Laryngeal cancer

Description of the disease

Laryngeal cancer is a malignant tumor that develops in the larynx, an organ located in the throat responsible for voice production, breathing, and protecting the airway from food aspiration. This condition disrupts vital bodily functions such as the ability to speak, breathe, and swallow.

Laryngeal cancer occurs more frequently in men over the age of 50, particularly in those who smoke and abuse alcohol. Other high-risk groups include individuals working in dusty environments (such as the textile industry) and those exposed to carcinogens such as petroleum, petroleum derivatives, benzene, phenolic resins, and asbestos. Chronic inflammatory processes in the oropharynx also increase the risk of malignant transformation.

Laryngeal cancer may develop in any of the three anatomical regions of the larynx:

• Supraglottic region (above the vocal cords): Tumors in this area can cause voice changes and difficulty swallowing.
• Glottic region (the vocal cords themselves): Tumors here are often accompanied by hoarseness or loss of voice, especially in early stages.
• Subglottic region (below the vocal cords, near the trachea): Less commonly affected, but tumors in this area may cause breathing difficulties.

Each of these regions plays a huge role in sound production, airway protection, and normal respiration, so a tumor in any of them can severely impact a person’s quality of life.

Symptoms that indicate the need for diagnosis and treatment

The symptoms of laryngeal cancer vary depending on the tumor’s location and stage, but the most common signs include:

• Hoarseness or other voice changes: one of the earliest and most frequent symptoms
• Sore throat or difficulty swallowing
• A sensation of a foreign object in the throat
• Persistent cough, possibly accompanied by blood-streaked sputum
• Enlarged lymph nodes
• Weight loss and fatigue, particularly in rapidly progressing disease

Diagnosis and treatment of laryngeal cancer

Diagnosis

Leading international clinics utilize the following procedures to diagnose laryngeal cancer:

• Laryngoscopy: The first step in diagnosis, allowing the doctor to visually examine the larynx using a laryngoscope. This can be indirect (via a mirror) or direct (using a flexible endoscope).
• Biopsy: If suspicious lesions are found during laryngoscopy, a tissue sample is collected for histopathological examination to confirm the presence of malignant cells.
• Computed tomography (CT) and magnetic resonance imaging (MRI): These imaging techniques help determine tumor size, location, and metastasis to surrounding tissues and lymph nodes.
• PET-CT (Positron emission tomography): Assesses the metabolic activity of the tumor and detects even the smallest metastases.
• Ultrasound of the neck: Evaluates lymph node condition and helps detect regional metastases.

Treatment

Treatment of laryngeal cancer depends on the stage of the disease, tumor location, and the patient’s overall health. According to the latest European and American clinical protocols, treatment may include:

Surgical intervention:

• Laryngectomy: Partial or total removal of the larynx. Total laryngectomy is performed when the tumor affects a large portion of the larynx or spreads to adjacent tissues.
• Organ-preserving surgery: In cases of smaller tumors, partial resection can be performed, allowing preservation of vocal function.
• Robotic-assisted surgery: Systems such as the Da Vinci robotic surgical system enable high-precision surgery with minimal damage to surrounding healthy tissues.

Radiation therapy:

Used as a standalone treatment in early stages, or in combination with surgery and/or chemotherapy in more advanced stages. Advanced techniques such as IMRT (Intensity-Modulated Radiation Therapy) allow radiation to be precisely directed at the tumor, minimizing exposure to healthy tissue.

Chemotherapy:

Used in advanced or metastatic cases, often in combination with radiotherapy. Modern chemotherapeutic agents help reduce side effects and increase treatment efficacy.

Targeted therapy:

A modern treatment modality that targets specific molecules or genes essential to cancer cell growth and survival. Unlike conventional chemotherapy, which affects all rapidly dividing cells, targeted therapy is more selective, thus minimizing collateral damage to healthy cells and reducing side effects.

Immunotherapy:

An advanced approach that activates the patient’s immune system to identify and destroy cancer cells. Agents such as immune checkpoint inhibitors (e.g., nivolumab) have shown promising results in treating advanced-stage laryngeal cancer.

Innovations in global cancer clinics

Modern technologies not only enable effective treatment of laryngeal cancer but also help restore lost functions post-surgery. For instance, in cases where the larynx has been completely removed, patients may undergo vocal cord prosthesis implantation or receive an artificial larynx. These procedures allow patients to regain the ability to speak, significantly improving their quality of life.