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Home / Learning About Throat Cancers /

Laryngeal Cancer – Stages, symptoms, prognosis and treatment options

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Laryngeal Cancer – Stages, symptoms, prognosis and treatment options

by LabexTrade
Laryngeal cancer is one of the most common cancers impacting the head and neck, representing about 25% of malignant tumors that affect this location and 2% of all deadly diseases.

Around 2/3 of these tumors appear in the true vocal cords and 1/3 affects the supraglottic larynx (that is, they are located above the vocal cords).

Laryngeal Cancer Symptoms

The first symptom is important and indicates the location of the lesion. Hence, odynophagia (aching throat) suggests supraglottic growth and hoarseness shows a glottic and subglottic growth. 

Supraglottic cancer is typically accompanied by other signs such as changes in voice quality, moderate dysphagia (difficulty swallowing) and a feeling of a "lump" in the throat.

Laryngeal Cancer Risk Factors

Association between extreme alcohol intake and cigarette smoking addiction demonstrates a clear connection with the development of cancer in the upper aerodigestive paths. Smoking is the most significant risk aspect for the development of laryngeal cancer. 

When excessive alcohol consumption is contributed to cigarette smoking, the danger increases for supraglottic cancer.

Laryngeal cancer patients who continue to smoke and drink are most likely to increase the risk and not to be able to cure the 2nd main tumor in the head and neck location.
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Laryngeal Cancer Treatment

The treatment of cancers of the head and neck can trigger issues with teeth, speech and swallowing. The earlier the diagnosis, the higher the possibility that the treatment will avoid psycho-social issues and physical deformities. 

It is essential to assess a multidisciplinary group made up of dental experts, plastic surgeons, reconstructive plastic surgeon, speech therapist, radiotherapist, cosmetic surgeon and clinician in the treatment planning, rehabilitation phase and evaluation of the outcomes of the healing techniques utilized.

In addition to the survival data, considerations about the lifestyle of patients amongst the healing techniques utilized are extremely crucial to determine the very best treatment. 

The impact of preserving the voice on the client's lifestyle is of the utmost importance, since laryngectomy (elimination of the throat) triggers 30% of clients to have incomprehensible esophageal speech and roughly 50% of them are prisoners in your home, therefore losing their jobs and withdrawing from social life. 

Depending on the place and stage of the cancer, it can be treated with radiotherapy or surgical treatment, with a series of surgeries available according to the qualities of the case and the client.

You can read more about the different operations in “Learn More About The Different Operations”

In some cases, in order to preserve the voice, radiotherapy can be picked.

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General Information About Laryngeal Cancer

Laryngeal cancer is a disease in which deadly (cancer) cells form in the tissues of the throat.

Use of tobacco items and drinking excessive alcohol can affect the danger of laryngeal cancer.

Symptoms and signs of laryngeal cancer include an aching throat and ear pain.

Tests that analyze the throat and neck are utilized to help diagnose and stage laryngeal cancer.

Particular factors affect diagnosis (opportunity of healing) and treatment alternatives.

Signs and symptoms of laryngeal cancer include an aching throat and ear discomfort.

These signs and symptoms might be caused by laryngeal cancer or by other conditions. Check with your physician if you have any of the following:

  • An aching throat or cough that does not disappear.
  • Problem or pain when swallowing.
  • Ear discomfort.
  • A swelling in the neck or throat.
  • A modification or hoarseness in the voice.

Tests that examine the throat and neck are utilized to help identify and stage laryngeal cancer.

The following tests and procedures might be used:

Physical examination of the throat and neck: An exam to check the throat and neck for unusual locations. The neck will be felt for swollen lymph nodes.
Biopsy: The elimination of cells or tissues so they can be viewed under a microscope by a pathologist to check for indications of cancer. The sample of tissue might be eliminated throughout one of the following treatments:
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Laryngoscopy: A treatment in which the medical professional checks the larynx (voice box) with a laryngoscope or a mirror to look for irregular locations. A laryngoscope is a thin, tube-like instrument with a light and a lens for viewing the inside of the throat and voice box. It might likewise have a tool to get rid of tissue samples, which are inspected under a microscopic lense for signs of cancer.
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Endoscopy: A procedure to look at organs and tissues inside the body, such as the throat, esophagus, and trachea to check for abnormal areas. An endoscope (a thin, lighted tube with a light and a lens for viewing) is inserted through an opening in the body, such as the mouth. An unique tool on the endoscope might be used to remove samples of tissue.
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CT scan (FELINE scan): A treatment that makes a series of comprehensive images of areas inside the body, drawn from various angles. The pictures are made by a computer linked to an x-ray maker. A dye might be injected into a vein or swallowed to assist the tissues or organs appear more clearly. This procedure is likewise called computed tomography, computerized tomography, or computerized axial tomography.
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MRI (magnetic resonance imaging): A treatment that utilizes a magnet, radio waves, and a computer to make a series of in-depth pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
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PET scan (positron emission tomography scan): A procedure to discover malignant growth cells in the body. Deadly tumor cells show up brighter in the image since they are more active and take up more glucose than normal cells do.
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PET-CT scan: A treatment that integrates the pictures from a positron emission tomography (ANIMAL) scan and a computed tomography (CT) scan. The PET and CT scans are done at the same time with the very same maker. The combined scans offer more comprehensive images of locations inside the body than either scan provides by itself. A PET-CT scan might be used to help detect disease, such as cancer, strategy treatment, or find out how well treatment is working.
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Bone scan: A procedure to check if there are quickly dividing cells, such as cancer cells, in the bone. An extremely small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones with cancer and is detected by a scanner.

