chronic consumption of alcohol, particularly alcoholic spirits, is also significant. When combined, these two factors appear to have a synergistic effect.

Some other quoted risk factors are likely, in part, to be related to prolonged alcohol and tobacco consumption. These include low socioeconomic status, male sex, and age greater than 55 years.

People with a history of head and neck cancer are known to be at higher risk (about 25%) of developing a second cancer of the head, neck, or lung. This is mainly because in a significant proportion of these patients, the aerodigestive tract and lung epithelium have been exposed chronically to the carcinogenic effects of alcohol and tobacco. In this situation, a field change effect may occur, where the epithelial tissues start to become diffusely dysplastic with a reduced threshold for malignant change.

Diagnosing Laryngeal Cancer

An examination of the neck and throat may show cancer of the throat. The sputum (what is coughed up) may appear bloody. A lump may appear on the outside of the neck. A laryngoscopy, which is examination by use of a tube with a small lighted camera (laryngoscope), allows the physician to look into the mouth and down the throat to see the tumor.

Indirect laryngoscopy can be highly effective, but requires skill and practice for consistent results. For this reason, many specialist clinics now use fiber-optic nasal endoscopy where a thin and flexible endoscope, inserted through the nostril, is used to clearly visualize the entire pharynx and larynx. Nasal endoscopy is a quick and easy procedure performed in clinic. Local anesthetic spray may be used.

A neck or cranial CT scan or cranial MRI may show throat cancer. These tests will also help determine if the cancer has spread to lymph nodes in the neck.

Biopsy and analysis of tissues that appear abnormal may confirm the presence of a cancerous tumor. If the lesion appears to be small and well localized, the surgeon may undertake excision biopsy, where an attempt is made to completely remove the tumor at the time of first biopsy. In this situation, the pathologist will not only be able to confirm the diagnosis, but can also comment on the completeness of excision, i.e., whether the tumor has been completely removed.

What are the treatment options for Laryngeal Cancer?

Once laryngeal cancer is found, staging tests are performed to find out if the cancer has spread and, if so, to what extent. Treatment depends on the stage of the cancer. For early stage laryngeal cancer, either surgery or radiation alone is the most common and appropriate therapies offered. For more advanced disease, either radiation (with chemotherapy) or surgery followed by radiation is the most common treatment given.

Surgery requires removal of a cancerous tumor and nearby tissue, and possibly nearby lymph nodes. Surgeries for laryngeal cancer include options such as total laryngectomy, partial laryngectomy, and tracheotomy or neck dissection.

Radiation therapy is the use of radiation to kill cancer cells and shrink tumors. This may be external radiation therapy, where the beam is directed at the tumor from a source outside the body.

Chemotherapy is the use of drugs to kill cancer cells. This form of treatment may be given in many forms including: pill, injection, and via catheter. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells. Chemotherapy may be used to reduce the size of a particularly large cancer.

Preventing Laryngeal Cancer

Since laryngeal cancer is extremely rare in nonsmokers, the best way to prevent this type of cancer is by not smoking.

Other measures you can take to reduce your risk of laryngeal cancer include avoiding excessive alcohol use and protecting yourself from toxic exposures that have been linked to laryngeal cancer.

Written by Sy Kraft (B.A.)
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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