laryngeal cancer

laryngeal cancer, malignant disease of the larynx (voice box). The most common type of malignant tumor identified on the larynx is squamous cell carcinoma.

Types

Squamous cell carcinoma occurs most often in men, particularly those between ages 55 and 65, and frequently arises from chronic irritation, overuse of the voice, or alcohol and tobacco use. Squamous cell carcinoma of the larynx is preceded by dysplasia, a condition characterized by the abnormal growth of epithelial cells of the larynx. Squamous cell carcinoma may attack the vocal cords, originating from the lining of the larynx. This form of the disease often remains confined to the larynx, and the patient has a good chance of recovery when the tumor is removed. Carcinoma can also develop in the area above the vocal cords and folds and may extend to the epiglottis (a flap of cartilage above the larynx) or the pharynx, the upper throat. From there, tumor cells usually invade the surrounding tissue and spread to other areas of the body by way of the lymphatic vessels.

Benign papilloma is the most common tumor of the larynx. It is a small warty growth that attaches to the vocal cords or at the joints between the cartilage plates. It is most frequent in singers, announcers, and people who use their voices strenuously and often. In adults it may form many polyps (lumps of tissue) that can plug the larynx; after removal it may reappear. A similar condition may occur in children, except that when they reach puberty the growths usually disappear spontaneously.

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Diagnosis and treatment

In many instances, 8 to 10 months may elapse before the first symptoms of hoarseness appear and a diagnosis of laryngeal cancer is made. To diagnose the disease, doctors combine physical inspection, imaging, and tissue analysis. The process often begins with an exam using a small mirror or an endoscope to view the throat. Suspicious areas are then studied with computed tomography (CT) or magnetic resonance imaging (MRI) scans. Biopsy, in which tissues are removed from the patient and examined by microscope, provides the final confirmation by revealing cancer cells in the tissue.

Laryngeal cancer typically can be treated in the early stages. Once diagnosed, the primary forms of treatment include surgery, radiation therapy, and chemotherapy. Surgery may entail laser surgery, cordectomy (partial or complete removal of the vocal cords), laryngectomy (partial or complete removal of the larynx), or vocal cord stripping (removal of superficial vocal cord tissue, largely sparing the vocal cords). Examples of chemotherapy used to treat laryngeal cancer include cisplatin, fluorouracil, and paclitaxel. Newer treatments include the use of immunotherapy (e.g., nivolumab) and targeted therapy (e.g., cetuximab), administered in combination with radiation or standard chemotherapy.