NHS
Laryngeal cancer or laryngeal carcinoma, denotes the growth of tumours in the larynx, specifically in the mucous layer. The location of the tumour determines the symptoms, treatment and outcome of the disease.
In around two thirds of all patients, the tumour will develop around the vocal chords, and in the remaining third the cancer will grow above the vocal chords. In a very small group of patients, the cancer will develop below the vocal chords.
The larynx is located in the neck and throat and plays a part in the respiratory system as well as in the production of sound. The larynx also protects the wind pipe and blocks it off during eating or vomiting. The larynx also connects the nose and throat with the wind pipe or trachea and lungs and is mostly made up of cartilage. In men, the larynx is externally visible as the Adam’s apple.
The larynx consists of three parts.
Around 650 patients are diagnosed with laryngeal cancer every year in Belgium. The outlook has remained at a similar level for quite a while, despite medical and pharmaceutical advances. For patients who are diagnosed while the tumour is at stage I, the 5-year survival rate is 90%. In stage IV this drops to 36%.
Laryngeal cancer is often detected at an early stage because the disease causes symptoms to occur early on in the process. Patients will feel a constant sense of irritation in the throat. Depending on the tumour location, patients may experience the following symptoms:
The cause of larynx cancer is unknown, but certain risk-inducing factors have been identified:
Laryngeal cancer often presents itself as a persistent cold or flu, but when symptoms continue for several weeks, a GP may refer their patient to an ear-nose-throat specialist who will perform a number of tests. These can include a laryngoscopy or stroboscopy. The first involves inserting orally a flexible tube with a mini-camera attached. Stroboscopy specifically focuses on the vibrations of the vocal chords.
Should the specialist suspect the patient may have cancer, further tests are conducted, such as ultrasound, CT scan, MRI scan, biopsy, lung X-ray, laryngoscopy, PET scan. A biopsy will also be performed in order to determine the differentiation of the cancer, which is vital information when it comes to determining the stage of the cancer and the subsequent treatment. Like many cancers, laryngeal cancer uses the TNM classification to grade the severity of disease.
The treatment of larynx cancer depends on its location as well as its stage. Options are: laser treatment, radiation, surgery and chemotherapy, or a combination of two or more of these. The combination of surgery and radiotherapy is the most frequently chosen option. The patient will get the urgent advice to stop smoking and drinking alcohol, even after treatment. For locally advanced or refractory laryngeal cancer, the use of VEGF and PD-L1 inhibitors may also be an option.
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