What is Throat Cancer?
Throat cancer is among the head and neck cancers; It occurs in the area where the vocal cords are located between the tongue root of the throat and the trachea. Laryngeal cancer is one of the most common cancer types among head and neck cancers.
What Are the Symptoms of Throat-Like?
Hoarseness lasting more than 3 weeks: Hoarseness is the most common symptom of laryngeal cancer, but laryngeal cancer is not the only cause of hoarseness. Many reasons such as acute laryngitis, also called laryngitis, shouting too much, smoking, reflux, runny nose, allergies, thyroid problems, old age can cause hoarseness. In addition to hoarseness, it is necessary to pay attention to sudden changes in the tone.
Difficulty in swallowing: Difficulty in swallowing can be defined in different ways. A feeling of crumbs stuck in the throat, not being able to swallow food completely, pain or burning sensation during swallowing, feeling as if the food is sticking to the throat can be called swallowing problems.
Not every swallowing difficulty is a symptom of laryngeal cancer. A harmless narrowing of the esophagus known as a stricture can also cause swallowing difficulties. However, advanced laryngeal tumors can also cause difficulty in swallowing.
Weight loss: Uncontrolled weight loss can occur as a symptom of many cancers, not just laryngeal cancer, and is more common in advanced stages of laryngeal cancer. Routine check-ups can be life-saving when 4-5 kg is lost in a short time.
Shortness of breath: Shortness of breath or wheezing are also among the symptoms of laryngeal cancer. Especially in cases of progressive wheezing and shortness of breath, laryngeal cancer should be considered.
- A feeling of lump or swelling in the throat
- Tiredness
- Bad breath
- Earache
- weight loss
Many of these symptoms can be caused by non-cancer health problems. Similar symptoms can be seen, especially in people who have used cigarettes and alcohol for many years.
These symptoms, which are the symptoms of laryngeal cancer, can also be caused by non-cancerous causes.
Chronic laryngitis, smoking, reflux, forcing the voice, non-malignant benign tumors, tissue growths called laryngeal nodules in the vocal cords, wart-like growths in the larynx caused by HPV can be confused with the symptoms of laryngeal cancer. However, taking into account the symptoms and having the necessary controls can be life-saving.
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What are the Causes of Throat Cancer?
Tobacco and alcohol use: Alcohol and tobacco use are among the most important risk factors that increase the risk of laryngeal cancer. The higher the amount of tobacco and alcohol use and the more years of use, the higher the risk factor. Those who smoke more than 25 cigarettes a day or have smoked for more than 30 years are about 40 times more likely to develop laryngeal cancer than non-smokers, and long-term and regular drinkers are 3 times more at risk than non-drinkers. Smoking is the cause of the majority of head and neck cancers, including laryngeal cancer. Do not use cigarettes or tobacco products. People who are constantly exposed to cigarette smoke also have an increased risk of developing laryngeal cancer.
Gender: The risk of laryngeal cancer is 4-5 times higher in men than in women. However, the prevalence of smoking among women in recent years causes laryngeal cancer to be seen more frequently in women.
Genetic factors: Those with a family history of head and neck cancer or laryngeal cancer have a higher risk of developing laryngeal cancer than those who do not.
Age: As in many cancer types, advancing age is among the most important risk factors in laryngeal cancer, and laryngeal cancer is rarely seen under the age of 40.
Diet: People who consume more red meat, processed foods or fried foods have a higher risk of developing laryngeal cancer, and there are studies showing that a diet deficient in vitamins A and E is also the cause of laryngeal cancer. Known as the Mediterranean diet, eating mainly fresh fruits and vegetables and getting enough vitamins A and E can reduce the risk of laryngeal cancer.
HPV virus: There are scientific studies showing that HPV (Human papillomavirus infection) virus, which is mostly transmitted sexually and causes genital warts, cervical and vaginal cancer in women, can also cause laryngeal cancer. HPV is a common infection and can go away on its own in most people without causing any problems.
Exposure to harmful substances: Prolonged exposure to some occupational harmful or chemical substances can lead to laryngeal cancer.
