A Family Doctor's Tale - LARYNGEAL CANCER

DOC I HAVE LARYNGEAL CANCER

Cancer of the larynx are not that common in a family practice however there are fairly many cases in the ENT Department.
 The only patient I saw in my clinic was a elderly man with loss of voice at the age of 55. He was referred to the ENT department after medication did not improve his voice. There a biopsy of the swelling in the larynx  show evidence of early cancer. He was treated by surgical removal of the swelling followed by radiotherapy. Happily he was well after the treatment except for still some hoarseness of the voice but there was no recurrence of the cancer.
The cases in the ENT department were different. Most have extensive surgery with tracheostomy. There has to be proper care of the tracheostomy. In most cases the tracheostomy can be closed after reconstructive surgery and speech therapy.


Laryngeal cancer occurs when the cells lining the larynx(the vocal box) become abnormal and proliferates giving rise to cancer cells.

It affects more men than women.


Various causes may be involved:
1.Genes. -males over the age of 55 years are at four times higher
risk than females.

2.Smoking. People who smokes have a higher risk than non smokers

3.Drinking alcohol can increase the risk of laryngeal cancer.

4.Occupation. There is evidence that workers exposed to sulfuric acid and asbestos have a higher risk of developing laryngeal cancer.

The following are symptoms of  Laryngeal cancer:
1.Hoarseness or other changes in the voice

2.A painless lump in the neck-usually a lymph node
infiltrated by cancer cells

3.Cough that does not go away

4.Persistent sore throat or a feeling that there is something
stuck in the throat

5.Difficulty in breathing or speaking

6.Ear pain

7.Weight loss

Diagnosis of Laryngeal Cancer is by:
Examination of the throat, vocal cords and neck for abnormal lumps

An endoscope is inserted into the throat to look at the vocal cords and their movement. 
The ENT specialist may extract issue (biopsy) which can be sent for testing, to confirm if there is a cancerous growth.

If a tumor is found, magnetic resonance imaging (MRI) can be
used to assess its size.

Treatment depends on the diagnosis of the laryngeal cancer and its spread outside of the vocal box.
Usually most laryngeal cancer are slow spreading. 

A.Radiotherapy.
This is the most common treatment for small cancer of the larynx. This involves the use of radiation to attack cancer cells, stopping them from growing or multiplying.

B.Chemotherapy.
This involves the use of anti-cancer medication to treat
the cancer.

For both methods, the patient may experience side-effects such as tiredness and nausea.

Radiotherapy are often used together with chemotherapy.

C.Surgery
Surgery is used only when the cancer can not be treated by
radiotherapy or chemotherapy because the removal of the vocal
cords or the entire larynx can cause the loss of voice.
The lymph node in the neck may also be removed at the same time.

If surgery is done , usually a tracheostomy or hole in the
windpipe is done to allow air to enter or escape from the tubes in the lungs.

Some patient may also require a feeding tube after surgery because swallowing of food is affected by the surgery.
Most people will learn to swallow again so the feeding tube is
temporary.

Early treatment is recommended as it increases the patient's chances of survival.
Delayed action could result in the cancer spreading to other parts of the body, making it more difficult to treat.

Living with a Tracheostomy.
The tracheostomy in the windpipe is necessary for air to enter and leave the lungs.
However the tracheostomy must be kept clean at all time and free of infection. Suction of mucus stuck in the windpipe may be necessary.
It is also dangerous for water to enter the windpipe and the lungs through the tracheostomy opening.
The tracheostomy opening should always be protected with a a
plastic stoma shield or scarf to prevent dust, water or smoke to
enter the windpipe.

After the surgery there may be loss of voice. 
A speech therapist is usually needed to teach the patient to learn to speak again.
He can teach the patient to use the oesophagus to force air
through the throat to produce new gutterial sounds. 
In the meantime, communication can be done with writing pads or computer.
New electronic and mechanical devices can also produce new
sounds

No one can be fully protected from laryngeal cancer.
However, you can modify your lifestyle practices to reduce your
chances of contracting laryngeal cancer.

Don't smoke. Smoking increases the risk of laryngeal cancer by two to four times. Those who smoke, can still lower their risk by cutting down on the number of cigarettes smoked a day. Better still, quit smoking.