What is laryngeal cancer
The larynx is the organ that houses the vocal cords (glottis) and is responsible, among other things, for phonation. It can be divided into three compartments: subglottis, glottis, and supraglottis. Laryngeal cancer is the cancer that originates in this organ and is predominant in men over 40 years old.
The main risk factors for laryngeal cancer are:
- Smoking – raises the risk of developing laryngeal cancer by about 10 times;
- Excessive alcohol consumption – especially when combined with smoking.
It is one of the most common cancers in the head and neck region (25% of malignant tumors in the region and 2% of all malignant neoplasms).
Subtypes of laryngeal cancer
Laryngeal cancer has two most important 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 begin as a premalignant lesion called dysplasia and progress to an invasive tumor (cancer). However, this does not always occur, and dysplasia can even disappear without any treatment, especially if the risk factor, such as smoking, is eliminated.
- Cancer of the minor salivary gland – It 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’s important to note that many of the symptoms below can also be associated with benign conditions. Therefore, it is important to consult a doctor or even a dentist to evaluate the site. The main symptoms are:
- Hoarseness and persistent voice change;
- Throat irritation that does not go away;
- Lump in the neck;
- Constant cough;
- Pain or difficulty swallowing;
- Difficulty breathing;
- Unexplained weight loss.
Diagnosis of laryngeal cancer
In laryngeal tumors, diagnosis is made through clinical examination with laryngoscopy. If a suspicious lesion is visualized and biopsy is feasible, it should be performed to confirm the diagnosis. If biopsy cannot be performed during laryngoscopy, the patient should be referred to a facility where biopsy can be performed under general anesthesia.
Once the disease is confirmed, other tests are performed to determine the extent (stage) and the best treatment. These may include:
- Computed tomography or magnetic resonance imaging – provides important information regarding the extent of the compromised structures, as well as assists in the differential diagnosis with benign lesions;
- PET/CT – performed in some cases to assess for disease-related lesions in other organs (metastases);
- Blood tests – Blood tests cannot diagnose laryngeal tumors. However, they are requested to assess the overall health status of the patient, especially before treatment.
Treatment for laryngeal cancer
Laryngeal cancer in early stages can be treated with radiation therapy alone or minimally invasive surgeries (endoscopic). In more advanced stages, depending on the extent of the disease, surgery followed by radiation therapy with or without chemotherapy may be necessary, or just radiation therapy combined with chemotherapy.
When surgical treatment involves the removal of the entire organ (total laryngectomy), there is loss of the laryngeal voice and the need for a permanent tracheostomy.
Other important treatment options for laryngeal cancer include:
- Intensity-modulated radiation therapy (IMRT) – is a type of radiotherapy that offers greater precision in treating the tumor. As a result, patients experience fewer side effects, and the outcomes are more significant.
- 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 down, or even stopping the growth of cancer cells. This therapy can be combined with radiotherapy for some types of early-stage cancer or chemotherapy in advanced cases.
- Immunotherapy: This type of treatment boosts the activity of the patient’s immune cells to fight the disease. It can be used alone or in combination with chemotherapy, depending on the patient’s clinical characteristics and the expression of PD-L1, a protein present on the tumor’s surface.
Prevention
The best way to prevent laryngeal cancer is to avoid its main risk factors: smoking and excessive alcohol consumption.
