Laryngeal cancer: symptoms, causes and treatment

Definition of laryngeal cancer

What is laryngeal cancer?

Laryngeal cancer is a type of cancer of the larynx that is caused by malignant (cancer) cells forming in the laryngeal tissue. The larynx is a part of the throat, which is located between the base of the tongue and the trachea.

The larynx contains vocal cords, which vibrate and make sound when exposed to air. The sound echoes through the mouth, pharynx and nose to make a sound.

The larynx, which is located in your throat, is made up of cartilage and flexible tissue that forms a support frame. Uncontrolled abnormal cells can appear anywhere on your larynx, such as:

• Supraglottis, which is the top of the larynx above the vocal cords, including the epiglottis. About 35% of cancer cases start in this area.
• Glottis, which is the middle part of the larynx where the vocal cords are located. Nearly 50% more cases of cancer occur in this section.
• Subglottis, which is the bottom of the larynx, between the vocal cords and trachea (windpipe). Cancer cases in this section are quite rare.

Quoted from the US National Cancer Institute website, laryngeal cancer, also known as vocal cord cancer, is a type of head and neck cancer.

How common is this condition?

Vocal cord cancer is a fairly common condition. Quoting from Globocan data in 2018, new cases of cancer that attacks the vocal cords reached 3,663 with a death rate of 2,146 people that year.

Laryngeal cancer signs & symptoms

What are the symptoms of laryngeal cancer?

The most important symptom of laryngeal cancer or vocal cord cancer is hoarseness or voice changes. However, these symptoms are different from the changes in the voice of puberty. The occurrence of this voice change is caused by cancer cells forming in the vocal cords (glottis). This symptom is sometimes recognized by the sufferer at an early stage.

However, if the cancer is first at the top of the vocal cords (supraglottis), the area below the vocal cords (subglottis) usually does not cause hoarseness or voice changes. Therefore, this disease is diagnosed more often at a later stage.

In addition to hoarseness, the symptoms of laryngeal cancer that you may experience are:

• Sore throat that doesn't go away.
• Persistent cough.
• Pain when swallowing.
• Difficulty swallowing (dysphagia).
• Ear pain.
• Difficulty breathing.
• Weight loss for no apparent reason.
• Lumps in the neck due to the spread of cancer to nearby lymph nodes.

When should you see a doctor?

You should check with your doctor if you experience the symptoms of cancer mentioned above. Especially if your voice turns hoarse within 2 weeks and does not improve and there is swelling in the neck.

Causes of laryngeal cancer

The cause of laryngeal cancer is not known with certainty. However, scientists believe that almost all cancers begin with changes in the cell's DNA. DNA itself contains a series of basic instructions for our body cells, such as when to grow and reproduce.

Changes in DNA can change the instructions that control cell growth, which means cells continue to grow without stopping. This causes cells to reproduce uncontrollably, resulting in the growth of tissue called tumors.

It is not known why the DNA in the laryngeal cells is affected in cases of cancer of the larynx. However, it seems that exposure to things that can damage the cells and tissue of the larynx increases the risk of developing cancer.

Laryngeal cancer risk factors

Although the cause is not known with certainty, scientists have found various factors that can increase the risk of laryngeal cancer or cancer of the vocal cords, including:

• Age

Vocal cord cancer most often appears in people over 55 years of age.

Men are affected more often than women.

• History of head and neck cancer

At least one in four people who have had head and neck cancer will have it again at a later date.

• Exposure to certain substances

Tobacco can damage the vocal cords, while alcohol can increase your risk of developing cancer, including cancer of the larynx. Both of these contain chemicals that can destroy cells in the larynx.

• Family history

People who have parents, siblings or siblings, or children diagnosed with head or neck cancer are twice as likely to develop cancer of the vocal cords.

• Unhealthy diet

Eating lots of red meat, processed foods, and fried foods can increase your risk of developing cancer of the throat.

