Laryngeal Cancer

Laryngeal cancer is cancer that grows in the larynx or voice box. Laryngeal cancer is generally characterized by symptoms such as hoarseness, difficulty or pain when swallowing, and persistent coughing.

The larynx is part of the respiratory system. This organ connects the trachea (airway) and the windpipe. Apart from having an important role in producing sound, the larynx also functions to prevent food and drink from entering the respiratory tract.

Laryngeal cancer has a different cure rate for each person. This depends on the location of the cancer in the larynx and the stage of the cancer. The sooner laryngeal cancer is detected and treated, the greater the chance for the patient to recover.

Causes and Risk Factors for Laryngeal Cancer

Laryngeal cancer occurs when the DNA in healthy cells in the voice box changes or mutations. These changes cause these cells to grow abnormally and uncontrollably.

It is not known why mutations in laryngeal cells occur. However, this condition is thought to be related to the following factors:

• Have a habit of smoking and consuming alcoholic beverages
• Have a family history of throat cancer
• Suffer from certain genetic disorders, such as Fanconi anemia
• Have a diet that is too much meat and not enough fruits and vegetables
• Experiencing long-term exposure to asbestos dust or asbestosis
• Suffering from a human papillomavirus (HPV) infection

Laryngeal Cancer Symptoms

Unlike other types of cancer, laryngeal cancer symptoms are generally easy to detect. Symptoms that appear include:

• Hoarseness
• Sore throat
• Dysphagia or difficulty swallowing
• Pain when swallowing
• Earache
• Weight loss drastically
• Persistent cough that may be accompanied by blood
• Appears neck lump or swelling in the neck
• It's hard to breathe

When to see a doctor

The above symptoms can be caused by diseases other than laryngeal cancer. Therefore, to be sure, check with your doctor if you experience the symptoms above, especially if the symptoms have lasted more than 1 week or are getting worse.

Diagnosis of Laryngeal Cancer

To diagnose laryngeal cancer, the doctor will first ask about the patient's symptoms, complaints, and medical history. After that, the doctor will do a thorough physical examination, including looking at the outside and inside of the throat to detect lumps.

After the question and answer session and physical examination, the doctor will carry out supporting examinations to confirm the diagnosis. These supporting examinations include:

• Endoscopy
  Endoscopy aims to see the condition of the throat and voice box. This procedure is performed by inserting a small tube with a camera (endoscope) through the nostrils (nasoendoscopy) or through the mouth (laryngoscopy).
• Biopsy
  Biopsy is done by taking a tissue sample that is suspected of being cancer and then examining it under a microscope. Tissue samples can be taken from the voice box through endoscopy or from a lump in the neck through aspiration.
• Scans
  Scans to diagnose laryngeal cancer can be done with an ultrasound, CT scan , PET scan, or MRI. Besides aiming to determine the size of the cancer, scanning also serves to detect the spread of cancer to the lymph nodes or other areas of the body.

The results of this examination will be a reference for the doctor to determine the stage or severity of laryngeal cancer. The following are the stages of laryngeal cancer:

• Stage 0
  Stage 0 indicates that the abnormal cells are present in the larynx and have not spread to other organs. These cells can develop into cancer and spread to other organs.
• Stage I
  At this stage, abnormal cells in the larynx have turned into cancer. These cells are still small and have not spread.
• Stage II
  Stage II indicates that the cancer is getting bigger, but has not spread to other organs.
• Stage III
  In stage III, the cancer gets bigger and begins to spread to the lymph nodes or nearby organs.
• Stage IV
  Stage IV indicates that the cancer has spread ( metastasized ) to other organs of the body away from the larynx.

Laryngeal Cancer Treatment

Treatment for laryngeal cancer depends on the location and size of the cancer, as well as the patient's health condition. In laryngeal cancer which is still in its early stages, the doctor will choose surgery or radiotherapy. Meanwhile, in advanced laryngeal cancer, doctors can carry out a combination of surgery, radiotherapy and chemotherapy.

All of these treatment methods are carried out to remove or kill cancer cells, as well as relieve symptoms experienced by patients. The following is an explanation of each laryngeal cancer treatment:

Radiotherapy

Radiotherapy is a procedure that uses radiation to kill cancer cells or stop them from growing. Radiotherapy can be done before surgery, to shrink the tumor so that it can be easily removed, or it can be done after surgery, to prevent cancer cells from growing back if some are still left.

Chemotherapy

Chemotherapy is the administration of special drugs to kill or stop the growth of cancer. Just like radiotherapy, chemotherapy can be done before or after surgery. Chemotherapy can also be done together with radiotherapy if surgical options are not feasible.

Surgery

There are three types of surgery to treat laryngeal cancer. The surgical method chosen by the doctor will be adjusted to the patient's condition. The following are the types of surgery:

• Endoscopic resection Endoscopic
  resection is performed to cut out small tumors in the larynx with the help of an endoscope that is inserted through the mouth, so it does not require external incisions. The cuts can be made with a laser or special surgical tools that are inserted with the endoscope.
• Partial
  laryngectomy Partial laryngectomy is performed to cut out the cancerous part of the larynx. This procedure requires an incision in the patient's neck. After the cancer is removed, the doctor will make a temporary hole in the neck to help the patient breathe and talk during the recovery process.
• Total
  laryngectomy Total laryngectomy is performed to remove the entire larynx. Lymph nodes around the larynx will also be removed if they have cancer. After that, the doctor will make a permanent hole in the neck to help the patient breathe.

Patients who undergo total laryngectomy cannot speak normally as before. However, patients may undergo some therapy to train other ways of communicating or using sign language .

Laryngeal Cancer Complications

There are a number of complications that can occur in patients with laryngeal cancer. These complications can occur due to laryngeal cancer itself or its treatment measures. Some of these complications are:

• Malnutrition
• Lost voice
• The esophagus narrows
• Dysphagia or difficulty swallowing
• Disturbances in the function of the tongue in tasting flavors
• Formation of scar tissue in the esophagus
• Dry mouth
• Weakened body resistance

Laryngeal Cancer Prevention

Some efforts that can be made to reduce the risk of developing laryngeal cancer are:

• Quit smoking and consuming alcoholic beverages
• Eat antioxidant -rich foods , such as strawberries, nuts, and spinach
• Use personal protective equipment when working or doing activities in places where there is a risk of exposure to hazardous compounds