- Sawdust
- Soot or coal dust
- Paint fumes
- Formaldehyde used in many industries such as paint production and cosmetics
- Nickel
- Isopropyl alcohol used as a cleaning solvent
- Sulfuric acid mist
- Asbestos
- Poor oral hygiene and reflux disease can also cause laryngeal cancer.
How is Laryngeal Cancer Diagnosed?
Early diagnosis of laryngeal cancer provides significant advantages in treatment. It is vital that those with one or more of the symptoms go to a specialist otolaryngologist without delay.
Doctor’s examination: In the diagnosis of laryngeal cancer, a doctor’s examination can give an idea about the disease. Physician in the examination; evaluate lifestyle and occupational risk factors such as smoking and alcohol use. Since there may be a lump-shaped swelling in the throat in laryngeal cancer, he performs a physical examination. During the physical exam, the doctor will examine the inside of the mouth for lumps or swelling, including the cheeks and lips, the floor of the mouth, the back of the throat, and the nose and ears. In addition, some tests and imaging methods can be used to clarify the diagnosis of laryngeal cancer.
Nasendoscopy: It is a type of endoscopy used by the physician to see the larynx and throat better. A flexible tube with a light and a small camera at the end is entered through the patient’s nostrils and the presence of an abnormal structure in the larynx is examined. No preparation is required before nasendoscopy.
Laryngoscopy: Nasendoscopy is applied when the larynx cannot be examined sufficiently or when a suspicious formation is determined. The endoscope used in the laryngoscope procedure is longer and the application is carried out orally. The use of blood thinners before the laryngoscope can be stopped. The procedure is usually done under general anesthesia.
Video Laryngostroboscopy: It can be applied in patients who are not suitable for general anesthesia or in the diagnosis of tumors arising in the vocal cords. The endoscope used has a camera and a fiber optic flash light at the end. It can also be applied to evaluate the vocal cords before, during and after the treatment, and the procedure, which takes about 30 minutes, can be performed under local anesthesia.
Biopsy: When a suspicious structure is seen in the areas examined during nasendoscopy or laryngoscopy, a tissue sample can be taken and sent to the laboratory. Some or all of the tissue suspected of cancer may be surgically removed for biopsy. Fine needle aspiration biopsy can also be performed in cases where there is a lump felt in the neck.
Imaging methods can also be used in the diagnosis of laryngeal cancer. Imaging methods such as X-ray, ultrasound, Computed Tomography (CT), Magnetic Resonance (MR), and PET give an idea of the exact area and size of the cancer.
What is the Treatment of Throat Cancer?
It is possible that the treatment of laryngeal cancer may differ according to the exact location of the tumor, its stage, grade and general health status of the patient. Generally, surgery, radiation therapy (radiotherapy) and chemotherapy are applied in the treatment of laryngeal cancer. One of these options or combination treatments can be used in the treatment.
Surgical Treatment of Laryngeal Cancer
Endoscopic (partial laryngeal removal by method) Resection (Endoscopic Laser Surgery)
It is a suitable surgical technique mostly for early stage laryngeal cancers and locally advanced laryngeal cancer patients.
Endoscopic resection surgery, which is popularly known as intraoral laser surgery, is performed orally, so no incision is made.
Since laser is used during the procedure, bleeding is less.
The procedure is performed in the operating room under general anesthesia.
Necessary surgical instruments and laser are passed through the tube placed from the mouth to the vocal cords, and in the operation performed under the microscope, the surgeon can clearly see the cancerous tumor.
Depending on the condition of the tumor, the surgeon can cut a part of it with a laser or completely remove it with a high-energy laser.
Before endoscopic laser surgery, it is necessary to determine whether the patient is suitable for this surgery. Since laser surgery is done orally, the patient’s teeth and throat structure must be suitable for this procedure.
The length of stay in hospital after intraoral laser surgery may vary depending on the region and size of the tumor.
Swelling, which usually occurs after endoscopic laser surgeries performed on large tumors, may cause breathing or feeding problems.
Intraoral laser surgery usually does not cause permanent problems in speaking and swallowing. There is a speech restriction for a few days after the surgery. In long-lasting speech problems, it is possible to work with a speech therapist to give positive results.
