Treatment of laryngeal cancer in Germany
Laryngeal cancer is a malignant tumour in the epithelial tissue of the corresponding organ. It is considered common with 1,5-3% of all cancer cases in different countries.
If detected at an early stage, the disease has a favourable prognosis. However, laryngeal cancer is usually detected during stage 3 or 4 for most patients and therefore the survival rates are reduced.
Causes of laryngeal cancer
The main risk factors for laryngeal cancer:
- HPV infection
- Some genetic syndromes (Fanconi anaemia, dyskeratosis)
- Exposure to chemicals (some types of paints, wood dust, refined products)
- Gender (the risk is 4 times higher in men than in women)
- Age ( Anyone over 65 is at risk)
The neoplastic process is often preceded by precancerous and background conditions. These may include:
- Facultative (laryngeal cancer risk is less than 15%)
- Obligate (risk of cancer exceeds 15%)
Obligate precancerous conditions include:
Facultative precancerous conditions of the larynx include:
- Scars after infections (tuberculosis, syphilis)
- Scars after chemical or thermal burns
- Contact fibroma
Symptoms of laryngeal cancer
The first symptoms of pharyngeal cancer do not always cause a patient to go see a doctor, therefore, the disease is diagnosed quite late, usually at stages 3-4.
The first signs include:
- Dry and sore throat
- Foreign body sensation
- Mild pain when swallowing
- Change in voice tone
Over time, a person develops a hoarseness, which is quite pronounced. A growing intensity of pain follows. The pain is also often felt in the ear. This is followed by a dry cough. If the tumour grows into the lumen of the larynx, this can cause respiratory disorders.
If cancer is located in the area of vocal folds, the symptoms are the fastest to occur. In this case, there is vocal fatigue, again followed by hoarseness and sometimes breathing problems.
Diagnosis of laryngeal cancer
The diagnosis of laryngeal cancer includes two stages. The first one involves detection of the tumour, while the second one is aimed at the determination of the histological type of the tumour.
The tumour can be diagnosed by means of:
- Indirect hypopharyngoscopy and laryngoscopy
The following diagnostic procedures include fiberoptic laryngoscopy and a needle biopsy of the tumour. A biopsy sample is sent to histology that helps to determine the type of the neoplasm.
Laryngeal cancer can only be diagnosed after a histological examination. This diagnosis has both high sensitivity and specificity, thus, these indicators can lead to 100% diagnosis in good European hospitals.
To evaluate the prevalence of the tumorous process and to plan a treatment strategy, doctors use the following diagnostic methods:
- Chest X-ray
The hospitals of Germany and other developed countries use positron emission tomography, which involves introduction of radioactive sugar (fluorodeoxyglucose) into the patient’s body. The tumour cells accumulate it and thus are highlighted. This technique helps not only to detect laryngeal cancer, but also its metastases.
Treatment of laryngeal cancer abroad
The main treatment methods include surgery and radiation therapy. The surgery is necessary during stage 3 and 4 (if the tumour is resectable and there are no contraindications). Sometimes radiation is enough in case of stage 1 and 2 and 85-95% of patients are completely cured with the preservation of the organ and its function.
One more option is laser treatment. It can be effective during the initial stages (stages 0 and 1). This kind of treatment is endoscopic (without any skin incisions). There can be a tumour recurrence after radiation or laser therapy. In this case, laryngeal cancer needs surgical treatment.
During stage 3, or in some earlier stages radiation therapy alone can fail to be effective. Therefore, a tumour resection or a partial resection of the larynx is performed. In some situations, it is necessary to completely remove the organ, as well as a part of the larynx or other adjacent structures.
An oncologist determines the feasibility and scope of surgery on the basis of a specific clinical situation assessing all risks and advantages.
Chemotherapy is an additional treatment method. It is used in the following cases:
- As an addition to radiation therapy in order to increase its efficiency
- After surgery to reduce the risk of recurrence
- In case of inoperable laryngeal cancer in order to improve patient’s quality of life
If chemotherapy failed to be efficient, the treatment can be completed by immunotherapy. European hospitals use drugs, which allow a human immunity to attack the tumour more intensively. Pembrolizumab (drug) is prescribed specifically for this purpose.
New treatments of laryngeal cancer
There are new treatments for laryngeal cancer constantly being developed. The surgical techniques are improved, while new methods of radiation and drug therapy also come into being.
- Transoral robotic surgery. The surgery is performed by a robot that is guided by a surgeon from a remote control.Thus, efficiency and accuracy of incisions are increased, while intraoperative mortality and a risk of complications are reduced. Robotic surgery also speeds up the period of rehabilitation.
- Proton beam therapy. This kind of treatment is available only in the best hospitals of Germany, Switzerland and other economically developed countries.German doctors have an opportunity to use not x-rays, but proton beams to destroy the tumours. The advantages of such therapy include a higher accuracy and minimal damage to the surrounding tissues, while a disadvantage is the high cost, since this treatment requires state of the art equipment.
- EGFR inhibitors. Laryngeal squamous cell carcinoma contains an abnormal amount of epidermal growth factor receptors on its surface. Special drugs have already been developed, which are responsive to such cells. Erbitux is a drug used in the European hospitals to treat laryngeal cancer.
- Angiogenesis inhibitors. A growing tumour requires a large number of nutrients and oxygen. Therefore, there are formed close to many blood vessels. The tumour releases chemicals that cause the body to grow new arteries to ensure its trophism. There have already been drugs developed which block these substances and prevent the growth of new blood vessels that feed the tumour. Avastin and Sutent are drugs, which are used to treat laryngeal cancer.
- Photodynamic therapy. This therapy is being examined for the efficient treatment of laryngeal cancer at an early stage. A specific substance is introduced into the body, which accumulates in cancer cells and makes them sensitive to light of a certain wavelength. Then it is used to destroy the tumour. Upon successful completion of the clinical testing, photodynamic therapy will be used in the European hospitals to treat laryngeal cancer.
Laryngeal cancer - Prognosis
Laryngeal cancer can be endophytic and exophytic, depending on the type of tumour growth. Exophytic has a more favourable prognosis, because it is characterised by clear boundaries and a low degree of infiltration in the laryngeal tissues. It does not grow to the side of the organ wall, but to its lumen.
The prognosis depends on the location. The most malignant cancer develops in the upper third of the larynx. It metastases spread quite early. Cancer of the vocal folds is the most favourable one. It grows slowly and its metastases spread quite late. It is characterised by exophytic growth.
The table below details the data of five-year survival rate of patients with laryngeal cancer in different areas. The table shows variations depending on the stage and location of the cancer.
Here you can find the cost of treatment for this disease at the German University Hospitals. Leave a request and we will provide a free consultation with a doctor and will start organizing the whole treatment process.
The program includes the following:
- Issuing of an invitation for getting a visa for treatment as quick as possible
- Fixing an appointment at a time convenient for you
- Preliminary organization of a comprehensive examination and discussion of the forthcoming treatment plan
- Arranging transfer from the airport to the hospital and back to the airport
- Provision of interpreting services and services of a personal medical coordinator
- If necessary, assistance in the organization of further surgical treatment
- Provision of a medical insurance against treatment complications covering up to 200,000 euro
- Preparation and translation of medical records and recommendations from the hospital
- Assistance in the subsequent communication with your attending physician, including consultations on repeated X-ray images through the unique medical document management system E-doc