Laryngeal cancer: causes and risk factors

• Leukoplakia, erythroplakia and dysplasia
• How often do malignant tumors of the oral cavity and oropharynx occur?
• Risk factors for developing cancer of the oral cavity and oropharynx
• Prevention of cancer of the oral cavity and oropharynx
• Diagnosis of cancer of the oral cavity and oropharynx
• Signs and symptoms of oral and oropharyngeal cancer
• Methods for diagnosing cancer of the oral cavity and oropharynx
• Staging oral and oropharyngeal cancer
• Treatment of cancer of the oral cavity and oropharynx
• Treatment results for cancer of the oral cavity and oropharynx
• What happens after treatment for oral and oropharyngeal cancer is completed?

The oral cavity and oropharynx consists of various tissues that can become sources of both benign and malignant tumors.

Benign tumors include: eosinophilic granuloma, fibroma, keratoacanthoma, leiomyoma, osteochondroma, lipoma, schwannoma, neurofibroma, papilloma, rhabdomyoma, odontogenic tumors, etc.

As a rule, the only treatment for such tumors is surgery, after which relapses are very rare.

Symptoms

The initial manifestations of the disease resemble a common cold:

• sore throat that makes it difficult to speak or swallow food;
• feeling of the presence of a foreign body in the throat;
• swelling of the tonsils;
• change in voice - hoarseness or nasality;
• frequent headaches;
• general weakness, decreased performance;
• slight increase in body temperature;
• enlargement of the submandibular lymph nodes.

However, unlike a cold, the first symptoms of throat cancer do not go away within a week. The listed signs intensify, and over time they are added:

• light spots on the mucous membrane;
• small bleeding ulcers;
• chronic cough;
• ear pain without signs of otitis media;
• weight loss for no apparent reason;
• the appearance of a tumor in the neck;
• difficulties in pronouncing words due to decreased mobility of the tongue;
• labored breathing;
• nose bleeding

Prevention of laryngeal cancer

Quitting smoking cigarettes, pipes, hookahs, and chewing tobacco is the basis for preventing the disease. Eliminating alcoholic beverages or reducing their consumption will help prevent not only laryngeal cancer, but also other pathologies.

There is an opinion that red meat and smoked meats increase the risk of cancer. You should reduce their number in the menu, eat fresh vegetables and fruits more often.

It is important to undergo medical examinations on time - medical examinations, medical examinations at enterprises. If you suspect a disease of the larynx, even if general symptoms appear, you should consult a doctor.

The information in this article is provided for reference purposes and does not replace advice from a qualified professional. Don't self-medicate! At the first signs of illness, you should consult a doctor.

Causes and risk factors

The mechanism that causes pathological changes in cells, due to which they begin to divide uncontrollably and uncontrollably, has not yet been precisely identified. However, today the factors contributing to the appearance of throat cancer have already been well studied. The main reasons are heavy tobacco smoking and alcohol consumption. In addition, the situation is aggravated by:

• being male;
• age over 40 years;
• living in a city with an unfavorable environmental situation;
• work in hazardous production;
• lack of vitamins and the predominance of meat in the diet;
• inherited predisposition to cancer;
• heartburn (gastroesophageal reflux);
• papillomavirus infection.

About 90% of patients with throat cancer are men aged 40-60 years, living in large cities and smoking at least a pack of cigarettes daily.

Forecast

The prognosis of the disease depends on how early the tumor is detected. Unfortunately, laryngeal tumors are often diagnosed late due to the nonspecificity of early symptoms.

Newly diagnosed stage III laryngeal cancer is 46.8%, stage IV – 17.0%. The mortality rate in the first year from the moment of diagnosis for lesions of the larynx is 24.2%.

A large number of patients develop resistance to radiation and chemotherapy. When conservative therapy is used, recurrent tumors occur in 20-40% of cases, the treatment of which is only possible through surgery.

Without treatment, laryngeal cancer lasts from one to three years. The prognosis of 85-90% of cases of complete recovery is given only if the tumor is detected early, treatment is started in a timely manner and completely completed.

