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Concept
Laryngeal cancer
Summary
Laryngeal cancers are mostly squamous-cell carcinomas, reflecting their origin from the epithelium of the larynx.
Cancer can develop in any part of the larynx. The prognosis is affected by the location of the tumour. For the purposes of staging, the larynx is divided into three anatomical regions: the glottis (true vocal cords, anterior and posterior commissures); the supraglottis (epiglottis, arytenoids and aryepiglottic folds, and false cords); and the subglottis.
Most laryngeal cancers originate in the glottis, with supraglottic and subglottic tumours being less frequent.
Laryngeal cancer may spread by: direct extension to adjacent structures, metastasis to regional cervical lymph nodes, or via the blood stream. The most common site of distant metastases is the lung. Laryngeal cancer occurred in 177,000 people in 2018, and resulted in 94,800 deaths (an increase from 76,000 deaths in 1990). Five-year survival rates in the United States are 60.3%.
The symptoms of laryngeal cancer depend on the size and location of the tumour. Symptoms may include the following:
Hoarseness or other voice changes
A lump in the neck
A sore throat or feeling that something is stuck in the throat
Persistent cough
Stridor - a high-pitched wheezing sound indicative of a narrowed or obstructed airway
Bad breath
Earache (due to referred pain)
Difficulty swallowing
Adverse effects of treatment can include changes in appearance, difficulty eating, dry mouth, or loss of voice that may require learning alternate methods of speaking.
The most important risk factor for laryngeal cancer is tobacco smoking. Death from laryngeal cancer is 20 times more likely for the heaviest smokers than for their non-smoking peers. Heavy chronic consumption of alcohol, particularly alcoholic spirits, is also a significant risk factor. When present in combination, the usages of alcohol and tobacco appear to have a synergistic effect. Other reported risk factors include being of low socioeconomic status, male sex, or age greater than 55 years.
Official source
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