Laryngeal Cancer

Laryngeal Cancer Treatment in Hyderabad, India

Laryngeal Cancer refers to the type of throat cancer that occurs in the Larynx (part of the throat) or the voice box. The malignant cells of this type of cancer generally begin in the larynx.

The larynx refers to the voice box that contains muscles and cartilage that allow you to talk, swallow, and breathe. 

Laryngeal cancer can be a part of other cancers such as neck and head cancer. This cancer can even damage the voice box permanently. It can even spread to other parts of the body if it is not treated quickly. The survival rates of this cancer can depend on when it was diagnosed and the specific location. 

Symptoms of Laryngeal Cancer

The signs and symptoms related to Laryngeal cancer can easily be detectable. A few of these symptoms can include:

• Hoarse voice

• Difficulty in breathing 

• Excessive coughing

• Coughing with blood 

• Neck pain 

• Ear pain 

• Sore throat 

• Difficulty in swallowing food 

• Swelling in the neck 

• Lumps on the neck 

• Sudden weight loss

You should keep in mind that the above signs and symptoms can be related to other conditions as well. Hence, if you have any symptoms, you should make an appointment with your doctor to rule out any possibility of cancer. 

Causes of Laryngeal Cancer

The causes of laryngeal cancer can vary, but some common factors include:

• Tobacco use: Smoking cigarettes, cigars, pipes, or using smokeless tobacco significantly increases the risk of developing laryngeal cancer.
• Alcohol consumption: Heavy and frequent alcohol consumption is another significant risk factor for laryngeal cancer. The risk is even higher when combined with tobacco use.
• Human papillomavirus (HPV) infection: Certain strains of HPV, a sexually transmitted virus, have been linked to an increased risk of developing laryngeal cancer.
• Occupational exposure: Prolonged exposure to certain chemicals and substances in certain workplaces, such as asbestos, wood dust, paint fumes, or diesel exhaust, may increase the risk of laryngeal cancer.
• Age and gender: Laryngeal cancer is more common in older adults, particularly those over 55 years of age. It also occurs more frequently in men than in women.
• Poor nutrition: A diet lacking in fruits and vegetables may contribute to the development of laryngeal cancer.
• Gastroesophageal reflux disease (GERD): Chronic acid reflux, which leads to inflammation and irritation of the larynx, may increase the risk of laryngeal cancer.

Types of Laryngeal Cancer

Most Laryngeal Cancers developed are Squamous Cell Carcinoma which begins in the squamous (thin and flat) cells that line the Larynx. However, some other types of Laryngeal Cancer include:

• Sarcoma: This refers to cancer that occurs in the connective tissues in the larynx. 
• Lymphoma: It refers to cancer that occurs in the lymphatic tissues of the larynx. 
• Adenocarcinoma: This is another rare type of cancer that begins in the glandular cells of the larynx.
• Neuroendocrine Carcinoma: This refers to the type of cancer that develops in the neuro (nerve) cells that work towards creating hormones (produced by endocrine glands). Hormones control the functions of different organs in the body.  

Risk factors for Laryngeal Cancer

Multiple factors can lead to an increased risk of Laryngeal Cancer. These mainly include certain lifestyle factors such as:

• Smoking 

• Chewing tobacco

• Not eating a sufficient amount of vegetables and fruits

• Consuming processed foods in large quantities

• Drinking alcohol

• Exposure to asbestos

• Family history of laryngeal cancer 

Diagnosis of Laryngeal Cancer

The diagnosis of Laryngeal cancer generally begins by looking at the medical history of the patient. If there are any potential symptoms of Laryngeal Cancer then the doctor will carefully examine the patient and begin a few series of tests. 

One of the first tests performed is a laryngoscopy. In this process, the doctor will either use a small scope or a series of mirrors to carefully examine the larynx. 

If there are any abnormalities found during diagnosis, the doctor may even perform a biopsy to detect any signs of Laryngeal Cancer. 

If the cancer is detected in the larynx, the doctor may even perform some other tests such as a CT or MRI scan to check if the cancer has spread to other parts of the body. 

