Laryngeal and Hypopharyngeal Cancer Treatment

Tests to help diagnose and stage laryngeal cancer: CT Scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. Physical exam of the throat and neck: An exam to check the throat and neck for abnormal areas. The doctor will feel the inside of the mouth with a gloved finger and examine the mouth and throat with a small long-handled mirror and light. This will include checking the insides of the cheeks and lips; the gums; the back, roof, and floor of the mouth; the top, bottom, and sides of the tongue; and the throat. The neck will be felt for swollen lymph nodes. A history of the patient’s health habits and past illnesses and medical treatments will also be taken. Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. The sample of tissue may be removed during one of the following procedures: Laryngoscopy: A procedure in which the doctor checks the larynx (voice box) with a mirror or a laryngoscope to check for abnormal areas. A laryngoscope is a thin, tube-like instrument with a light and a lens for viewing the inside of the throat and voice box. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer. Endoscopy: A procedure to look at organs and tissues inside the body, such as the throat, esophagus, and trachea to check for abnormal areas. An endoscope (a thin, lighted tube with a light and a lens for viewing) is inserted through an opening in the body, such as the mouth. A special tool on the endoscope may be used to remove samples of tissue. Laryngeal and hypopharyngeal cancer can often be successfully abolished, more especially if the cancer is found early. While complete elimination of the cancer is the primary goal of laryngeal and hypopharyngeal cancer treatment, it is also very important to preserve the function of the affected organs. Therefore, when laryngeal and hypopharyngeal cancer treatment is to be carried out, doctors consider the effect of the treatment plan on the patient’s quality of life; such as, how the person feels, looks, talks, eats, and breathes. Laryngeal and hypopharyngeal cancer treatment would often significantly impact these functions, so treatment decisions are always carefully made. There are 3 main options for laryngeal and hypopharyngeal cancer treatment; 

• Radiation therapy, 
• Surgery, and 
• Systemic therapy (chemotherapy, immunotherapy, and targeted therapy). 

One or more of these therapies for laryngeal and hypopharyngeal cancer treatment. Surgery and radiation therapy are the most commonly used laryngeal and hypopharyngeal cancer treatments. Systemic therapy, especially chemotherapy, may often be used before or during radiation therapy and/or surgery to increase the chances of destroying cancer cells. Choice treatment and recommendations depend on several factors; such as the type and stage of cancer, possible side effects and patient’s preferences, and overall health.  Surgery In surgical laryngeal and hypopharyngeal cancer treatment, the entire cancerous tumour and some of the healthy tissue around it are removed. However, it is sometimes impossible to completely remove cancer. In such cases, other treatments option will be carried out. The commonly used surgical procedures in laryngeal or hypopharyngeal cancer treatment are;

• Partial laryngectomy: That is, only a part of the larynx is removed. This helps preserve the natural voice of the patient. This surgery could be of four (4) techniques 

• Supraglottic laryngectomy: Removal of the area above the vocal folds. This may also involve the removal of part of the hypopharynx along with cancer. In such a case, this procedure is known as Partial Pharyngectomy.
• Cordectomy: Removal of the vocal fold.
• Vertical hemilaryngectomy: Removing one side of the larynx.
• Supracricoid partial laryngectomy: Removing the vocal folds and the surrounding area.
• Total laryngectomy: Removal of the entire larynx.

• Laryngopharyngectomy: The removal of the entire larynx, as well as the vocal folds and part, or all, of the pharynx.
• Neck dissection: If cancer spreads to the lymph nodes in the neck, a neck dissection is carried out. Neck dissection is the surgical removal of the lymph nodes in the neck. Neck dissections is of several types – partial neck dissection, modified neck dissection, and selective neck dissection.
• Laser surgery: This uses light beams to remove small tumours in the larynx. It can also be used to perform a partial laryngectomy. This is, however, still a relatively new treatment approach.

Radiation therapy This involves the use of high-energy rays to kill cancer cells by damaging the DNA inside the tumour cells and destroying their ability to reproduce. This prevents spreading and recurrence. It may either be externally or internally administered. External radiation involves the use of a machine to target the radiation at the cancerous area. Internal radiation, known as brachytherapy, involves using radioactive seeds or wires by placing them in the affected area. Systemic therapy  This is the use of medication to destroy cancerous cells. These medications are given through the bloodstream to reach the cancer cells throughout the body. They may also be given orally as pills or capsules that is swallowed. Systemic therapies used for laryngeal and hypopharyngeal cancer treatment are;

• Chemotherapy.
• Targeted therapy.
• Immunotherapy.

