Larynx & Pharynx Cancer

Cancer Treatment

Pharyngeal and laryngeal cancers are commonly grouped together as throat cancers. Pharynx is a muscular tube that begins behind the nose and ends in neck, and is divided in to three parts; nasopharynx, oropharynx and hypopharynx. Larynx is commonly referred to as voice box, which is also divided in to three parts; supraglottis, glottis and subglottic regions.

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Symptoms of Larynx & Pharynx Cancer

Persistent cough

Change in voice, such as hoarseness

Difficulty in breathing

Foreign body sensation (a lump or sore that persists)

Enlarged neck lymph nodes

Cancer Treatment

Terminology

Nasopharyngeal cancer – arises from the nasopharynx; the part of the pharynx, just behind the nose.
Oropharyngeal cancer – arises from the oropharynx; the part of the pharynx behind the mouth.
Hypopharyngeal cancer – arises from the hypopharynx; the lower part of the pharynx, behind the larynx (voice box) and above esophagus (food pipe).
Glottic cancer – arises from the vocal cords (mid portion of larynx).
Supraglottic cancer – arises in the upper portion of larynx, above the vocal cords.
Subglottic cancer – arises in the lower portion of larynx, below the vocal cords.

Cancer Treatment

Risk Factors

Tobacco use, including smoking and chewing tobacco
Alcohol use
Viral infections, including human papillomavirus (HPV) and Epstein-Barr virus (EBV)

Prevention

Avoid all forms of tobacco: Tobacco in all forms i.e. smoking beedis, cigarettes, chewing tobacco, snuff etc should be stopped immediately. Exposure to smoke (passive smoking), from someone else smoking should be avoided as far as possible. To overcome the addiction, nicotine replacement products like chewing gums or nicotine patches, can be suggested by your doctor.

Avoid drinking alcohol: Stop drinking alcohol even as a social drinker. Various de-addiction centers and social groups are available to help alcoholic to overcome their alcohol addiction.

Consume diet rich in fruits and vegetables: The vitamins and antioxidants in fruits and vegetables may help reduce the risk of various cancers.

Protect yourself from HPV: Some throat cancers are thought to be caused by the sexually transmitted infection with human papillomavirus (HPV). HPV vaccine, may reduce the risk of throat cancer and other HPV-related cancers.

Diagnosis

Bronchoscopy and upper gastrointestinal scopy: These tests help in direct visualization of the tumour, its location, extent and size and also aids in guided biopsy, for tissue diagnosis.

Biopsy: Biopsy from the tumor involves small tissue obtained from the tumor and examined under microscope to prove cancer as well as to determine the exact histopathological type of cancer.

Imaging: CT scan of the head and neck region is performed for further detailed characterization of the tumor. In case of large tumors or multiple lymph nodes in neck, whole body PET CT is suggested to rule out spread of the tumor to other sites, like lungs, liver, bone etc.

Treatment options for laryngeal and pharyngeal cancers

Radiotherapy and chemotherapy are the main stay of treatment for these types of cancers.

Surgical options are available for specific scenarios, where partial, total laryngectomy (removal of voice box) and laryngopharyngectomy along with removal of lymph nodes, may be suggested as per the stage of the tumor. Even after complete removal of voice box, patient can speak using special voice prosthesis and electro-larynx.

Recently, endoscopic and minimally invasive robotic surgeries are available for early cancers with good results.