LARYNGEAL CANCER

Laryngeal cancer is cancer of the voice box. Cancer most commonly occurs on the vocal folds causing hoarseness or shortness of breath. Some individuals may notice symptoms of increased cough and difficulty swallowing. Others may note a neck mass, throat or neck pain, or even ear pain. When found early, success rates at treating laryngeal cancer are very high.

Causes of laryngeal cancer:

• Tobacco and alcohol use
• Human papilloma virus (HPV)

Diagnosis of Laryngeal Cancer

Diagnosis of laryngeal cancer is made first during laryngoscopy and stroboscopy – this is a procedure performed in the office where a small camera is used to examine the vocal folds. Cancer typically appears as “mass” often red or white in color. In addition to identifying the mass careful attention is paid to how the vocal folds move. If vocal fold movement is impaired, this can mean that a cancer is more advanced. A biopsy is then taken of the vocal fold, most often during laryngoscopy in the operating room.

Once a diagnosis of cancer is made a CT scan is often performed to assess the depth of the cancer. If lymph nodes of the neck are abnormally enlarged this may signify that cancer has spread.

Cancer of the left vocal fold. This patient was first treated with radiation therapy for cancer of the larynx. The cancer recurred and was removed through the mouth using a laser.

Treatment of Laryngeal Cancer
There are often different methods of treating laryngeal cancer including surgery, radiation therapy or a combination of the two.

Smaller cancers may be treated in the operating room entirely through the mouth. Laryngoscopy is performed and using a laser the cancer is removed. An advantage of this is the ability to leave normal tissue undisturbed.

Left vocal fold cancer. This was removed with a laser and the patient did well with an excellent voice afterwards.

Another option is radiation therapy. This is a series of treatments over 6 weeks in which high energy radiation beams are targeted towards the vocal folds. The cancer is gradually killed over this period of time.

A total laryngectomy is a surgery in which the voice box is removed. This leaves a patient with a permanent stoma, or hole in the neck for breathing. After laryngectomy a patient loses his natural ability to speak. However, there are alternate methods of making sound such as a tracheoesophageal prosthesis which are easy to use and be understood. Many individuals with laryngectomies are able to communicate with others on the phone and work without problems.

Chemotherapy is typically used with advanced caners, and is typically combined with radiation therapy.