• Human papilloma virus (HPV)

HPV is known to cause cell changes in the cervix that can lead to cervical cancer. It is thought that HPV virus infection also has a similar effect on throat cells.

Laryngeal cancer treatment

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

For diagnosis, the doctor can immediately perform a laryngoscopy. The doctor uses a long stick lens to look inside the throat to check if the vocal cords are moving properly.

The doctor may also perform a direct laryngoscopy and insert a thin lighted tube (laryngoscope) through the living or mouth looking down the throat. A biopsy can also be done. In a biopsy, small pieces of tissue are removed to view cancer cells under a microscope.

Cancer of the larynx should be examined in stages to find out how far it has spread. The examination is usually performed by computed tomography (CT) or magnetic resonance imaging (MRI).

What are the treatment options for laryngeal cancer?

There are several ways to treat laryngeal cancer, which is cancer of the vocal cords, which doctors usually recommend, including:

Radiotherapy

Radiotherapy is a cancer treatment that relies on radiation energy to kill cancer cells. In addition, this treatment is also sometimes used to reduce the size of the tumor before surgery.

In the case of cancer in the vocal cords, hyperfractionation radiation therapy is an option. This cancer treatment is carried out by giving a smaller than normal daily dose of total radiation divided into two doses and the treatment given twice a day.

Operation

In addition to radiotherapy, the patient may be asked by the doctor to undergo vocal cord surgery. The goal is to remove cancer cells from spreading and damaging the surrounding tissue. Some of the types of surgery chosen to treat laryngeal cancer are:

• Cordectomy. Surgery to remove only cancerous vocal cords.
• Supraglottic laryngectomy. Surgery to remove the cancerous supraglottis only.
• Hemylaryngectomy. Surgery to remove half of the vocal cords affected by cancer.
• Partial laryngectomy. Surgery to partially remove the larynx (voice box). Partial laryngectomy helps maintain the patient's ability to speak.
• Total laryngectomy. Surgery to remove the entire larynx. During this operation, a hole is made in the front of the neck so that the patient can breathe and this is called a tracheostomy.
• Laser surgery. A surgical procedure that uses a laser beam (a narrow, intense beam of light) as a knife to make a bloodless incision in the tissue or to remove surface lesions such as tumors in the larynx.

Chemotherapy

Apart from undergoing surgery or radiotherapy, patients may also undergo chemotherapy. This is the treatment of cancer with drugs, which serve the same purpose as radiotherapy.

Several types of drugs that doctors usually prescribe in chemotherapy are carboplatin, 5-fluorouracil (5-FU), docetaxel (Taxotere®), paclitaxel (Taxol®), and epirubicin. The doctor may give one type of drug or a combination depending on the severity of the cancer.

Home treatment of laryngeal cancer

In addition to following cancer treatment in the hospital, lifestyle changes that are suitable for cancer patients also need to be implemented, including:

• Live a healthy life by exercising and following a cancer diet directed by a dietitian or regular doctor.
• Follow the doctor's prescription and instructions.
• Take care of the vocal cords to keep them healthy.
• Quit smoking and stop drinking alcohol.

Laryngeal cancer prevention

Laryngeal cancer or cancer of the vocal cords can be prevented by reducing the various risks. The following are ways to prevent this type of cancer that you can do:

Quit smoking and drinking alcohol

The risk of cancer of the throat will increase if you have this habit. Whether it's just smoking or just drinking alcohol. The risk will be even greater if drinking alcohol is accompanied by smoking.

Avoid chemical exposure

Use protective equipment during work such as masks, supporting respirators, and gloves. Follow the applicable SOPs in carrying out work.

Eat healthy, nutritious foods

Increase your intake of fruits, vegetables, whole grains, and nuts. Instead, you need to limit processed red meat, preservative foods, and foods high in sugar.

Avoid HPV infection

This virus spreads sexual activity, such as oral sex or multiple partners. To avoid infection, always use condoms during sex and do not change partners. This infection can also be prevented by undergoing HPV vaccination.