1.What is laryngeal cancer? Which part of the body is the larynx located?
The larynx is the organ where we make sounds and is located in the center of the front of the neck, right where the laryngeal node is. The upper part of the larynx is continuous with the oropharynx and the lower part is connected with the trachea. There is a band in the left and right of the larynx called the vocal cords, and when we speak, airflow passes through the vocal cords and sound is produced by the opening and vibration of the vocal cords.
Anatomically, the laryngeal cavity is divided into 3 regions.
(1) Supraglottic region.
The larynx above the vocal folds (including the epiglottis, aryepiglottic folds, pseudovocal folds and laryngeal chambers)
(2) The vocal fold region.
(3) Subglottic area of the vocal folds: between the lower vocal folds and the beginning of the trachea. Cancer that occurs in the larynx is called laryngeal cancer.
2.How is laryngeal cancer caused?
Smoking and alcohol abuse are the causes of laryngeal cancer. Therefore, the incidence of laryngeal cancer in men is greater than that in women. The best way to prevent laryngeal cancer is to quit smoking and drinking.
3.What are the manifestations of laryngeal cancer?
Because the larynx is an articulation organ, hoarseness occurs when a tumor grows on the vocal cords. Because of the growth of tumor, it may also cause pain in throat (sometimes cause earache), breathlessness, foreign body sensation in throat, cough, blood in sputum, neck lump, etc.
4.What tests should be done if I suspect laryngeal cancer?
When these symptoms persist and get worse gradually, you should see a doctor. The doctor will first do a physical examination based on the internal manifestations and touch the neck for any lumps. If necessary, laryngoscopy and CT will be done, which is a slim tube that can see the whole laryngeal cavity, and when a lump is found, a biopsy can be taken for pathological examination to confirm the diagnosis, and CT examination can be done to understand the extent of surrounding invasion and metastasis of the cancer. MRI, barium meal and other auxiliary examinations can also be done to understand the lesion in detail.
5.What should be done after the diagnosis of laryngeal cancer? Should we operate immediately?
The treatment methods for laryngeal cancer include radiotherapy, surgery and chemotherapy. The choice of treatment means depends on the stage of laryngeal cancer, and the treatment principles are different for different stages. People have only one articulation organ, so rash surgery will make people lose their articulation function forever and become mute. Therefore, the treatment of laryngeal cancer not only emphasizes the cure, but also the importance of preserving the normal laryngeal articulation function. Surgery for laryngeal cancer should be considered carefully! The following are described separately.
Early stage laryngeal cancer: radiotherapy and surgery have the same effect. If you don’t want to become mute, please prefer radical radiotherapy. Mid-stage laryngeal cancer: partial radiotherapy can be done first, if the radiotherapy effect is good, you can continue to complete radiotherapy to radical dose, otherwise surgery to remove the larynx. Advanced laryngeal cancer: the lesion is extensive and the prognosis is not good, so all treatments are needed at this time. Generally, it is preoperative radiotherapy + surgery + postoperative radiotherapy (or chemotherapy).
6.How to stage laryngeal cancer?
The staging of laryngeal cancer is complicated, so for the sake of understanding, the following is a brief overview.
Early stage laryngeal cancer: refers to stage I-II lesions, tumor is confined to the laryngeal cavity, and the vocal cord activity is normal or limited
Intermediate laryngeal cancer: refers to stage III lesion, the tumor is confined to the larynx with vocal cord fixed, or with metastatic lymph nodes in the neck ≤3cm Late laryngeal cancer: refers to stage IV lesion, the tumor invades outside the laryngeal cavity (such as invading thyroid cartilage, trachea, esophagus, neck tissue, etc.), or the lymph nodes in the neck >3cm, or distant organ metastasis.
7.Is radiotherapy for laryngeal cancer painful? How long does radiotherapy take? What is the time to know whether radiotherapy is effective or not?
Radiation therapy uses radioactivity to inhibit the division and growth of tumor cells, and ultimately to destroy the tumor. It takes several days to several weeks for the effect of radiotherapy to take effect, and the necrosis of tumor cells will continue for some time after radiotherapy is completely finished. Therefore, the efficacy of radiotherapy is usually judged by re-examination of electronic laryngoscopy and CT 3 months after the end of radiotherapy.
While the radiation kills the tumor cells, the normal tissue cells in the irradiated field will also be damaged. As the radiotherapy continues, this damage will gradually accumulate and manifest as: no pain and other discomfort at the beginning of radiotherapy, but as the radiotherapy continues, the patient will feel pain in the throat, increased swallowing pain, skin pigmentation or ulceration in the radiotherapy area. The radiotherapist will deal with these symptoms accordingly. These radiotherapy reactions will recover soon after radiotherapy is finished, so do not give up radiotherapy because of these temporary radiotherapy reactions to the extent of losing the opportunity to preserve the throat and speak.
Radical radiotherapy alone takes 6-7 weeks to complete. Pre-operative radiotherapy usually takes 4-5 weeks. If the residual tumor is large, it takes the same time for radical radiotherapy; if only a small amount of cancer cells remain, the radiotherapy time is the same as preoperative radiotherapy.
8.What if laryngeal cancer recurs after radiotherapy review?
Early laryngeal cancer radiotherapy and surgery have similar effect, with 5-year survival rate of 65-90%. Therefore, regardless of surgery or radiotherapy, there is a certain percentage of recurrence rate. For those who have recurred after radiotherapy for early laryngeal cancer and then choose surgery to remove it, the final 5-year survival rate can be increased to 80-95%.