Laryngeal cancer is a malignant tumor of the corresponding organ of the neck. Most cases of the disease are caused by smoking or human papillomavirus infection. For the treatment of laryngeal cancer, doctors resort to surgery, radiation therapy, and chemotherapy, and in the advanced stages, targeted therapy and immunotherapy can be used as well. You can go to one of the foreign hospitals to get the best treatment results.
Content
- Causes of laryngeal cancer
- Symptoms of laryngeal cancer
- Diagnostics of laryngeal cancer
- Surgical treatment
- Voice rehabilitation
- Radiation therapy
- Drug treatment
- Why is it worth undergoing laryngeal cancer treatment abroad?
- Treatment in Europe with Booking Health
Causes of laryngeal cancer
The main risk factors for laryngeal cancer are as follows:
- smoking;
- papillomavirus infection;
- alcohol;
- obesity;
- poor nutrition and malnutrition;
- genetic syndromes, including Fanconi anemia, dyskeratosis congenita;
- effect of asbestos;
- male gender (in men, laryngeal cancer occurs 5 times more often);
- age (most patients over 65 years of age).
Some studies show that the risk of laryngeal cancer is increased in patients with gastroesophageal reflux disease. It can cause chronic laryngeal inflammation due to the constant reflux of hydrochloric acid.
Symptoms of laryngeal cancer
In most cases, symptoms of laryngeal cancer manifest themselves late. The exception is tumors that develop in the vocal cords. They cause a hoarse voice. This group of neoplasms has the best prognosis. Laryngeal cancer is not only detected earlier but also less likely to metastasize.
Other symptoms include:
- sore throat;
- dysphagia (difficulty swallowing);
- earache;
- painful swallowing;
- weight loss;
- swollen cervical lymph nodes;
- neck swelling.
Diagnostics of laryngeal cancer
For the visual detection of the tumor, the following methods can be used:
- indirect laryngoscopy allows examining only part of the larynx to the vocal cords;
- direct laryngoscopy is an endoscopic procedure that makes it possible to examine the entire larynx.
During direct laryngoscopy, a doctor inserts a thin tube through the patient's nose and into the throat with a flexible endoscope. He can see the tumor with a mini video camera. If a suspicious mass is identified, a biopsy is performed. The procedure is performed under local anesthesia and does not take more than 10 minutes.
Endoscopic procedure with a rigid laryngoscope can be performed as well. This procedure is performed under anesthesia.
To clarify the stage of cancer, panendoscopy may be performed. This is an endoscopic examination of several organs at once. The doctor examines the larynx, trachea, bronchi, pharynx, and esophagus. The procedure is performed in the operating room under general anesthesia. With its help, doctors can see if the laryngeal tumor has spread to adjacent organs.
Other methods for clarifying the diagnosis are as follows:
- computed tomography is used to determine the swollen cervical lymph nodes and detect metastases in the chest;
- ultrasound is performed to scan soft tissues of the neck to detect lymph nodes affected by metastases;
- MRI is used to scan the neck, as well as other parts of the body, most often the central nervous system;
- PET is a whole-body scan after the administration of a radiopharmaceutical, which is used to search for distant metastases.
Patients also undergo general clinical tests before treatment to identify possible contraindications to surgical interventions or other treatment methods, they are examined to assess the function of the heart and lungs. Doctors perform a dental examination; assess hearing, speech, and nutritional status.
Surgical treatment
Head and neck surgery is technically complex and not equally successful in all hospitals. Studies have proven that specialized centers with extensive experience demonstrate better treatment outcomes. Complete tumor removal is performed more often, and neoplasms recur less often. Upon the treatment completion, people suffer fewer complications and have a better quality of life.
Endoscopic interventions. They are performed only at a very early stage. Doctors insert a thin tube with a video camera, as well as surgical instruments, into the larynx through the mouth. They resect a section of the mucous membrane along with the tumor. This procedure is often performed using a laser abroad.
Laryngectomy. This is a basic surgery for cancer of the larynx. It is performed through an incision in the neck. Laryngectomy involves total or partial removal of the larynx. Whenever possible, foreign specialists remove only part of the organ. Functional outcomes are best if the tumor is located above the vocal cords. Then the doctor can remove this part of the larynx, and the person retains the ability to talk. Some patients undergo hemilaryngectomy, which is the removal of half of the larynx. Then there is only one vocal cord. Although functional impairment develops after this surgical intervention, the ability to speak is still preserved.
