Laryngeal cancer main causes early symptoms and the latest treatment methods

Laryngeal Cancer: Early Detection, Symptoms, and Treatment Laryngeal cancer is a disease that can threaten both your voice and breathing if not diagnosed early. The problem is that its initial symptoms are often mild, such as a hoarse voice or frequent sore throat, which leads many people to delay seeking medical attention. article, we will explore the causes of laryngeal cancer, the warning signs you should never ignore, and the latest treatment options available, so you can detect the disease early and protect yourself.

What is Laryngeal Cancer?

Laryngeal cancer is a type of cancer that affects the larynx, the part of the throat responsible for speaking, breathing, and swallowing, which also contains the vocal cords.

Cancer occurs when cells in the larynx start to grow abnormally and uncontrollably. These cells can invade surrounding tissues and harm the body.

Locations Where Laryngeal Cancer Can Develop
Laryngeal cancer can appear in any of its three parts:

Upper part (Supraglottic): About 35% of cases start here.
Middle part (Glottic – contains the vocal cords): About 60% of cases.
Lower part (Subglottic): About 5% of cases.

Is Laryngeal Cancer Curable?
Yes, laryngeal cancer is treatable. The treatment plan depends on:

The location of the tumor
The stage of cancer
The patient’s overall health

Main Treatment Options:

Surgery: To remove the tumor.
Radiation therapy: Often used after surgery or for small tumors.
Chemotherapy: Used for advanced tumors or in combination with other treatments.

Sometimes a single treatment is sufficient, while in other cases, a combination of treatments is needed depending on the patient’s condition.

Survival Rates by Stage
Survival rates vary based on the cancer stage at diagnosis, according to data from sources like the American Cancer Society:

Early Stage:
- Cancer is limited to the larynx and has not spread to lymph nodes.
- 5-year survival rate: ~70–90%, depending on type and location.
Intermediate Stage:
- Cancer has spread to nearby lymph nodes but not to distant organs.
- 5-year survival rate: ~50–70%.
Advanced Stage:
- Cancer has spread extensively to lymph nodes or distant organs such as the lungs or liver.
- 5-year survival rate: ~30–50%, lower if the spread is significant.

Factors Affecting Survival

Type of cancer: Some types, especially glottic cancers, have better outcomes if detected early.
Overall health: Chronic diseases can reduce the chances of recovery.
Treatment response: The effectiveness of surgery, radiation, and chemotherapy greatly impacts the result.
Early diagnosis: Detecting the tumor before lymph node involvement significantly improves survival.

Types of Throat Cancer
Throat cancers are classified by tumor location or affected cell type. Major types include:

Nasopharyngeal Cancer:
- Occurs in the upper part of the throat, just behind the nose.
- More common in regions like southern China and North Africa.
- Sometimes linked to Epstein-Barr Virus (EBV).
- Symptoms: nasal obstruction, nosebleeds, hearing loss, neck lumps.

2. Oropharyngeal Cancer
Occurs in the middle part of the throat and includes the base of the tongue, tonsils, soft palate, and the back of the mouth.

Often linked to HPV infection, smoking, or alcohol use.
Symptoms: difficulty swallowing, persistent hoarseness, neck lumps, throat or ear pain.

3. Hypopharyngeal Cancer
Occurs in the lower part of the throat near the larynx and esophagus.

Usually diagnosed late because early symptoms are subtle.
Symptoms: severe difficulty swallowing, throat or neck pain, lumps, sometimes hoarseness.

4. Laryngeal Cancer
Occurs in the larynx itself, which is responsible for voice production.

More common in smokers and older adults.
Types of laryngeal cancer:
- Glottic Cancer: Affects the vocal cords; often causes early hoarseness.
- Supraglottic Cancer: Affects areas above the vocal cords; symptoms may appear later.
- Subglottic Cancer: Less common; usually diagnosed at a later stage.

5. Benign Tumors with Potential to Become Malignant
Sometimes, benign growths in the tonsils or surrounding tissues can, if left untreated, rarely transform into cancer.

Causes of Laryngeal Cancer

Laryngeal cancer occurs when normal laryngeal cells transform into malignant cells. Key risk factors include:

Smoking

The most common direct cause.
Cigarettes, cigars, and hookah all significantly increase the risk.

Heavy Alcohol Consumption

Irritates throat and laryngeal cells.
Risk increases substantially when combined with smoking.

HPV Infection

Certain types of HPV are linked to a higher risk of laryngeal cancer.

Exposure to Chemicals

Occupational exposure to metal dust, industrial chemicals, or plastic fumes may increase risk.

Chronic Acid Reflux (GERD)

Continuous stomach acid exposure irritates laryngeal cells, raising the risk of malignant changes.

Nutritional Deficiency

Lack of vitamins and minerals, especially A, C, and E, weakens cells and increases sensitivity to cancerous changes.

Family History

Having relatives with other cancers slightly increases risk.

Chronic Inflammation or Repeated Injury

Chronic laryngitis or repeated exposure to hot foods or smoking irritates the larynx, increasing the likelihood of cell transformation.

Stages of Laryngeal Cancer

Laryngeal cancer is classified based on tumor size and spread, affecting treatment and prognosis. Doctors often use the TNM system (Tumor–Node–Metastasis), but simplified stages are:

Stage 0 – Early Localized Cancer

Tumor is very limited within the larynx, usually in the top tissue layer (Carcinoma in situ).
No lymph node involvement.
Treatment: minor surgery or radiation therapy.

Stage I

Tumor is larger than Stage 0 but still confined to the larynx.
Only the vocal cords or a small part of the larynx is affected.
No spread to lymph nodes or distant organs.
Treatment: surgery or radiation, sometimes combined.

