Laryngeal Cancer

Laryngeal cancer originates from the voice box. The cancerous growth may arise from the vocal cords, called a glottic cancer, or from the region above and below the vocal cords, called supra-glottic and sub-glottic cancers respectively.

Laryngeal cancer is strongly associated with tobacco smoking.


Symptoms

          Persistent or progressive voice change or hoarseness
          Persistent throat pain
          Cough when swallowing
          Difficult or noisy breathing
          Difficult or painful swallowing
          Deep seated ear pain
          Hard painless neck lump on one or both sides of the neck


Treatment

Early Stage Cancer (Stage I & II)

Early stage laryngeal cancers are usually treated with SINGLE MODALITY TREATMENT. This may be in the form of:


          SURGERY

                 or

          RADIATION THERAPY


Surgery for early stage cancers can be performed open, endoscopically or robot-assisted. These organ preserving procedures remove just the cancerous areas, while preserving the critical structures necessary for the essential functions of speech and swallowing.


Advanced Stage Cancer (Stage Ill & IV)

Depending on the site, size and stage of the cancer (disease factors), as well as the patient’s age and co-morbid medical conditions (patient factors), treatment for advanced stage laryngeal cancer may involve:


          SUGERY followed by RADIATION THERAPY, with or without CHEMOTHERAPY

                 or

          COMBINED CHEMO-RADIOTHERAPY, with SURGERY as salvage treatment if there is evidence of recurrent
            or residual disease


Surgical procedures performed for laryngeal cancers include:

          Partial Laryngectomy, removal of part of the voice box, on a horizontal or vertical axis
          Supracricoid Laryngectomy
          Total Laryngectomy, removal of the entire voice box


A total laryngectomy is often required for patients who develop recurrent laryngeal cancer after treatment with combination chemo-radiotherapy.

Although apparently a very morbid procedure, patients who have undergone a total laryngectomy can return to very normal and productive lives.

They are able to swallow normally and resume a normal diet, and learn to communicate effectively again, albeit with a slightly different voice, by way of a small passage made between the upper airway and gullet, called a tracheo-esophageal puncture TEP, or with the aid of a hand-held electronic device, called an electrolarynx.

There will, however, be a permanent opening in the lower neck called a tracheostomy that requires special care, but which most patients get familiar to quite quickly, and incorporate into their normal daily routine.

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