Laryngeal cancer is most prevalent in men over the age of 40. Hoarseness, throat irritation, lump on the neck and constant coughing are symptoms.
The larynx is the organ that houses vocal cords (glottis) and it is responsible, among other things, for phonation. It can be divided into three compartments: subglottis, glottis and supraglottis. Laryngeal cancer originates in this organ and is predominant in men over 40.
The main risk factors for laryngeal cancer are:
- Smoking – raises the risk of developing laryngeal cancer by about 10 times;
- Excessive consumption of alcoholic beverages – especially if associated with smoking.
It is one of the most common cancers of the head and neck region (25% of the malignant tumors of the region and 2% of all malignant neoplasms).
Laryngeal cancer subtypes
Laryngeal cancer has two major subtypes:
- Squamous cell carcinomas – almost all laryngeal cancers develop from the squamous cells of the epithelium, the inner lining layer of the organ. Most squamous cell cancers of the larynx start as a premalignant lesion, called dysplasia, and develop into an invasive tumor (cancer). However, this does not always happen, and dysplasia can even disappear without any treatment, especially if the risk factor, such as smoking, is removed;
- Minor salivary gland cancer: this is a rare neoplasm that originates in small glands known as minor salivary glands, located in the larynx. These glands produce mucus and saliva to lubricate and moisten the area.
Symptoms of Laryngeal Cancer
It is important to mention that many of the symptoms below can also be associated with benign conditions. Therefore, at any sign it is important to see a doctor or even a dentist to evaluate the site. The main symptoms are:
- Persistent hoarseness and voice change;
- Throat irritation that does not subside;
- Nodules on the neck;
- Constant cough;
- Pain or difficulty swallowing;
- Difficulty breathing;
- Weight loss for no apparent reason.
Diagnosis of laryngeal cancer
In laryngeal cancer, the diagnosis is made through clinical examination with laryngoscopy. If any suspicious lesion is visualized and a biopsy is possible, it should be performed to confirm the diagnosis. If it is not possible to perform a biopsy during laryngoscopy, the patient should be referred to a place where the biopsy can be done under general anesthesia.
Once the illness is confirmed, other tests are performed to define the extent (stage) and optimal treatment. These may include:
- Computed tomography or nuclear magnetic resonance: brings important information regarding the extent of compromised structures, as well as assists in differential diagnosis with benign lesions;
- PET/CT: performed in some cases to evaluate whether there are lesions related to illness in other organs (metastases);
- Blood tests: blood tests cannot diagnose laryngeal tumors. However, they are requested to evaluate the general health status of the patient, especially before treatment.
Laryngeal cancer in early stages can be treated only with radiotherapy or minimally invasive (endoscopic) surgery. In more advanced stages, depending on the extent of the disease, surgery followed by radiation therapy with or without chemotherapy, or only radiation therapy combined with chemotherapy, may be necessary.
When surgical treatment involves removing the entire organ (total laryngectomy), there is loss of the laryngeal voice and the need for a definitive tracheostome.
Other important forms of treatment for laryngeal cancer are:
- IMRT radiotherapy: it is a type of radiotherapy that has greater precision when treating the tumor. Thus, the patient has fewer side effects and the results are more expressive;
- Targeted therapy: these are drugs that work differently from standard chemotherapy. They tend to have different (and less severe) side effects, preventing the tumor cell from multiplying, slowing or even stopping the growth of the cancerous cells. This therapy can be combined with radiotherapy for some early-stage cancers or chemotherapy in advanced cases;
- Immunotherapy: this type of treatment increases the activity of the patient’s defense cells to fight the disease. It can be used in combination or not with chemotherapy depending on the patient’s clinical characteristics and the expression of PDL1, which is a protein present on the surface of the tumor.
The best way to prevent larynx cancer is to stay away from its main risk factors: smoking and drinking too much alcohol.