Many patients suffering from laryngeal cancer require a total laryngectomy. Doctors remove the entire larynx. After this surgery, the person will breathe through a tube on the front surface of the trachea – tracheostomy. Without additional treatment, the patient cannot speak. But there are methods of voice rehabilitation that allow patients to return to speech.
During surgical intervention, the connection between the oral cavity and the pharynx is not disturbed. Therefore, difficulty swallowing usually does not develop.
Neck lymph node dissection. This is an additional stage of surgery for laryngeal cancer aimed at removing the lymph nodes of the neck, which collect lymph from the tumor, as well as nerves, muscles, and veins. Depending on the stage of laryngeal cancer, dissection can be selective, modified, or radical. The more extensive the surgery, the lower the risk that cancer will recur. At the same time, a more traumatic operation causes more side effects, including irreversible ones. Neurological disorders can also develop due to intersection of nerves, and edema due to impaired lymph movement. Therefore, doctors strive to cure the disease with as little tissue removal as possible.
Thyroidectomy. This surgical procedure is required only if laryngeal cancer has spread to the thyroid gland. This organ is removed. As a result, production of hormones stops, and the patient is forced to receive hormone replacement therapy for life.
Reconstructive stage. After removing the larynx, lymph nodes, and possibly other organs of the neck, doctors repair the defects using the patient's tissues. These may be local tissues or free flaps from the other body parts.
Voice rehabilitation
After surgical treatment for laryngeal cancer, many people lose the ability to speak. This inevitably happens if the larynx is completely removed. But speech can be restored. Doctors use the following methods:
Esophageal speech is the simplest, and least expensive, but least effective, method of voice rehabilitation. The patient is taught ventriloquism. He swallows air and speaks words, releasing it from the esophagus. Their speech is quiet and slurred.
Electrolarynx is a popular method of voice rehabilitation for patients of the 20th century, but today only 10% of patients use it. The problem with the electrolarynx is that it only allows you to speak in a low, monotonous voice with a metallic timbre.
Tracheoesophageal bypass with endoprosthesis placement is a progressive method of rehabilitation for patients with laryngeal cancer. It is the main method of restoring speech in Europe. The doctor forms a fenestration between the esophagus and the trachea. Aiir can now flow from the respiratory tract into the esophagus through this hole. The laryngeal prosthesis is placed inside the esophagus. It allows patients to reproduce speech. Although the digestive system is connected to the respiratory system, a special valve prevents food from entering the trachea. The laryngeal prosthesis needs to be replaced periodically. How often depends on the quality of the device. Some prostheses are replaced every few months. New advanced devices must be replaced every few years.
Radiation therapy
The following two types of radiation therapy can be used for laryngeal cancer:
- external beam radiation therapy is a standard method of irradiation with a device that is located outside the human body;
- brachytherapy is contact irradiation of the tumor with radioactive seeds placed into the larynx.
Brachytherapy is used less often. It is a choice option for endoscopic treatment of early-stage laryngeal cancer or suppression of recurrent neoplasms. The advantage of brachytherapy is that it does not irradiate the tissues surrounding the tumor. The beams do not pass through healthy organs on their way to the target, as the radioactive seeds are delivered directly to the tumor.
External beam radiation therapy for laryngeal cancer is used more frequently. It can be applied in the following situations:
- the main treatment method in situations where surgery is contraindicated or impossible due to the advanced stage of the disease;
- after surgery to reduce the risk of laryngeal cancer recurrence;
- to suppress recurrent tumors;
- to relieve symptoms in the advanced stage of laryngeal cancer.
Radiation therapy is combined with chemotherapy often. In this form, it is called chemoradiation therapy.
The problem with radiation therapy for head and neck tumors, including laryngeal cancer, is the close location of many organs, large nerves, and blood vessels. Therefore, it is desirable to use advanced and high-precision methods for tissue irradiation. Doctors abroad use the following radiation therapy options:
IMRT stands for intensity-modulated radiation therapy. It allows doctors to safely irradiate neoplasms of any localization, even if they surround critical anatomical structures. Physicians can recreate the contours of the target in 3D mode and reduce the dose of radiation to the organs at risk.
