Laryngeal Cancer Treatment in Delhi, India

Laryngeal cancer, or cancer of the voice box, is a severe condition that can significantly impact an individual's ability to speak and breathe. Located in the throat, the larynx plays a crucial role in voice production and protecting the airway during swallowing.

This form of cancer is frequently linked to risk factors like tobacco use and alcohol intake, and its severity can range from localised tumours to more advanced stages that may necessitate complicated treatment strategies.

Types of Laryngeal Cancer

Laryngeal cancer can be classified based on the part of the larynx affected:

Supraglottis (Upper Part)

This type affects the area above the vocal cords, including the epiglottis. It may cause symptoms like throat pain and difficulty swallowing.

Glottis (Middle Part)

This is the most common type of laryngeal cancer, affecting the vocal cords. It often presents with hoarseness or changes in the voice.

Subglottis (Lower Part)

This type affects the area below the vocal cords and can be more challenging to detect early, leading to symptoms like breathing difficulties.

Laryngeal Cancer Symptoms

Early symptoms of laryngeal cancer can be subtle but may include:

• Hoarseness or voice changes: Persistent changes in voice or hoarseness lasting more than two weeks.
• Throat pain: Pain or discomfort in the throat, which may extend to the ear.
• Difficulty swallowing: Pain or trouble swallowing may be accompanied by a feeling of something stuck in the throat.

Advanced symptoms might include:

• Breathing difficulties: If the tumour grows large enough to obstruct the airway.
• Unexplained weight loss: Significant weight loss without a known cause.
• Persistent cough: A cough that doesn't go away or blood in the cough.

Laryngeal Cancer Causes

Laryngeal cancer arises from the abnormal growth of cells in the larynx. The primary causes include:

• Tobacco use: Smoking is a major cause of laryngeal cancer, significantly increasing the risk of developing this condition.
• Alcohol consumption: Heavy drinking is another major risk factor that can contribute to the development of laryngeal cancer, especially when combined with smoking.
• Human Papillomavirus (HPV): Certain strains of HPV are linked to head and neck cancers, including laryngeal cancer.
• Occupational hazards: Exposure to carcinogens such as asbestos or certain chemicals can increase the risk.

Stages of Laryngeal Cancer

The staging of laryngeal cancer helps determine the appropriate treatment:

• Stage 0: Abnormal cells are present but have not invaded deeper tissues.
• Stage I: Cancer is localised to one area of the larynx.
• Stage II: Cancer has spread to nearby tissues but is still confined to the larynx.
• Stage III: Cancer has spread to lymph nodes or more extensive areas of the larynx.
• Stage IV: Cancer has spread to other parts of the body or extensive regions of the larynx.

Laryngeal Cancer Diagnosis

Accurate diagnosis is essential for effective treatment. The process typically involves:

Initial Evaluation

• Physical examination: The doctor will examine the throat and neck for abnormalities.
• Patient history: Discuss symptoms, risk factors, and medical history to guide further testing.

Diagnostic Tests

• Laryngoscopy: A procedure using a flexible or rigid scope to view the larynx and identify abnormalities.
• Endoscopy: Allows for direct visualisation of the larynx and possible biopsy.
• Biopsy: A tissue sample is collected for pathological analysis to verify the existence of cancer cells.
• Imaging tests: CT scans, MRIs, and PET scans provide detailed images to determine the extent and stage of the cancer.

Laryngeal Cancer Treatment

Surgery

Surgical options depend on the stage and location of the cancer:

• Cordectomy: Removal of part or all of the vocal cords.
• Supraglottic Laryngectomy: Removal of the part of the larynx above the vocal cords.
• Hemilaryngectomy: Removal of one side of the larynx.
• Partial Laryngectomy: Removal of part of the larynx.
• Total Laryngectomy: Complete removal of the larynx, often requiring a tracheostomy.
• Thyroidectomy: Removal of the thyroid gland if affected.
• Laser surgery: Use of lasers to remove small tumours or lesions.