Here are the procedures involved in the diagnosis of laryngeal cancer:

• Medical History and Symptoms Assessment:
  • Patient Interview: The healthcare provider will ask about the patient's symptoms, including hoarseness, difficulty swallowing, persistent sore throat, ear pain, coughing, and any changes in voice.
  • Risk Factors: The provider will inquire about risk factors, such as smoking history, alcohol use, exposure to certain chemicals (like asbestos), and family history of cancer.
• Physical Examination:
  • Head and Neck Exam: A thorough examination of the head and neck will be performed to check for any visible signs of tumors or abnormal lymph nodes.
  • Laryngeal Examination: The doctor may use a laryngoscope, a thin, flexible tube with a light and camera, to visualize the larynx. This can be done in the office setting.
• Imaging Studies: X-rays:
  • While not commonly used alone for diagnosis, chest X-rays can help determine if cancer has spread to the lungs.
  • CT Scan (Computed Tomography): A CT scan of the neck and chest can provide detailed images of the larynx and surrounding structures, helping to assess the extent of the cancer.
  • MRI (Magnetic Resonance Imaging): MRI can be useful for evaluating soft tissue structures and determining the involvement of nearby tissues or organs.
  • PET Scan (Positron Emission Tomography): Sometimes combined with CT, a PET scan can help identify cancerous cells throughout the body.
• Biopsy:
  • Direct Laryngoscopy: If abnormal areas are identified during laryngoscopy, a biopsy may be performed. This involves taking a small sample of tissue from the larynx for examination under a microscope.
  • Fine Needle Aspiration (FNA): If there are enlarged lymph nodes in the neck, FNA may be performed to obtain cells from the lymph nodes for testing.
• Laboratory Tests:
  • Pathology Examination: The biopsy sample is sent to a pathologist, who examines it for cancer cells. The type and grade of cancer are determined based on cellular characteristics.
• Staging:
  • Once diagnosed, additional tests may be conducted to determine the stage of the cancer, which helps in planning treatment. This can include further imaging studies to see if the cancer has spread to lymph nodes or other organs.

Staging of cancer

Once cancer is detected, the next step for diagnosis would be staging. This shows how far cancer has travelled or spread in the body. To do so, the doctor can use the TNM system. Under this system, the doctor will be able to identify the size of the tumour,  the depth of the tumour, and whether the tumour has metastasized or not. 

Most Laryngeal Cancers spread to the lungs as well. Tiny tumours that have not spread to the lymph nodes are the least serious type of cancer. Whereas, once the tumours reach the lymph nodes, cancer moves on to an advanced stage. 

Treatment of Laryngeal Cancer

The treatment of laryngeal cancer depends on the stage of the diagnosis as well as the size of the tumour. If cancer is detected at an early stage, then the doctor will recommend either radiation therapy or surgery.

Surgery

Surgery is one of the most common methods of treatment for any type of cancer. Although there may be a few risks, these risks are more likely to occur if the tumour is not removed. These risks can include:

• Difficulty in breathing 

• Difficulty in swallowing 

• Neck disfigurement

• Change or loss of voice 

• Permanent neck scars

Radiation Therapy

Apart from surgery, the doctor may even suggest undergoing radiation therapy to treat the tumour. Radiation therapy helps to kill all the remaining cancer cells. 

Chemotherapy

Chemotherapy is another treatment option available to cure Laryngeal cancer. Chemotherapy can help in:

• Killing the remaining cancer cells after surgery and radiation 

• Treat cancer at an advanced stage instead of undergoing surgery 

• Treat advanced cancer symptoms that can't be entirely removed

If the tumour is comparatively small or if it is too late to treat the tumour with surgery, then the doctor may suggest an initial treatment instead of going for surgery. The treatment helps to make sure you live a better quality of life. 

Targeted Therapy

Targeted therapy drugs, such as cetuximab, target specific proteins in cancer cells to stop their growth. This treatment is often combined with radiation or chemotherapy, especially for cancers that are resistant to standard treatments.

