Head & Neck
Larynx Cancer
Cancer occurs when abnormal cells multiply in an uncontrolled way to form a tumour. Benign Tumours grow locally and can damage surrounding structures but tend not to spread distantly. Tumours that can spread around the body (metastasize) are referred to as malignant. Cancer generally refers to a malignant tumour. Cancer can develop in any part of the body – including the Larynx or Voice Box.
What is Larynx cancer?
Larynx cancer is cancer of the voicebox. Almost all these cancers develop from the cells that line part of the inside of the larynx, called squamous cells. Larynx cancers may develop in different parts of the larynx called the Glottis (vocal cords), Supraglottis (above the vocal cords) or the Subglottis (below the vocal cords).
What causes Larynx cancer?
Tobacco and alcohol use are the main risk factors for larynx cancer. The combination of tobacco use and drinking further increases larynx cancer risk to around 35 times the normal.
Other risk factors for oral cancer may include:
- Human Papillomavirus (HPV) infection
- Some rare genetic syndromes
- Occupational exposures to carcinogens
Sometimes, oral cancer can occur in the absence of these risk factors.
What are the symptoms of Larynx cancer?
Symptoms of larynx cancer depend on which type tumour you have. Because of the different locations of these cancers the symptoms tend to occur in different sequences:
- Glottic cancer - these cancers affect the vocal cords and can cause:
- Hoarse Voice
- Breathing Difficulty
- Coughing Blood
- Throat or ear pain
- Neck Lump
- Supraglottic Cancer - These affect the structures that protect the airway when swallowing and cause:
- Throat or ear pain
- Coughing Blood
- Swallowing Difficulty
- Breathing Difficulty
- Hoarse Voice
- Neck Lumps
- Subglottic Cancer - these mainly affect the top of the windpipe and cause:
- Breathing Difficulty and Stridor
- Coughing Blood
- Hoarseness
- Neck Lumps
The most common types of larynx cancers are glottic cancers. Even small glottic cancers measuring only millimetres cause a persistent hoarse voice. Never ignore a hoarse voice, it can be an early sign of larynx cancer, getting it checked out is simple and can save your life.
How is larynx cancer diagnosed?
At My ENT Specialist, A/Prof McGuinness will take a history and perform a thorough physical examination.
Most often we use a Nasal Endoscopy to see inside the larynx and make a diagnosis. Nasal Endoscopy is a procedure performed in the office in which we use a thin, flexible tube with a camera and light source at its end to look inside the throat and to take pictures. It only takes a few minutes and is entirely painless. Videostrobolaryngoscopy is a specialized technique performed at the same time as nasal endoscopy. It is useful to show us how invasive the tumour may be and which types of treatment would be best.
If a cancer is suspected then a biopsy will generally be required. This is usually performed as a day procedure under general anaesthetic and is called Microlaryngoscopy and Biopsy. It is very safe and generally painless.
CT, MRI and PET scans may be required to determine the location, stage and spread of the cancer.
What is the treatment for larynx cancer?
The treatment and prognosis of larynx cancer depends on the site of the cancer, the size of the cancer, and its spread. When formulating your individual treatment plan, your general health is another important consideration.
Glottic Cancer
Because they cause a hoarse voice many glottic cancers are discovered early (T1,T2 stage) and because it is rare for these early cancers to spread to lymph nodes the rate of cure for glottic cancers is better than for other types of larynx cancer. Generally there are 2 options for early glottic cancers. A/Prof McGuinness is an expert on a technique called trans oral laryngeal microsurgery (TOLM) where a CO2 laser mounted on a microscope is used to carefully remove the laryngeal cancer via the mouth. This is generally a day surgery procedure. Cure rates are excellent and 98% of patients can expect to be cured.
An alternative treatment is with Radiotherapy, this generally takes 6 weeks as an outpatient. Cure rates are the same as surgery. We will talk to you about the options and help you decide which is best for you.
More advanced Glottic cancers and most supraglottic and subglottic cancers are treated with Chemotherapy as surgery for these cancers involves removing the voice box (laryngectomy). Surgery is still required for very advanced cancers (T4 stage)
Treatment of larynx cancer requires a multidisciplinary team and is individualised for each patient.
At My ENT Specialist, we are proud to form part of a multidisciplinary team that offers exceptional care for oral cancer patients, irrespective of the stage of their illness.