Protect Your Voice: Laryngeal Cancer Awareness
Imagine your voice—a unique sound that conveys your emotions and carries your laughter. But laryngeal cancer can take that away.
According to Indian Council of Medical Research (ICMR) Annual Report 2022, laryngeal cancer accounts for about 2.6% of all cancers in India. This blog covers the causes, symptoms, and treatment options for laryngeal cancer.
What is Laryngeal Cancer?
Laryngeal cancer is a type of head and neck cancer that affects the larynx, a part of your throat. The larynx is the voice box that helps you speak, swallow, and breathe.
An abnormal growth of cancerous cells, which can multiply uncontrollably, leads to laryngeal cancer, which affects the voice.
Laryngeal cancer can occur in any main three parts of the larynx:
- The glottis is the middle part of the larynx, the vocal cords. More than 60% of the cancer occurs here.
- The supraglottis is the upper part of the larynx. More than 35% of cancer occurs here.
- The subglottis is the part of the larynx. About 5% of cancer occurs here.
Voice box cancer may not show any significant symptoms, which can be easy to mistake for a cold or other conditions. Being aware of the signs and symptoms empowers you to seek medical attention and early detection, which can help you achieve better outcomes.
What are the signs and symptoms of Laryngeal Cancer?
Having a hoarse voice for more than 3 weeks is considered to be one of the main symptoms of laryngeal cancer. Other common symptoms may include
- Cough and sore throat
- A lump in the neck or throat
- Pain or uncomfortable feeling while swallowing
- Wheezing sound while breathing
- In severe cases, breathlessness may occur
- Ear pain
- The feeling that there is something stuck between your throat
If any of these symptoms persist for more than a week, consult your healthcare provider for a check-up.
What are the causes of Laryngeal Cancer?
Laryngeal cancer typically occurs when healthy cells in the larynx are damaged or grow uncontrollably. The risk factors are
- Smoking tobacco
- Increased alcohol intake
- Exposure to toxic chemicals such as coal dust and asbestos
- Having an unhealthy diet
- Family history (genetically inherited)
- Certain infections, such as sexually transmitted diseases (STDs) and human papillomavirus (HPV), can also cause laryngeal cancer.
How do you diagnose Larynx Cancer?
The doctor will ask you about your symptoms and medical history, followed by a physical examination of your throat and neck. They can also check for any abnormalities inside and outside of your throat, such as lumps and swellings.
After a physical examination, your doctor may proceed with diagnostic tests such as
1. Laryngoscopy: During laryngoscopy, your doctor may use a thin, flexible tube with a light, lens, and video camera to obtain a clear image of your larynx. During this procedure, your doctor can also take tissues from any abnormal area in the larynx and send the samples to laboratories for testing.
2. Biopsy: If any abnormalities are found on laryngoscopy, a biopsy will be performed. In this procedure, a small part of the tissue will be taken out and examined by a pathologist under a microscope.
3. Imaging scans: The imaging scans used for laryngeal cancer are
- Computed tomography (CT) and magnetic resonance imaging (MRI) can provide a clear image of the tumour's size and its location.
- In a PET (Positron Emission Tomography) scan, a small and safe dose of a radioactive substance is injected into the vein, which highlights the areas of cancer cells.
Parts of the diagnosis may include the staging of cancer.
What are the stages of laryngeal cancer?
After diagnosis, the staging of cancer can be done, by which your doctor can tell how severe and how far the cancer has spread. Doctors use the TNM system for staging laryngeal cancer.
- “T” refers to the size and affected tissues of the primary tumour.
- “N” is used to identify how far the cancer has spread to the lymph nodes.
- “M” shows whether the cancer has advanced or spread into other organs or more lymph nodes.
What are the treatment options for Laryngeal Cancer?
The treatment options for throat cancer may include
1. Radiation therapy: This is the primary treatment option used to treat laryngeal cancer. Radiation therapy uses high-energy rays to kill or shrink the size of cancer cells. It is also used as a follow-up treatment for surgery to remove remaining cancer cells. The types include:
- External beam radiation therapy (EBRT): This is considered the primary therapy where the rays are delivered from outside the body.
- Internal radiation therapy (Brachytherapy): In this method, the radioactive material is directly placed into the tumour.
The side effects may include
- Mouth ulcers
- Dry mouth
- Loss of appetite and taste
- Tiredness and feeling sick
- Sore skin which may look red or dark (like sunburn)
2. Chemotherapy: Chemotherapy uses anti-cancer drugs to kill the cancer cells in the body. It can be used as a standalone treatment or in combination with other treatments. It will be given intravenously (IV) into the bloodstream.
In advanced-stage cancer, it is used to shrink the size of the tumour before surgery or radiation therapy.
After surgery or radiation therapy, it can be used to kill the remaining cancer cells in the body.
- Chemoradiotherapy(Combined with radiotherapy) works more effectively in most cases where both chemotherapy and radiation therapy will be given simultaneously.
The side effects of chemotherapy may include:
- Hair loss
- Feeling sick and tired
- Bleeding and bruising easily
- Constipation and diarrhoea
- Sudden weight loss
- Increased risk of infection
3. Targeted therapy and Immunotherapy: The targeted therapy works by specifically targeting the cancer cells, genes, and proteins that help in the growth and survival of cancer cells. The cetuximab (Erbitux) targets the epidermal growth factor receptor (EGFR) on the surface of the cancer cells.
