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Cancer from A to Z

Types of cancer, how to prevent them, diagnosis and treatment.

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Laryngeal Cancer

Laryngeal Cancer is a type of throat cancer, with approximately 2.100 new cases diagnosticated every year in Spain. Fortunately, these numbers are declining as fewer people choose to smoke.

Laryngeal Cancer is located in the larynx, or "voice box", the area of the throat which includes the vocal cords. It consists of three parts:

  • Glottis: the middle portion of the larynx that contains the vocal cords
  • Supraglottis: the area above the vocal cords
  • Subglottis: the area between the vocal cords and the trachea (windpipe)

Symptoms of laryngeal cancer include:

  • Hoarseness or other change in the voice
  • Difficulty swallowing or breathing
  • Persistent sore throat
  • Ear pain
  • Lump in the neck

Having one or more of the symptoms listed above does not necessarily mean you have laryngeal cancer. However, it is important to discuss any symptoms with your doctor, since they may indicate other health problems.

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Clinical trials
Sym015(Anti-MET) en Pacientes con tumor solido avanzado.
Ensayo de fase 1a/2a, abierto y multicéntrico, para investigar la seguridad, tolerabilidad y actividad antitumoral de dosis repetidas de Sym015, una mezcla de anticuerpos monoclonales dirigida frente al receptor MET, en pacientes con tumores malignos sólidos en fase avanzada
DU176b-D-U311
Estudio fase IIIB, prospectivo, randomizado, abierto que evalúa la eficacia y seguridad de Heparina/Edoxaban versus Dalteparina en tromboembolismo venoso asociado con cáncer.
Estudio fase III, multicéntrico, aleatorizado, doble ciego, con control activo para evaluar la seguridad y eficacia de Rolapitant en la prevención de náuseas y vómitos por la quimioterapia (NVIQ) en pacientes que reciben quimioterapia altamente emética
Tumores sólidos. Antiemesis Estudio fase III, multicéntrico, aleatorizado, doble ciego, con control activo para evaluar la seguridad y eficacia de Rolapitant en la prevención de náuseas y vómitos por la quimioterapia (NVIQ) en pacientes que reciben quimioterapia altamente emética (QAE). A phase III, multicenter, randomized, double blind, placebo controlled study of the safety and efficacy of Rolapitant for the treatment of Chemotherapy-induced nausea and vomiting in subjects receiving highly Emetogenic Chemotherapy (HEC)
Ensayo clínico en fase I de determinación de dosis del antiangiogénico multidiana Dovitinib (TKI258) más paclitaxel en pacientes con tumores sólidos
Ensayo clínico en fase I de determinación de dosis del antiangiogénico multidiana Dovitinib (TKI258) más paclitaxel en pacientes con tumores sólidos.

People who smoke, especially in combination with alcohol consumption, are at the most at risk for developing laryngeal cancer.

 

Other risk factors include:

 

Gender: men are up to five times more likely to get cancer of the larynx than women, and black men have the highest risk.

 

Age: most cases occur over the age of 65.

 

Exposure to certain chemicals: including nickel, asbestos and sulfuric acid fumes.

Depending on the tumor location, some larynx cancers are found early. Cancer that forms on the vocal cords (not above or below) is often diagnosed early because of the hoarseness caused.

 

Staging
 

Staging is the process of finding out how far the cancer has spread. This is very important because the type of treatment and the outlook for recovery depend on the stage of the cancer.

The staging system most often used for laryngeal cancer is the TNMstaging system, also known as the American Joint Committee on Cancer (AJCC) system.

 

This system gives three key pieces of information:

  • T stands for tumor (how far it has spread within the larynx or hypopharynx and to nearby tissues)
  • N describes whether the cancer has spread to lymph nodes
  • M stands for spread (metastasis) to distant organs

All of this information is combined to arrive at a stage. After stage 0 (which is carcinoma in situ or cancer that has not grown beyond the lining layer of cells), stages are labeled using Roman numerals from I through IV (1-4). The smaller the number, the less the cancer has spread. A higher number, for example, stage IV, means a more serious stage of the disease.

For early stage laryngeal cancers (stages I-II), patients respond equally well to surgery or radiation treatment. For intermediate stage cancers (stages II-III), a combination of radiation and chemotherapy or radiation and surgery provide the best opportunity to preserve the larynx. Depending on the location and size of the tumor, some patients may undergo radiation or surgery alone.

Surgery
Surgery may involve partial or total removal of the larynx (laryngectomy), portions of the subglottis or supraglottis or removal of just the vocal cords (cordectomy). In some patients, the thyroid gland may also be removed. Partial laryngectomy allows surgeons to preserve speech. At MD Anderson, two procedures are used to preserve normal function:

Transoral Laser Microsurgery (TLM) uses a flexible, hollow-core fiber to transmit CO2 laser energy, enabling surgeons to reach otherwise inaccessible areas and to perform a 360-degree resectionaround tumors in ways that were previously not possible.

Supracricoid Partial Laryngectomy: the supraglottis, vocal cords and thyroid cartilage are removed, while sparing other structures needed to swallow and produce speech.

While advanced techniques are helping preserve normal function, patients who have had their entire larynx or vocal cords removed will lose the ability to speak or breathe normally. There are several options to restore speech:

  • A special valve implanted between the trachea and esophagus (food pipe), which eliminates the need for an electrolarynx
  • Using a handheld vibrating device (electrolarynx) to produce sounds and words
  • Intensive speech therapy to learn how to use the esophagus for speaking

 

Other Treatments
 

Chemotherapy drugs can be used to shrink the tumor before surgery or to kill lingering cancer cells after surgery and/or radiation treatment. A combination of chemotherapy and radiation may be used as a primary treatment for patients with larger tumors or those who cannot tolerate surgery.

 

Survivorship
 

Laryngeal cancer patients are strongly urged not to smoke or drink alcohol both during and after cancer treatment. Drinking and smoking can make treatments less successful, as well as greatly increasing the chances for recurrence.

 

Regular follow-up and screening is vital due to the high risk of cancer returning to the larynx or other areas in the head and neck region. Patients may have to see their doctor every two months for the first two years after treatment, since 80-90% of new cancers occur within the first three years.