Radiation Therapy

Radiation therapy targets cancer cells using high-energy rays. It is often used for:

• Primary treatment: For early-stage cancers or when surgery is not possible.
• Adjuvant therapy: After surgery to eliminate remaining cancer cells.

Side effects may include sore throat, dry mouth, and skin irritation.

Chemotherapy

Chemotherapy uses drugs to kill cancer cells:

• Use: Typically used with other treatments for advanced cancers or when cancer has spread.
• Common drugs: Cisplatin, carboplatin, and 5-fluorouracil.

Side effects may include nausea, hair loss, or fatigue.

Targeted Therapy

Targeted therapy targets specific cancer cell mechanisms. It involves drugs that specifically attack cancer cells without affecting normal cells. It's used for cancers that have certain genetic mutations or markers.

Immunotherapy

Immunotherapy helps the body's immune system fight cancer:

• Overview: Drugs or other substances are used to stimulate the immune system.
• Benefits: It may be effective for certain patients with advanced laryngeal cancer.

Side effects may include flu-like symptoms and inflammation.

Laryngeal Cancer Post-Treatment Care

Rehabilitation

Post-treatment care focuses on recovery:

• Speech therapy: Essential for patients who have undergone surgery affecting the vocal cords.
• Swallowing therapy: Helps patients regain the ability to swallow effectively.

Follow-Up Care

• Regular check-ups: Essential for monitoring recovery and detecting any recurrence.
• Monitoring for recurrence: Includes routine imaging and physical examinations.

Laryngeal Cancer Prevention

Preventive measures can help reduce the risk:

• Avoid tobacco: Quitting smoking is the most effective way to lower the risk.
• Limit alcohol consumption: Reducing alcohol intake can also decrease risk.
• HPV vaccination: Protecting against HPV can reduce the risk of head and neck cancers.
• Regular check-ups: Early detection through regular medical exams can improve outcomes.

Risk Factors of Laryngeal Cancer

• People with certain lifestyles are more prone to cancer than others.
• People with a history of laryngeal cancer in the family.
• Consuming a lot of processed food and not eating enough vegetables or fruits.
• Abuse of alcohol and tobacco in the form of chewing and smoking are the major contributors to laryngeal cancer.

Possible Complications of Laryngeal Cancer

Complications start majorly when metastasis has begun. Metastasis is the migration of cancerous cells to the other parts of the body. It may affect the kidney, liver, lungs, central nervous system, etc. Malignant cells rarely invade the bone marrow.

Prognosis of Laryngeal Cancer

The outcome of the disease depends on several factors, such as age, location of cancer, size of the tumour, severity of the tumour and the body's acceptance of the treatment and medications. In case of higher-level tumour formation, some follow-up treatments are advised so that the health is always in check and there is no relapse in any form.

Natural Progression of Laryngeal Cancer

If the cancer is left untreated, the tumour will keep increasing in size and severity. At stages III and IV, the malignant cells will breach the bloodstream and lymph nodes. This will cause the malignant cells to flow to vital organs such as the liver and kidney. Then the vital organs will start getting affected and become cancerous. The patient will lose health rapidly and ultimately, it will lead to a very painful death.

Outlook

The outlook for laryngeal cancer patients varies based on the stage and treatment response. Early detection and advanced treatments often lead to favourable outcomes. After treatment, patients may face lifestyle changes but can achieve a good quality of life with proper care and support.

Frequently Asked Questions

1. How common is laryngeal cancer?

Laryngeal cancer is relatively rare compared to other cancers but has a significant impact on affected individuals.

2. Where does laryngeal cancer spread first?

Laryngeal cancer extending beyond the larynx can affect nearby structures, potentially involving the thyroid gland, trachea, oesophagus, tongue, lungs, liver, and bones.

3. Is there screening for laryngeal cancer?

Routine screening is not widely recommended; however, high-risk individuals may benefit from regular check-ups.

4. How do I take care of myself if I have a total laryngectomy?

Care involves learning to manage a stoma, using speech therapy, and adhering to follow-up care instructions.

5. Will I be able to use my voice after laryngeal cancer treatment?

Voice function depends on the extent of surgery and rehabilitation, with options available to assist in regaining speech.

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