Cancer Of The Larynx

Get In Touch

Feel free to contact our friendly reception staff with any general or medical inquiries

+254 (020) 272 0480

Cancer Of The Larynx

The larynx, also called the voice box, is located in the throat at the top of the windpipe. It contains vocal cords that vibrate when air passes over them allowing us to make sounds and speak.

Cancer of the larynx is a disease of the voice box where abnormal cells grow out of control and spread quickly. They may spread to the glands of the neck and in some instances to other parts of the body like the chest.
The two greatest factors that increase the risk of laryngeal cancer are tobacco and alcohol

1- Tobacco: This is the leading cause of head and neck cancer. It includes all tobacco products, including cigarettes, cigars, pipes, smokeless tobacco, chewing tobacco, snuff and betel quid
2- Alcohol: Frequent or heavy consumption of any type of alcohol, such as beer, wine, or liquor, also raises the risk
The most common symptoms of laryngeal cancer are:

1- Change or hoarseness of voice for a prolonged time
2- Trouble breathing or noisy breathing
3- Difficulty or painful swallowing
4- Lump in the neck
5- Persistent ear pain
6- Sore throat that doesn’t go away
7- Cough or coughing up blood

The above complaints are frequently caused by other conditions other than cancer of the larynx. However, persistence of symptoms despite appropriate treatment should increase suspicion of cancer
Getting to a diagnosis starts with a history and a physical examination.

If the history and physical examination make the ENT doctor less suspicious that your lesion is cancer, he or she might try some medications and rehabilitation before jumping to a diagnosis of cancer.

If the ENT doctor raises the possibility of laryngeal cancer, a cancer work up is initiated.

Looking into your mouth and down your throat into the voice box with a mirror or endoscopy (a tube with a camera passed) or an examination under anaesthesia (in an operating room is performed. Imaging procedures (Xrays, ultrasound, CT scans or MRIs) to create a picture of inside of the body, and laboratory tests is done. This helps with staging the disease and knowing its extent. Knowing the stage of the disease helps the ENT doctor plan treatment.

A biopsy is the removal of a small piece of tissue to examine under a microscope to see if it is cancerous. A fine needle aspirate is done is commonly done if you have a lump in the neck. The doctor puts a thin needle in the lump and removes a small sample of tissue. Then a pathologist looks at the tissue under a microscope. These are the only ways to be certain if you have cancer.

If you came to the ENT doctor after having a lesion removed and found it was cancer only after having the lesion removed, the doctor might skip some of the tests and jump to follow-up or additional treatment.

Be sure to bring all the reports and images with you from any prior treatment or if it is for a second opinion
The prognosis depends on the:

1- Stage of the cancer
2- Size and location of cancer
3- Grade of the cancer
4- Age, gender and general health
5- Whether this is a new cancer or a recurrent cancer

Staging is a process that tells the doctor if the cancer has spread and if it has, how far. It depends on the severity of the original tumour, and whether the cancer has spread to lymph nodes or distant parts of the body. Staging is an important step in evaluating treatment options. Staging is slightly different for each specific type of head and neck cancer, but can be generalized as follows:

Stage 0: Also called “carcinoma in situ,” meaning it has not yet invaded nearby tissue.
Stage 1: Cancer has invaded nearby tissue, but has not yet spread to lymph nodes or other parts of the body
Stage 2: Cancer has grown even deeper into nearby tissue, but still has not spread to lymph nodes or other parts of the body.
Stage 3: Cancer has either grown much deeper into surrounding tissue or started to spread to one lymph node.
Stage 4a: Cancer has grown completely through surrounding tissue into adjacent structures (such as tissue, cartilage, bone, or nerves) and may have spread to a few lymph nodes OR cancer has spread to more than one lymph node.
Stage 4b: Cancer has spread (metastasized) to other parts of the body

It is staged by physical examination, endoscopy and various imaging and lab tests. Staging helps understand the spread and extent of the disease.

The staging of the cancer is important in treatment options and prognosis.
After treatment with surgery or radiation, people can have problems eating, swallowing, or talking. If this happens, you will have treatment called rehabilitation, or “rehab” for short. During rehab, doctors, nurses, and other health professionals will work with you on eating, swallowing, or talking

Is there follow-up after treatment?

After treatment, your doctor will check you every so often to see if the cancer comes back. Follow-up tests can include exams, blood tests, and imaging tests. People who are treated for laryngeal cancer also need to see their dentist for regular follow-ups.

You should also watch for the symptoms listed above. Having those symptoms could mean your laryngeal cancer has come back. Tell your doctor if you have any symptoms.
There are 3 major ways to restore voice and speech production after surgery to the voice box.

Artificial larynx-this is a battery-powered device that produces vibrations when held against the neck and allows one to produce oral speech. An advantage is that it allows for immediate post-operative speech production. A distinct disadvantage is that the sound produced is robotic in nature.
Trachea-esophageal (TE) voice restoration-this offers spontaneous effortless speech production. Its success depends highly on surgical and clinical expertise.
Esophageal speech-this requires air drawn into the oesophagus then expelled causing vibrations and speech. The primary disadvantage is the time required to learn the technique and the voice quality.
The different options are not applicable to all patients without a larynx. The choice depends on the needs of the patient, capabilities, family support and motivation
Recurrent cancer is cancer that has come back after it has been successfully treated. The cancer is likely to come back in the first 2 or 3 years. It may come back in the larynx or other parts of the body.
The treatment options for cancer of the larynx that has come back are:

1- Surgery with or without radiotherapy
2- Radiotherapy
3- Chemotherapy
One of your biggest allies in battling cancer is your ENT doctor and cancer doctor (oncologist). Questions are your primary resource to gain a better understanding of your disease and enhance your quality of care. Well-thought-out questions can help you get the most out of your appointments and can make all the difference. Here are some questions you may want to ask:

What diagnostic tests do I need? What do they involve?
Can you explain my pathology report and test results to me?
What is the stage of the disease? What is the prognosis?
What is the goal of treatment? What are my treatment options?
What are the benefits of each treatment?
What are the risks and side effects of each treatment?
How will my condition be monitored during treatment?
Do you have any advice on managing side effects? What can I do to take care of myself during treatment?
What is treatment recovery like?
What should I tell other people (kids, parents, siblings, friends, etc.) about my cancer when they ask?
What will my follow-up appointment schedule be like?