- Immunotherapy helps to enhance the immune system to fight cancer cells in the body. Drugs such as Pembrolizumab are used in treating advanced laryngeal cancer, which helps the body’s immune system fight against cancer cells.
The common side effects of targeted therapy and immunotherapy are:
- Fatigue
- Skin rashes and itching
- Fever and Nausea
- Diarrhoea
- Mouth sores
- Sensitive to sun
Your healthcare team will help you in managing the side effects of the treatment.
What are the surgery options available for Laryngeal Cancer?
There are different types of surgery options based on the tumour size, location and how far it has spread. The main goal of surgery is to remove the tumour while preserving the larynx functions. The different types of surgery are
1. Laser surgery: This is used to treat early-stage laryngeal cancer, where a laser is used to remove the cancerous cells from the larynx. The benefits may include
- This laser can target and remove the cancer cells more accurately.
- This ensures quick recovery when compared with other extensive surgery options.
- There will be reduced bleeding as it cauterises (burns to remove or close a part of the body) the blood vessels.
2. Partial laryngectomy: This process removes some areas of the larynx affected by cancer cells. Some of your vocal cords can be left in place so that you can still talk, but your voice can be hoarse or weak.
- Your surgeon may need to make a temporary hole in your neck to attach a breathing tube. This is referred to as a temporary tracheostomy.
- Once your larynx has recovered, you can remove the tube. The hole will heal, leaving a tiny scar.
3. Total laryngectomy: This procedure involves the complete removal of the larynx. This procedure is complicated as it may have some effects on the patient.
- There will be a permanent hole in the neck called a stoma to breathe after surgery. Proper training will be given on how to use and clean the stoma.
- In some cases, the natural voice will be affected, and some alternative methods can be used to speak, such as
- Tracheoesophageal Puncture (TEP): A voice prosthetic that is placed in the hole which helps to speak.
- Electrolarynx (Voice Box Device): This battery-operated device produces vibrations that produce sound and help with speech.
The common side effects of surgery may include
- Change or loss of natural voice
- Difficulty in swallowing and breathing
- Wound healing and infection problems
- In rare cases, loss of smell and taste may occur
What is the survival rate of Laryngeal Cancer?
The five-year survival rate of laryngeal cancer in India is approximately 28%.
However, early detection and effective treatment will help achieve better outcomes. As there are various advancements in medical treatment, early diagnosis can enhance the survival rate.
Empowering Voices
Dr Vishal Rao, a Bangalore-based oncologist specialist, has developed a voice prosthetic called “AUM”. In comparison, other voice prosthetics in the market cost around rupees 15,000 to 30,000 and have to be replaced every six months. The AUM will cost only 50 rupees. He says, “We believe that speech and communication are not a privilege but a right. We cannot hold them back from a patient only because he/she is poor,”
Veer Singh Yadav is the longest laryngeal cancer survivor who has survived for more than six decades after the surgery. “Veer Singh Yadav is certainly an inspiration for cancer patients as he lived for over 60 years after the surgery with his strong willpower and discipline, said Dr L N Meena of Bundi District Hospital”.
Frequently Asked Questions (FAQs)
1. What are the early signs of laryngeal cancer?
The early signs of laryngeal cancer may include small growths of vocal cords that may produce hoarseness or persistent cough, pain which gets worse during swallowing and pain in the ear.
2. How to avoid laryngeal cancer?
You can prevent laryngeal cancer by adopting a healthy lifestyle. Avoid tobacco and alcohol usage and prefer a healthy diet and lifestyle to reduce the risk of developing the condition.
3. What age does throat cancer start?
Most of the laryngeal cancer starts at over the age of 55 or older. It is less common to occur in people who are younger than 55.
4. How to check for laryngeal cancer?
You can go for diagnostics tests such as CT, PET scan, laryngoscopy and biopsy to check for laryngeal cancer.
5. Is larynx cancer curable?
Yes, if the cancer has been detected in the early stage, it is curable. If the tumour has not metastasised or spread to the near lymph nodes and tissues, effective treatment may result in a cure.
What’s in Store
While dangerous, laryngeal cancer can be effectively treated with early detection and specialised treatment. By staying knowledgeable about the symptoms, knowing the importance of frequent check-ups, and taking a proactive attitude to health, you may significantly reduce your risk and get better results if diagnosed.
Laryngeal cancer awareness is the first step toward prevention and effective treatment. Empower yourself with knowledge, encourage people around you to do the same, and seek medical attention if you see any concerning symptoms. Remember that your voice is an important part of who you are, and taking care of it is key to sustaining not only your health but also your quality of life.
References
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4743184/
- https://www.cancer.gov/types/head-and-neck/hp/adult/laryngeal-treatment-pdq#_170
- https://emedicine.medscape.com/article/848592-overview
- https://www.ucsfhealth.org/conditions/larynx-cancer
- https://www.ncbi.nlm.nih.gov/books/NBK65859/
- Igissin N, Zatonskikh V, Telmanova Z, Tulebaev R, Moore M. Laryngeal Cancer: Epidemiology, Etiology, and Prevention: A Narrative Review. Iran J Public Health. 2023 Nov;52(11):2248-2259. doi: 10.18502/ijph.v52i11.14025. PMID: 38106821; PMCID: PMC10719707.
Note: The information provided in this blog is intended for general knowledge. It is important to remember that it should not replace professional medical advice. If you have any concerns about your health or cancer symptoms, please consult a healthcare provider.