Stages

The appearance of symptoms of laryngeal cancer is often preceded by a precancerous condition - dysplasia of the mucous membrane, which develops with constant irritation from cigarette smoke, strong alcohol or pollutants. If the irritating factor is eliminated, this condition often disappears on its own, otherwise a transition to the so-called zero stage of cancer is possible - in situ, or “in situ”, when pathological cells remain within the epithelial tissue. Subsequently, rapid growth and spread of the tumor occurs.

Otolaryngologists and oncologists distinguish four main stages of the disease.

1. The pathological formation remains within the original part of the larynx, spreading into the mucous membrane and submucosal layer. Symptoms are absent or subtle.
2. The tumor grows into all layers of throat tissue, but remains within the original region. Sore throat and voice changes appear.
3. The neoplasm penetrates into the tissues adjacent to the throat and regional lymph nodes. The sore throat intensifies, cough, ulcers and other characteristic symptoms appear.
4. The tumor grows so much that it becomes clearly visible on the neck. It grows into all surrounding tissues and metastasizes to nearby and distant organs. The patient's condition deteriorates sharply, and he is tormented by constant pain.

Types

This form of cancer of the throat and larynx can have several main varieties, which differ in manifestation and approaches to their treatment.

Let's take a closer look at the types of laryngeal cancer:

1. Squamous cell non-keratinizing cancer of the larynx.
2. Squamous cell keratinizing.
3. Highly differentiated squamous cell.

What are the stages of development of this disease and what are their external manifestations?

• Stage 0, 1, 2, 3, 4 of throat cancer, stage classification according to the TNM system, symptoms, diagnosis, treatment and life prognosis

Diagnostics

If cold symptoms do not disappear within two to three weeks, you should visit an otolaryngologist as soon as possible and be diagnosed with throat cancer. The examination includes:

• laryngoscopy - examination of all parts of the larynx using an endoscope to detect pathological changes;
• biopsy of tumors for subsequent histological examination of cells to identify laryngeal cancer;
• X-ray of the esophagus and larynx to determine how deep the tumor has spread;
• Ultrasound of the neck to detect metastases;
• MRI of the larynx to clarify the size and topology of the tumor;
• immunological blood test to identify tumor markers.

Attention!
You can receive free medical care at JSC “Medicine” (clinic of Academician Roitberg) under the program of State guarantees of compulsory medical insurance (Compulsory health insurance) and high-tech medical care.

To find out more, please call +7, or you can read more details here...

Anatomy of the larynx

In an adult, the larynx is located at the level of the IV-VI cervical vertebrae along the midline of the neck. At the top it comes into contact with the hyoid bone, at the bottom it passes into the trachea, at the back it is covered with fiber and communicates with the pharynx. The anterior surface of the larynx is covered with muscles, fascia and skin.

The organ has a complex anatomical structure - it contains cartilage, ligaments, many muscles and joints. The large thyroid cartilage, also called the Adam's apple, is palpated on the neck and protrudes significantly forward in men.

Functions of the larynx:

• respiratory – regulation of external respiration, its depth and rhythm;
• insulating (protective) - protection of the respiratory tract from food entering during swallowing, harmful impurities from the air (for this, a spasm of the larynx occurs), evacuation of foreign particles trapped in the respiratory tract by coughing;
• vocal (phonatory) - the formation of vowels and parts of consonant sounds when air passes through the glottis.

Laryngeal cancer is a malignant neoplasm, most often developing from squamous epithelium. Localized in all parts of the organ.

Treatment

Treatment methods for throat cancer are selected according to the size of the tumor, the degree of involvement of neighboring organs in the oncological process, the presence of metastases, and the general condition of the patient.