Chemotherapy: The use of medication to kill cancer cells, and prevent further division and growth. Chemotherapy is a systemic treatment, which means it is capable of killing cancer cells that have travelled to other parts of your body.  Targeted therapy: This treatment is targeted at specific genes or proteins of the cancer, or tissues that contribute to the growth and survival of the cancer. This treatment regimen blocks the growth and spread of the cancerous cells, while limiting the damage to healthy cells. Immunotherapy: Also known as biologic therapy. This therapy is designed to boost the body’s natural defences to fight the cancer. It uses materials made either internally (by the body) or externally (in a laboratory) to improve, target or restore immune system function. Side effects of laryngeal and hypopharyngeal cancer treatment

• Redness or skin irritation of the treated area.
• Dry mouth or thickened saliva due to damage of the salivary gland.
• Nausea and fatigue. 
• Bone pain. 
• Mouth sore and/or sore throat.
• Pain or difficulty swallowing. 
• Hoarseness or changes to the voice. 
• Loss of appetite, as a result of change in the sense of taste. 
• Hearing loss, as a result of build-up of fluid in the middle ear or nerve damage.
• Build-up of earwax, which dries out due to effect of the radiation therapy’s on the ear canal.
• Scarring (fibrosis).
• Difficulty in breathing, due to swelling in the mouth and tongue.
• Permanent loss of voice or speech impairment. 
• Lymphedema. 
• Facial disfigurement. 
• Numbness in parts of the neck and throat. 
• Less mobility in the shoulder and neck area.

Symptoms

• Hoarseness or other voice changes that do not go away within 2 weeks.
• An enlarged lymph node or lump in the neck.
• Airway obstruction, difficulty breathing, and noisy breathing.
• Persistent sore throat or a feeling that something is caught in the throat.
• Difficulty swallowing that does not go away.
• Ear pain.

Causes

The following are a few causes which may increase the onset of this type of cancer.

• Smoking or use of Tobacco
• Use of excessive Alcohol
• Exposure to asbestos, wood dust, paint fumes, and certain chemicals may increase a person's risk of developing laryngeal and hypopharyngeal cancer.
• Poor nutrition.
• A diet low in vitamins A and E can raise a person's risk of laryngeal and hypopharyngeal cancer.

FAQ

What is laryngeal and hypopharyngeal cancer? 

Laryngeal cancer is a form of cancer that develops in the tissue of the larynx. While hypopharyngeal cancer is the growth of cancerous cells in the hypopharynx (the area where the larynx and oesophagus meet).

What are the various laryngeal and hypopharyngeal cancer symptoms?

The following are possible laryngeal and hypopharyngeal cancer symptoms

• Swollen lymph nodes in the neck.
• Cough. 
• Sore throat.
• Having the feeling of a lump in the throat.
• Hoarseness or voice change.
• Difficult or painful swallowing.
• Frequent choking on food.
• Breathing difficulty.
• Noisy breathing.
• Ear pain.
• Lump in the neck.
• Sudden weight loss.
• Bad breath.

What causes laryngeal and hypopharyngeal cancer? 

Laryngeal and hypopharyngeal cancer is due to genetic mutations. These mutations lead to the uncontrollable growth of cells, which continue to live after healthy cells would normally die. The accumulating cells lead to the formation of tumour in the larynx and pharynx.

What are the risk factors of laryngeal and hypopharyngeal cancer?

The exact causes of the mutation that leads to laryngeal and hypopharyngeal cancer are not known. But certain factors that may increase the risk have been identified.

• Tobacco use; chewing and smoking.
• Alcohol abuse.
• Poor nutrition.
• Sex: Men are at an increased risk than women
• Age: People older than 65 are at more risk. 
• Race: It is more common in African-Americans than in other races.
• Workplace exposures to toxic substances: Such as wood dust, paint fumes, asbestos, and some other chemicals appear to increase the risk for laryngeal cancer. 
• Gastroesophageal reflux disease (GERD). 
• Viral infections; such as human papillomavirus (HPV) and Epstein-Barr virus increase the risk of laryngeal and hypopharyngeal cancer.

Are there any lifestyle and home remedies to laryngeal and hypopharyngeal cancer?

• Quit smoking and alcohol consumption. 
• Eat healthy and well. 
• Wear protective clothing if you work where you are exposed to toxic substances.
• Consume more fruits and vegetables.

Are there any coping and support tips for laryngeal and hypopharyngeal cancer?

• Learn enough about laryngeal and hypopharyngeal cancer. This will help you with decision making.
• Find someone to talk to and share your feelings. 
• Take care of yourself during treatment.