The client drinks a liquid that contains barium (a silver-white metallic substance). This procedure is also called an upper GI series.

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The following stages are utilized for laryngeal cancer:

Stage 0 (Cancer in Situ).

In Stage 0, irregular cells are found in the lining of the throat. These abnormal cells might become cancer and spread into close-by typical tissue. Stage 0 is likewise called carcinoma in situ.

These cancers are usually glottic (vocal cord) cancers that are found early because of voice modifications.

They are almost constantly treatable with either endoscopic surgical treatment or radiation treatment.

The patient is then viewed closely to see if the cancer returns.

Radiation can be utilized if the cancer does come back.

Almost all individuals at this stage can be cured without major surgical treatment. 

It's crucial for them to know that if they smoke, continuing to do so makes treatment less most likely to work and increases the danger that another growth will establish.

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Stage I.

Many people with stage I and II laryngeal cancers can be treated successfully without completely eliminating their throat.

Either radiation alone (without surgery) or partial laryngectomy can be used in many people. 

Many doctors utilize radiation treatment for smaller sized cancers. 

Voice results tend to be much better with radiation treatment than with partial laryngectomy, and there tend to be fewer problems with radiation treatment.

In stage I, cancer has formed in the supraglottis, glottis, or subglottis area of the larynx:

Supraglottis: Cancer remains in one location of the supraglottis and the vocal cords work generally.

Glottis: Cancer remains in one or both vocal cords and the vocal cords work usually.

Subglottis: Cancer is in the subglottis only.

Stage II.

In stage II, cancer has formed in the supraglottis, glottis, or subglottis area of the larynx:

Supraglottis: Cancer is in more than one location of the supraglottis or has infected the area at the base of the tongue or to tissues near the vocal cords. The vocal cords work usually.

Glottis: Cancer has actually spread to the supraglottis, subglottis, or both, and/or the vocal cords do not work typically.

Subglottis: Cancer has actually spread to one or both vocal cords and the vocal cords might not work usually.

The treatment for glottic (vocal cord) cancers and supraglottic cancers (those beginning above the vocal cords) is somewhat different. Some early glottic cancers might be treated by getting rid of the singing cable with cancer (cordectomy), and even by laser surgery. Radiation or surgery is generally enough to deal with most glottic cancers unless there are indications that the treatment may not have actually treated the cancer (such as finding cancer cells at the edge of the removed tumor). Your choices may consist of radiation chemoradiation, therapy, or surgery to get rid of more of the throat if you need more treatment after surgical treatment.

Supraglottic cancers are more likely to spread out to the neck lymph nodes. 

If, after surgical treatment, the cancer is found to have features that make it more likely to come back, more treatment such as radiation therapy, chemoradiation, or more extensive surgical treatment may be needed.

Stage III.

In stage III, cancer has actually formed in the supraglottis, glottis, or subglottis location of the larynx:

  1. cancer remains in the throat just and the vocal cords do not work, and/or cancer has spread out near or through the inner part of the thyroid cartilage. Cancer may have also infected one lymph node on the same side of the neck as the primary growth and the lymph node is 3 centimeters or smaller sized; or

  2. cancer is in one area of the supraglottis and the vocal cords work typically. Cancer has actually spread to one lymph node on the same side of the neck as the main growth and the lymph node is 3 centimeters or smaller sized; or

  3. cancer is in more than one location of the supraglottis or has actually infected the area at the base of the tongue or to tissues near the vocal cords. The vocal cords work normally. Cancer has likewise spread to one lymph node on the same side of the neck as the primary tumor and the lymph node is 3 centimeters or smaller.
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The primary options for initial treatment for these cancers are surgery or chemotherapy with radiation. 

Radiation therapy alone (or with the targeted drug cetuximab) may be an alternative for people who can not endure more intensive treatments.

Surgical treatment for these tumors is usually a complete removal of the throat (total laryngectomy), however a small number of these cancers might be dealt with by partial laryngectomy.

If they haven't spread currently, these cancers have a higher danger of spreading to nearby lymph nodes in the neck, so these lymph nodes are frequently removed in addition to the tumor if surgery is being done. 

