Hoarseness that lasts longer than 2-3 weeks may be a symptom of laryngeal cancer. It is a type of cancer that affects men ten times more than women. Treatment of laryngeal cancer depends on the stage of the disease - with larger lesions, it consists in partial or complete removal of the larynx.

Laryngeal cancertypically attacks between the ages of 45 and 70. It is the most commoncancerthat occurs in the head and neck. Interestingly, men are ten times more likely to suffer from laryngeal cancer than women. However, these proportions are changing as more and more women smoke. Early in life, cancer can develop in the epiglottis, glottis, and subglottis. In Poland, the highest number of neoplasms located in the epiglottis is recorded, which is a poor prognosis, because this is where the rich network of the lymphatic vessels in the neck is located, hence the early metastases to the lymph nodes in the neck. A specific form of epiglottic carcinoma is called colonic cancer that develops on the border of the larynx, pharynx and esophagus. The first symptoms of such cancer are dysphagia (difficulty swallowing, i.e. the passage of food from the mouth to the stomach), followed by odynophagia, i.e. painful swallowing. Glottic cancer, especially when confined to one vocal ligament, has the best prognosis. Initially, it becomes a hoarse voice that does not resolve despite anti-inflammatory treatment.

How does laryngeal cancer start?

Neoplasm development is usually preceded by a precancerous condition with papillomas, white spots or streaks on the mucosa (leukoplakia), and sometimes keratinization of the mucous membranes (pachydermia). As it develops, the cancer infiltrates and destroys surrounding tissues. Over time, it closes the larynx, which leads to impaired breathing and, consequently, suffocation. Cancer cells, along with lymph and blood, move to nearby lymph nodes and distant organs, causing metastases.

Detection of changes related to laryngeal cancer - research

The basis for the diagnosis of laryngeal cancer is an ENT examination, during which, apart from the classic palpation of the neck, laryngoscopy should be performed. This examination enables the assessment of the nature of the lesion, the presence of lesions and the taking of specimens for histopathological examination. To assess the extent ofneoplastic process, chest X-ray, ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) are performed.

Symptoms of laryngeal cancer

The first symptoms of laryngeal cancer may be mistaken for an infection. Attention should be drawn to:

  • hoarseness that lasts longer than 2-3 weeks
  • foreign body sensation in the throat and difficult swallowing
  • voice timbre change
  • coughing up a lot of sputum
  • bad breath
  • unilateral sore throat radiating into the ear
  • shortness of breath
  • cough
  • spitting blood
  • enlargement of the lymph nodes in the neck
  • weight loss
  • weakness, fatigue
  • pale skin.

Laryngeal cancer treatment - when is larynx removal necessary?

The type of treatment must be adapted to the stage of the disease. In less advanced neoplasms of the larynx, microsurgical removal of changes in the vocal cord or chordectomy, i.e. removal of the affected vocal cord, is performed. In the case of larger lesions, partial or total laryngectomy is performed, i.e. a procedure involving partial or complete removal of the larynx. During partial laryngectomy, the patient retains his voice and proper breathing. With total loss, the patient loses not only the larynx, but also - usually - the surrounding lymph nodes. An important element of treatment is radiotherapy in combination with chemotherapy.

Each insured person has the right to receive a grant from the National He alth Fund for the purchase of a throat microphone (electronic prosthesis of the larynx).

Under the supervision of a phoniatrist, the patient learns esophageal speech after removing the larynx (the voice is unnaturally low, quite quiet, has a small range of pitch, which makes intonation and conveying emotions difficult, but understanding the message is not a problem). Some patients use an electronic larynx. The voice then resembles the speech of a robot, but the content of the speech is understandable to the listener.

One of the methods of operating on laryngeal cancers is endoscopic laser chordectomy. This procedure is performed through the oral cavity. After the larynx is completely removed, surgeons perform a tracheostomy, i.e. the tracheal opening to the front of the neck. Radiotherapy is also an important element in the treatment of laryngeal cancer.

Innovative reconstruction of the larynx

The innovative reconstruction of the larynx was carried out by the team of prof. Adam Maciejewski from the Oncology and Reconstructive Clinic of the Oncology Center in Gliwice. The new larynx is made up of rib cartilage, temporal lobe and cheek mucosa. The operation was carried out in two stages. First, the affected part of the larynx was removedcancer and lymph nodes. The tumor was 2 cm in diameter. The rib cartilage was then removed and was to become a support for the new larynx. The next step is to collect a fragment of the temporal lobe with which the larynx formed of cartilage is wrapped around it. A small fragment of the mucosa was taken from the patient's cheek, which was lined with the reconstructed larynx. The operation lasted 7 hours. Not only did it extend the patient's life, but also preserve its good quality.

Important

Laryngeal cancer favors:

  • smoking
  • alcohol abuse
  • chronic laryngitis
  • effects of heavy metals (chromium, nickel, uranium) and asbestos
  • vitamin A deficiency
  • burns or mechanical trauma to the larynx
  • working with your voice
  • viral infection resulting in laryngeal papillomas.

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Oncology