Laryngeal Cancer Laryngectomy Surgery
Depending on the size and location of the tumor, the part of the larynx affected by cancer or the whole is removed with the surgical method.
Operations in which a part of the larynx is removed, also called partial laryngectomy, can be performed by making a small incision in the neck, or it can be performed by mouth without incision.
In partial laryngectomy operations, a small hole is made in the neck so that the patient can breathe, and this hole is usually closed after the operation.
After partial laryngectomy operations, temporary speech problems may be experienced for a while, but generally speaking and breathing problems are not seen after the healing process.
In total laryngectomy operations, in which the entire larynx is removed, the trachea is connected to the hole in the throat in order to breathe.
In total laryngectomy, that is, the operations where the entire larynx is removed, the permanence of the hole in the throat is in question.
After total laryngectomy operations, the patient loses his voice. The patient can communicate with voice prostheses produced as a speech device or a sound device.
After total laryngectomy surgeries, problems such as swallowing, taste and smell can be seen as well as voice problems.
Laryngeal Cancer Radiotherapy Treatment
Radiotherapy treatment is the first choice in early stage laryngeal cancer. Radiotherapy, in which high energy is used to destroy cancer cells, can be performed alone or combined with surgery and chemotherapy, depending on the location and size of the tumor.
Radiotherapy treatment can sometimes be applied after laryngeal cancer surgeries. In order to prevent the recurrence of laryngeal cancer, in cases where the tumor cannot be completely removed or in tumors growing along the larynx wall, radiotherapy can be performed after surgery.
In patients with advanced laryngeal cancer, radiotherapy can be applied together with chemotherapy for better results.
Radiotherapy in advanced stages of laryngeal cancer can reduce problems such as difficulty in swallowing or breathing.
During radiotherapy treatment; Side effects such as fatigue, redness or darkening of the skin, sore throat, difficulty swallowing, swelling may occur.
Chemotherapy Treatment in Throat Cancer
Chemotherapy treatment in laryngeal cancer can be performed before and after surgery, and it is generally applied together with radiotherapy.
With pre-operative chemotherapy, the size of the tumor can be reduced to a level that can be operated.
Chemotherapy can be used to prevent laryngeal cancer from recurring.
In recent years, targeted smart drugs have come to the fore in chemotherapy treatment. Targeted smart drugs reduce the side effects of chemotherapy and increase the effectiveness of the treatment.
What are the Types of Laryngeal Cancer?
Laryngeal cancer is divided into types according to the type of cell in which it starts.
Squamous cell type laryngeal cancer: Almost 95 percent of laryngeal cancers are of this type. It starts in squamous cells in the epiglottis or in cells of the same structure in other parts of the larynx.
Squamous cell type laryngeal cancer is also divided into types according to the region where it spreads.
- Glottic cancer – starts in the vocal cords
- Supraglottic cancer – starts in the upper part of the vocal cords
- Subglottic cancer – starts below the vocal cords
- Oropharyngeal cancer – starts just behind the mouth
- Nasopharyngeal cancer – starts in the back of the throat
Adenocarcinoma laryngeal cancer: Although its incidence has increased in recent years, it is much rarer than squamous cell type laryngeal cancer, it starts in adenomatous cells that produce mucus scattered on the surface of the larynx.
There are also very rare types of laryngeal cancer. Such as small salivary gland tumors, sarcomas, melanoma, non-Hodgkin lymphoma or extramedullary plasmacytoma.
Frequently asked Questions
Smoking is the main risk factor for laryngeal cancer. While laryngeal cancer, which develops in approximately one of every 100,000 people in the society, is mostly seen in smokers, there has been an increase in laryngeal cancer in women recently with the increase in smoking. The most important symptom of laryngeal cancer is hoarseness. Especially in hoarseness that lasts more than 2 weeks, a specialist should be consulted.
Smoking and alcohol should be avoided as the most important risk factors for laryngeal cancer. Quitting smoking significantly reduces the risk of laryngeal cancer. A fruit and vegetable-based diet is important, make sure you get the necessary vitamins and antioxidants. Since HPV can cause laryngeal cancer, HPV vaccination should be done if necessary.