• Surgery is a radical and most effective method, which involves removing malignant tissue. In the early stages, surgery is used as an independent method of combating the tumor, in later stages it is used in combination with radiation and chemical therapy. Depending on the size of the tumor, the surgeon removes part of the larynx or the entire organ. In some cases, lymph nodes, cervical tissue and other anatomical structures affected by metastases are simultaneously removed.
• Radiation therapy is used after surgery to destroy residual cancerous lesions, and if intervention is not possible, as the main method of treatment. In some cases, radiation can destroy a small tumor without surgery.
• Chemotherapy is used before surgery to shrink the tumor, and in combination with radiation therapy to prevent recurrence after surgery. In advanced stages of cancer, chemoradiotherapy is used as the primary treatment to control tumor growth and symptoms.
• Targeted therapy in the early stages is used in combination with radiation therapy, in later stages - in combination with chemotherapy.

Doctor's second opinion

The larynx, nasopharynx and esophagus are not organs that can be correctly assessed by any doctor. Thus, a thorough and attentive analysis of CT or MRI images is extremely important because it allows you to answer questions that are important when choosing treatment methods. For example, is the tumor located in the subglottic space or supraglottic? What is its stage, is there any germination of the surrounding tissue? Is there damage to regional lymph nodes? In order not to make a mistake in diagnosis, you can resort to a Second Opinion and send the research results for consultation with a highly specialized diagnostician. Otherwise, analysis of CT or MRI images may be fraught with errors. Today you can send images for consultation using various medical services, such as the National Teleradiological Network.

Rehabilitation

Recovery after surgery to remove the larynx or part of it is a difficult and lengthy process. The patient cannot eat normally and is forced to take food through a tube, and cannot speak. After a certain time, when it becomes clear that the operation was successful, the patient’s larynx is restored and plastic surgery of the vocal cords is performed. To restore voice function, it is necessary to undergo a rehabilitation course, which includes special physical procedures, exercise therapy exercises, sessions with a psychotherapist, and training in new speech skills.

Questions and answers

What does throat cancer look like?

In the initial stages, cancerous growths may appear as small bumps located on the mucous membrane of the throat. Subsequently, as the pathologically altered tissue disintegrates, ulcers form in their place. Increasing in size, the tumor becomes noticeable from the outside, forming a characteristic bulge under the skin of the neck.

How do you know if you have throat cancer?

The presence of a cancerous tumor in the throat should be suspected when:

• voice changes - hoarseness, distortion of intonation, roughness;
• sensation of a foreign body in the throat;
• pain that worsens when swallowing;
• frequent nosebleeds.

If your throat hurts for more than two weeks and does not go away, you should immediately visit an otolaryngologist.

Is there a cure for throat cancer?

If detected early, throat cancer is completely curable in 85-90% of cases. Even in the most advanced cases, at least 20% of patients live more than five years. The earlier treatment is started, the higher the patient's chances of recovery.

Attention! You can cure this disease for free and receive medical care at JSC "Medicine" (clinic of Academician Roitberg) under the State Guarantees program of Compulsory Medical Insurance (Compulsory Medical Insurance) and High-Tech Medical Care. To find out more, please call +7(495) 775-73-60, or on the VMP page for compulsory medical insurance

Classification

Tumors in the oropharynx are divided into three types:

Figure 1. Leukoplakia

Figure 2.1. Erythroplakia

Figure 2.2. Erythroplakia

List of sources

• Kaprin A.D., Starinsky V.V. Malignant neoplasms in Russia in 2015 (morbidity and mortality) - M.: MNIOI im. P.A. Herzen branch of the Federal State Budgetary Institution "NMRRC" of the Ministry of Health of Russia, 2021.
• Malignant tumors of the head and neck. edited by Kropotova M.A.., Podvyaznikova S.O., Alieva S.B., Mudunova A.M. Clinical guidelines for the treatment of head and neck tumors of the National Oncology Network (USA) - M.: ABV-Press LLC, 2011.
• A.I. Paches, E.G. Matyakin. Tumors of the larynx. Tumors of the head and neck: hands / A.I. Paches. – 5th ed., add. and processed – M.: Practical Medicine, 2013.