Immunotherapy

In advanced cases, immunotherapy may be used to help the immune system recognize and attack cancer cells. Drugs like pembrolizumab or nivolumab are used to treat recurrent or metastatic laryngeal cancer.

Rehabilitation and Speech Therapy

After treatment, especially if the larynx or vocal cords are removed, patients may require speech therapy to help with communication. In cases of total laryngectomy, alternative speech methods like a voice prosthesis may be needed.

Recovery

Recovery from laryngeal cancer (cancer of the voice box) depends on the type of treatment you undergo—whether surgery, radiation, chemotherapy, or a combination. Here’s how affected areas recover and what to do during the recovery process:

1. Recovery After Surgery:

• If part of the larynx (voice box) is removed, the body needs time to heal. You may experience:
• Voice Changes: Your voice may sound different, and in some cases, a speech therapist can help you improve speaking abilities.
• Breathing: If the surgery affected your airway, a temporary tracheostomy (a tube in your neck) might be placed for easier breathing until healing is complete.
• Swallowing: You may have difficulty swallowing for some time and may need a feeding tube until you're able to eat and drink normally again.

What to do:

• Rest your voice and follow your doctor’s advice on using the voice box.
• Stay hydrated and eat soft foods if swallowing is difficult.
• Follow up with speech therapy if needed.

2. Recovery After Radiation Therapy:

• Radiation can cause sore throat, dry mouth, and changes in taste. Over time, these side effects can lessen, and tissue healing occurs.

What to do:

• Keep your mouth moist by drinking water regularly.
• Use prescribed mouth rinses to soothe your throat.
• Avoid spicy or acidic foods until healing improves.

3. Recovery After Chemotherapy:

• Chemotherapy may weaken your immune system, making recovery slower. Your energy levels may also be affected, and it can take weeks to regain full strength.

What to do:

• Eat nutritious foods to help the body recover.
• Rest when needed and avoid exposure to infections.
• Stay in regular contact with your doctor for any symptoms that arise.

Prevention of Laryngeal Cancer

• Avoid Tobacco Products
  • Quit Smoking: Smoking is the leading risk factor. Quitting can significantly lower your risk.
  • Avoid Chewing Tobacco: This form also increases the risk of laryngeal cancer.
• Limit Alcohol Consumption
  • Moderation is Key: Heavy drinking, especially combined with smoking, increases cancer risk. Limit alcohol intake to moderate levels.
• Maintain a Healthy Diet
  • Eat More Fruits and Vegetables: A diet rich in antioxidants can help reduce cancer risk. Focus on colorful, fresh produce.
  • Limit Processed Foods: Reducing processed and high-fat foods is beneficial.
• Protect Against HPV
  • Get Vaccinated: The HPV vaccine can lower your risk of HPV infections that may lead to laryngeal cancer.
• Minimize Exposure to Workplace Carcinogens
  • Use Protective Gear: If you work with toxic substances (e.g., asbestos, wood dust), use appropriate safety equipment.
  • Ensure Proper Ventilation: Good ventilation helps reduce inhalation of harmful fumes.
• Stay Hydrated
  • Drink Plenty of Water: Staying hydrated helps maintain throat health and moisture.
• Regular Medical Check-Ups
  • Monitor Health: Regular check-ups can help catch any early signs of laryngeal cancer. Report any persistent symptoms like hoarseness or throat pain to your doctor.
• Practice Good Oral Hygiene
  • Maintain Oral Health: Regular dental check-ups and good oral hygiene may help reduce the risk of cancers in the mouth and throat.
• Strengthen Your Immune System
  • Exercise Regularly: Engage in physical activities to boost immunity.
  • Manage Stress: Effective stress management techniques can enhance overall health.

How can CARE Hospitals help?

We provide comprehensive and specialised care in the field of oncology at CARE Hospitals. Our multidisciplinary team will assist and support you throughout the process. Our support staff will always be available to help you and will gladly answer any questions you may have. Our hospital is backed by state-of-the-art technology and equipment and opts for advanced procedures that help in obtaining the best possible outcomes.