Stage II

Tumor begins to grow but remains within the larynx.
No lymph node spread.
Symptoms may increase: hoarseness, difficulty swallowing.
Treatment: usually surgery with radiation; sometimes chemotherapy.

Stage III

Tumor is large and may spread to nearby parts of the larynx or other vocal cords.
May involve one lymph node on the same side of the neck.
Symptoms more pronounced: difficulty speaking, pain, voice changes.
Treatment: more extensive surgery + radiation or chemotherapy.

Stage IV

Most advanced stage: tumor is very large or has spread to distant sites.
May involve multiple lymph nodes or distant organs (lungs or liver).
Severe symptoms: significant difficulty swallowing and breathing, weight loss, persistent pain.
Treatment: major surgery, radiation, chemotherapy, often using a multimodal approach.

Key Signs of Laryngeal Cancer
Laryngeal cancer usually develops gradually, and early symptoms can be mild, which is why early detection is crucial:

Voice Changes or Persistent Hoarseness:
Most common sign, especially if hoarseness lasts more than 3 weeks without a clear cause. May include weakness or partial loss of voice.
Difficulty Swallowing (Dysphagia):
Pain or trouble swallowing food or liquids. Sometimes feels like “something stuck” in the throat.
Throat or Neck Pain:
Persistent pain not linked to a cold, sometimes radiating to the ear due to shared nerves.
Neck Lump or Swelling:
Due to cancer spreading to lymph nodes. Often painless at first.
Persistent Cough or Coughing Up Blood:
Long-lasting cough not related to a cold. Blood in mucus may be an early warning sign.
Difficulty Breathing or Wheezing:
Tumor pressing on the airway may cause shortness of breath or a whistling sound when breathing.
Unexplained Weight Loss or Loss of Appetite:
Often seen in advanced stages.
Other Symptoms:
Fatigue, swelling of the face or neck (rare), repeated throat infections.

Diagnosing Laryngeal Cancer

Accurate diagnosis is essential to determine tumor type, location, and size. Steps include:

Clinical Examination:
Using a small mirror or flexible laryngoscope to check for color changes, swelling, or abnormal masses in the throat and larynx.
Symptom Evaluation:
Discussion of persistent hoarseness, difficulty swallowing, ear or throat pain, neck lumps, or chronic cough with blood.
Laryngoscopy:
Flexible scope through the nose or rigid scope through the mouth to fully examine the larynx and identify tumors or abnormalities.
Imaging:
- CT Scan: Determines tumor size and spread to surrounding tissues.
- MRI: Evaluates tumor involvement of muscles or thyroid.
- PET Scan: Occasionally used to detect spread to lymph nodes or other areas.
Biopsy:
Small tissue sample is analyzed to confirm cancer type and aggressiveness.
Additional Tests:
Blood tests to assess overall health and sometimes evaluation of lymph nodes to check for spread.

Treatment of Laryngeal Cancer

Treatment depends on tumor type, location, stage, and aims to destroy or control cancer growth. Options include:

1. Radiation Therapy:

Uses high-energy rays to kill or stop cancer cells from dividing.
External Beam Radiation: Directs radiation from outside the body.
Fractionated Radiation: Daily doses split to reduce side effects and improve effectiveness.
Monitored for thyroid function as radiation may affect it.

2. Surgery:
Aims to remove the tumor while preserving voice and breathing when possible:

Vocal Cord Removal: Only affected vocal cords.
Supraglottic Laryngectomy: Removes upper part of larynx.
Hemilaryngectomy: Removes half the larynx.
Partial Laryngectomy: Removes part of the larynx.
Total Laryngectomy: Complete removal of larynx; creates a tracheostomy for breathing.
Thyroidectomy: Removes part or all of the thyroid if affected.
Laser Surgery: Precise removal of small or superficial tumors.

3. Chemotherapy:

Drugs administered orally, intravenously, or intramuscularly to kill cancer cells or prevent division.
Often combined with surgery or radiation for advanced cases or as primary therapy if surgery isn’t possible.

4. Immunotherapy:

Enhances the immune system to attack cancer cells.
PD-1 / PD-L1 inhibitors (e.g., Nivolumab, Pembrolizumab) used for recurrent or metastatic cases.

5. Targeted Therapy:

Focuses on specific cancer cells using drugs or proteins:
- Monoclonal Antibodies (e.g., Cetuximab)
- Radiation Sensitizers make tumor cells more responsive to radiation.

Treatment by Stage & Location

Early Stage (I–II):

Surgery or focused radiation, sometimes laser removal.
Goal: remove tumor while preserving voice.

Stage III:

Multimodal therapy: surgery + radiation + chemotherapy, sometimes with clinical trials.
Treatment depends on tumor location: supraglottic, glottic, or subglottic.

Stage IV:

Extensive treatment needed: surgery + radiation + chemotherapy + sometimes clinical trials.
Advanced spread requires tailored approaches based on tumor size, lymph node involvement, and overall health.

Recurrent or Metastatic Laryngeal Cancer:

Focuses on controlling the tumor, relieving symptoms, and improving quality of life.
Options include surgery, radiation, chemotherapy, immunotherapy, and clinical trials.

Prevention of Laryngeal Cancer

Quit Smoking: Major risk factor.
Limit Alcohol: Especially combined with smoking.
Maintain Oral Hygiene: Brush twice daily, floss regularly.
Prevent Viral Infections: HPV and EBV vaccines, maintain oral hygiene.
Healthy Diet: Fruits and vegetables rich in vitamins and antioxidants; reduce processed foods.
Maintain Healthy Weight and Exercise: Reduces chronic inflammation.
Regular Medical Checkups: Persistent hoarseness, difficulty swallowing, or throat pain warrants ENT consultation for early detection