The incidence of laryngeal cancer accounts for 5.7% to 7.6% of all malignant tumors in the body and ranks third after nasopharyngeal cancer, nasal cavity and sinus cancer in the field of otolaryngology. The age of prevalence is 50-70 years old. The incidence rate is the highest in northeast China, and most of the patients are male. The cause of the disease is not yet clear, but the cities with heavy air pollution are higher than those with light pollution. Smoking, alcohol consumption, air pollution and virus infection are the main causes.
Early manifestations of laryngeal cancer.
1.Progressive hoarseness, progressively increasing hoarseness, is often a typical early symptom of laryngeal cancer. Hoarseness may be caused by various diseases, such as upper respiratory tract infection and laryngitis. These diseases can gradually improve after treatment, while the hoarseness of laryngeal cancer patients progressively worsens with the growth of cancer tumors.
2. Abnormal sensation of throat: early on, there is discomfort of swallowing or foreign body sensation in the throat, or even irritating dry cough; if laryngeal cancer patients are accompanied with intractable headache and neck pain, it means that they may have already entered the middle or late stage. For unexplained foreign body sensation in the throat or hoarseness, if the treatment effect is not good, whether it is caused by laryngeal cancer should be excluded.
3.Coughing up sputum with blood: tumor stimulation can cause persistent dry cough, tumor enlargement can cause dyspnea and laryngeal obstruction, and blood in sputum can appear in late stage.
When you or your family members have any symptom, you should consult a specialist for treatment
Most laryngeal cancers develop in the vocal cords. Even a small tumor can prevent the two vocal cords from meeting and vibrating. Therefore, if you or your family members experience hoarseness, throat discomfort, sore throat, etc., and if these symptoms persist for a long period of time and get progressively worse, anti-inflammatory treatment is ineffective, it should be suspected. Any middle-aged or elderly person who has had a hoarse voice for more than six weeks, and in a few cases, a neck lump, should seek medical attention from an ear, nose and throat specialist.
If you notice any of these symptoms, it is important to have them checked by a doctor. But remember, most people who have these symptoms do not necessarily have cancer. For example, laryngitis caused by a common viral infection can also show these symptoms.
What can cause laryngeal cancer?
To date, the cause of laryngeal cancer is not fully understood, but there are many studies and reports.
It is generally believed that the occurrence of laryngeal cancer is related to heavy smoking, viral infection, human papilloma virus infection, oncogenes, anti-cancer genes, and sex hormones. People with laryngeal cancer are mainly middle-aged and elderly, and men are more likely to develop laryngeal cancer than women. Like other cancers, laryngeal cancer is not contagious.
How is it diagnosed?
When you arrive at the hospital, the specialist will ask you about your medical history and then do a physical examination, which includes the presence of enlarged lymph nodes on both sides of your neck, using a laryngoscope. The doctor will ask you to open your mouth and stick your tongue out, spray anesthetic into your throat, and then place the laryngoscope in the back of your mouth to examine the larynx. If abnormalities are found, or if you cannot see clearly with the mirror, the doctor will ask you to have a fiberoptic examination, which can know exactly the appearance of the lesion site, the scope and the activity of the organ, can see the parts that cannot be seen by indirect laryngoscopy, whether there is a tumor, and can clamp the biopsy for pathological examination, with video and photos for data preservation. Only after the biopsy is done, the doctor can make the final diagnosis. If your larynx is anesthetized, please do not eat anything for one hour after the examination until your larynx returns to normal sensation. Otherwise, there may be a risk of food entering elsewhere when you swallow.
What should I do if I am diagnosed with laryngeal cancer?
If the biopsy shows that you have laryngeal cancer, please don’t panic and be afraid, go to a specialist hospital as soon as possible and discuss with the specialist which treatment option to choose.
The choice of laryngeal cancer treatment is related to the degree of the lesion. Early stage patients can choose radiotherapy or surgery, while mid- to late-stage patients can choose a comprehensive treatment based on surgery, including partial laryngectomy, total laryngectomy and combined radical laryngectomy.
You may find that other laryngeal cancer patients in the hospital are treated differently from you. This happens all the time because they have different types of cancer and therefore need different treatments. Some people want to hear more professional advice before choosing a treatment, so talk to your doctor and ask for an intra-departmental consultation so that you can hear more expert opinions.
When you have laryngeal cancer, please quit your smoking habit as soon as possible, it will help you a lot in your healing process.
Surgical treatment
Surgical treatments include partial laryngectomy, total laryngectomy and combined radical laryngectomy for laryngeal cancer.
If partial laryngectomy is performed, the articulation function will be affected and become hoarse, but you can still speak, and your breathing usually does not need to be rerouted, and your life is generally normal. If total laryngectomy is performed, the patient’s life will be more affected, and the articulation function will be lost, and the patient will need to have a median tracheostomy under the anterior neck, and the breathing will be rerouted, which will cause inconvenience.
Patients often have ideological concerns about the renewal of speech after total laryngectomy, medical staff and family members should do patient and meticulous explanation work, pointing out that after surgery, after exercise, through the early son larynx can also communicate with others to eliminate their concerns. Make routine examination before the operation, blood preparation, skin test and body temperature measurement one day before the operation. Sleeping pills and fasting are given the night before surgery.
During the procedure, the surgeon will insert a gastric tube to bring liquid nutritional food through the nose and into your stomach. A drainage tube is placed in the wound to drain unnecessary fluid and allow the wound to heal as quickly as possible.
Nasal feeding tube is very important for patients with total laryngectomy, please do not remove it at will, usually leave it in place for 7-10 days and remove it if the wound heals well, or continue nasal feeding if a pharyngeal fistula develops, until the fistula heals and only then eat through the mouth.
Pay attention to the tightness of the tracheal tube ligature, generally to intervene a finger without patient discomfort is appropriate, too loose must be tied tightly to prevent the tracheal sleeve slip out. After hemilaryngectomy, the tracheal sleeve can be removed after the swallowing function is restored. After blocking the tracheal sleeve for 24 hours before removal, no respiratory distress occurs, the sleeve can be removed and the wound can be closed with butterfly tape.
It must be cool that the disinfection time for removing the inner cannula should not be too long, preferably not more than 30 minutes, too long, easy to make the inner diameter of the outer casing blocked by secretions after drying crust. In case of dry weather, a mixture of proportional saline – chymotrypsin, gentamicin, 2-3 drops once an hour, into the tracheal sleeve can be used.
The tracheostomy will follow you for the rest of your life and you may panic at the beginning. The nurse will help you to take care of this stoma until you are confident to handle it by yourself.
Because the air inhaled through the breathing hole goes directly into the lungs, patients must remember to avoid cold and hot environments, as well as inhaling exhaust fumes, smoke and dust. You will not sneeze through your nose in the future. In addition, your sense of smell will sometimes be affected, but you will regain some of it after a few months.