Radiation treatment, often given with chemo, may be needed after surgical treatment, particularly if the cancer has actually infected the lymph nodes or has other functions that make it most likely to come back.

Another option may be to start with just chemotherapy, which is called induction chemotherapy. 

Radiation treatment or chemoradiation is then given if the growth diminishes. 

If the tumor doesn't shrink, surgery is typically the next treatment.

Stage IV.

Stage IV is divided into stage IVA, stage IVB, and stage IVC. Each substage is the same for cancer in the glottis, supraglottis, or subglottis.

In stage IVA:

  1. Cancer has spread through the thyroid cartilage and/or has spread to tissues beyond the larynx, such as the neck, trachea, esophagus, or thyroid. Cancer may have also spread to one lymph node on the very same side of the neck as the primary tumor and the lymph node is 3 centimeters or smaller sized; or
  2. Cancer may have spread out from the subglottis, glottis, or supraglottis to tissues beyond the throat, such as the neck, trachea, thyroid, or esophagus. The vocal cords may not work normally. 

Cancer has spread out:

  • to one lymph node on the very same side of the neck as the main growth and the lymph node is 3 centimeters or smaller. Cancer has spread out through the outside covering of the lymph node; or.
  • to one lymph node on the exact same side of the neck as the main tumor and the lymph node is larger than 3 centimeters but not larger than 6 centimeters. Cancer has actually not spread out through the outdoors covering of the lymph node; or.
  • to more than one lymph node on the exact same side of the neck as the primary tumor and the lymph nodes are not larger than 6 centimeters. Cancer has not spread through the outdoors covering of the lymph nodes; or.
  • to lymph nodes on both sides of the neck or on the side of the neck opposite the primary growth and the lymph nodes are not larger than 6 centimeters. Cancer has not spread out through the outdoors covering of the lymph nodes.

In stage IVB:

Cancer might have spread out from the supraglottis, glottis, or subglottis to the area in front of the spinal column, the area around the carotid artery, or the area in between the lungs. The vocal cords might not work generally. 

Cancer has actually spread out:

  • to one lymph node that is larger than 6 centimeters. Cancer has not spread through the outdoors covering of the lymph node; or.
  • to one lymph node on the very same side of the neck as the main growth and the lymph node is larger than 3 centimeters. Cancer has spread out through the outdoors covering of the lymph node; or.
  • to more than one lymph node throughout the neck. Cancer has actually spread out through the outside covering of the lymph nodes; or.
  • to one lymph node of any size on the side of the neck opposite the main growth. Cancer has actually spread through the outside covering of the lymph node; or
  • Cancer has actually spread from the glottis, subglottis, or supraglottis to the space in front of the spine, the location around the carotid artery, or the location in between the lungs. Cancer might have likewise spread to one or more lymph nodes anywhere in the lymph and the neck nodes may be any size.
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In stage IVC

Cancer has spread to other parts of the body, such as the lungs, liver, or bone.

Cancer has actually also spread out to one lymph node on the same side of the neck as the primary tumor and the lymph node is 3 centimeters or smaller.

Cancer might have spread out from the subglottis, glottis, or supraglottis to tissues beyond the larynx, such as the neck, trachea, thyroid, or esophagus. 

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Cancer has actually spread:

Cancer may have spread out from the glottis, supraglottis, or subglottis to the space in front of the spinal column, the area around the carotid artery, or the location in between the lungs. Cancer has spread out.

As in Stage III, the main choices for preliminary treatment are surgical treatment or chemotherapy with radiation. 

Immunotherapy might be another option for some people with stage IV cancer.

If any cancer remains after treatment, surgery can then be done to attempt to remove it. 

In these cases, the finest treatment might be surgery to eliminate the throat and nearby tissues with cancer (such as the thyroid gland).

Cancers that are too big or have actually spread out too far to be entirely removed by surgical treatment are frequently treated with radiation, usually integrated with chemotherapy or cetuximab. 

Another alternative might be treatment with an immunotherapy drug, either alone or with chemotherapy. 

In some cases, if the tumor diminishes enough, surgery of lymph nodes in the neck might be an alternative. 

But for many advanced cancers, the goal of treatment is typically to slow the development or stop of the cancer for as long as possible and to assist alleviate any symptoms it may be causing.

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Most experts agree that treatment in a clinical trial needs to be thought about for sophisticated phase laryngeal cancers. 

This way patients can get the best treatment offered now and may likewise get the treatments that are believed to be even much better.

If you would like to join our FREE Post-Vocal Surgery Support Group, you can do so here: www.facebook.com/groups/labexsupportforlaryngectomee/ 

You  may want to check out our Youtube Channels as well: https://www.youtube.com/channel/UCa-6497yfIbbZbhUoqlKYvQ  

You can learn more about throat cancer surgeries in our other article here: https://labextrade.com/learn-more-about-the-different-throat-cancer-operations/ 

 

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