Proton therapy is the most advanced type of radiation therapy that is used only in specialized centers. Unlike conventionally used photons, protons release most of their energy only when they reach the target. They release a minimal radiation amount as they pass through healthy tissues. As a result, doctors can irradiate the tumor more safely and also increase the radiation dose, getting better results in laryngeal cancer treatment with acceptable toxicity.
Drug treatment
Doctors use the following methods of drug therapy for laryngeal cancer:
- chemotherapy;
- targeted therapy;
- immunotherapy.
The most common treatment option is chemotherapy. It is prescribed for laryngeal cancer treatment in the following situations:
- the main method of treatment for laryngeal cancer when surgery is impossible, within the framework of chemoradiotherapy;
- after surgery, if possible together with radiation therapy (but if the patient is weakened and cannot tolerate such cancer treatment, only chemotherapy is used);
- before surgery to reduce laryngeal cancer in size;
- before radiation therapy, if the patient is not undergoing surgery;
- in advanced laryngeal cancer to control symptoms.
In the advanced stages of laryngeal cancer, targeted therapy with EGFR inhibitors is carried out. These drugs block the division of cancer cells. Targeted therapy is used if chemotherapy does not work or is contraindicated. It can be combined with radiation therapy.
In the case of end-stage laryngeal cancer, doctors resort to immunotherapy. Patients receive checkpoint inhibitors. They block PD-1 proteins, blocking the ability of the tumor to evade the immune response and enhancing antitumor immunity.
Why is it worth undergoing laryngeal cancer treatment abroad?
For the treatment of laryngeal cancer, you can go to one of the countries with advanced medicine. There are several reasons for you to undergo treatment for this disease abroad:
- in the early stages, minimally invasive endoscopic operations are performed with full preservation of the larynx and speech function;
- operations are performed in specialized centers with extensive experience in removing head and neck tumors, so the best results are achieved in laryngeal cancer treatment;
- preference is given to organ-preserving operations if they can cure the disease (after removing part of the larynx, speech can be preserved);
- performance of reconstructive and plastic stages of the surgery, restoring the functions of the organs and the neck and providing an acceptable aesthetic outcome of treatment;
- even after total removal of the larynx, patients restore speech: doctors perform a tracheoesophageal bypass with the placement of a voice prosthesis;
- the use of the very latest methods of radiation therapy for laryngeal cancer, including IMRT, proton therapy;
- the use of modern drug therapy methods for the treatment of laryngeal cancer: not only chemotherapy but also targeted therapy and immunotherapy.
Treatment in Europe with Booking Health
To undergo treatment for laryngeal cancer in one of the European hospitals, you are welcome to use the services of the Booking Health company. On our website, you can find out the cost of treatment and compare prices in different hospitals in order to book a medical care program at a favorable price. Treatment in Europe will be easier and faster for you, and the cost of treatment will be lower.
Please leave your request on the Booking Health website. Our specialist will contact you and consult you on treatment in Europe. Booking Health company will fully organize your trip to another country. We will provide the following benefits to you:
- We will select the best European hospital, whose doctors specialize in laryngeal cancer treatment.
- We will solve the language barrier problem, and we will ensure communication with the doctor of the European hospital.
- We will reduce the waiting period for the medical care program. You will receive treatment on the most suitable dates.
- We will reduce the price. The cost of treatment in Europe will be reduced due to the lack of overpricing and additional coefficients for foreign patients.
- We will solve any organizational issues: we will prepare documents, meet you abroad and take you to the hospital, book a hotel, and provide interpreting services.
- We will prepare the program and translate medical documents. You do not have to repeat the previously performed diagnostic procedures.
- We will help you keep in touch with doctors after the completion of treatment in Europe.
- We organize additional diagnostic examinations and treatment in European hospitals.
- We will buy medicines abroad and forward them to your native country.
The leading doctors from around the world will take care of your health. The Booking Health specialists will help reduce the cost of treatment, organize your trip to the European hospital, and you can fully focus on restoring your health.
Authors:
The article was edited by medical experts, board certified doctors Dr. Nadezhda Ivanisova and Dr. Farrukh Ahmed. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
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Sources:
National Cancer Institute
Cancer Support Community
Cancer. Net
