What is Cancer of the larynx -
Laryngeal cancer is a disease in which malignant (cancerous) cells form in the tissues of the larynx.
From malignant neoplasms of the larynx is cancer (cancer laryngis). Laryngeal cancer affects mainly men aged 40 to 70 years of age: per 100 men account for 8 women.
There are the following three major divisions of the larynx
• The top, or the vestibular division of the larynx, including the scooped-epiglottis ligament with guttural hand, false vocal cords, morganeve the ventricles and the epiglottis.
• Middle division is the area of the true vocal cords.
• Lower or subglottic, part of the larynx.
What triggers / Causes of Cancer of the larynx
In the etiology of cancer is known to attach importance to a number of diseases of the larynx, are called precancerous. These include:
• papilloma, long-existing
• leukoplakia of mucous membranes and dyskeratosis her
• pachydermia
• fibroma on a broad basis
• branchial and other origin of the cyst laryngeal ventricles
• chronic inflammatory processes that are not inferior to treatment, due to syphilis, alcoholism, Smoking.
Most reliable is the malignancy of papillomas. Intermediate in form between precancer and cancer is the so-called "carcinoma in situ Classification of cancer of the larynx 1 takes into account the localization and stage of the tumor. This is dictated by the characteristics of the course, depending on the location of the lesion, which in turn is explained by the anatomical structure of the larynx, particularly the lymphatic system.
Pathogenesis (what is happening) at the time of Cancer of the larynx
Distinguish the following stages of larynx cancer
I stage. The tumor or ulcer, limited to mucosa and submucosa layer and not extending beyond one Department of the larynx.
Stage II. The tumor or ulcer, also limited to the mucosa and submucosal layer, fully occupies any part of the larynx, but not beyond its limits. The mobility of the larynx is preserved. In regional areas metastases are not detected.
Stage III
• a) the tumor goes to the underlying tissues, causing the immobility of the corresponding half of the larynx, but does not exceed the limits of any one it Department-
• b) the tumor spread to other departments of the larynx. The presence of single or multiple mobile regional metastases single or limited rolling metastasis.
Stage IV
• a large tumor occupying the major part of the larynx with infiltration of the underlying tissues-
• b) a tumor that's growing in neighbouring authorities-
• ) fixed metastases in the lymph nodes of the neck - g) tumor of any size in the presence of distant metastases.
Symptoms of Cancer of the larynx
The symptoms of laryngeal cancer depend on the stage and localization. The tumor on the epiglottis or false vocal cords could not be apparent, to remain unnoticed for the patient. On the contrary, with the localization of the true vocal cords very early disturbed voice formation: first, change the tone of voice, it becomes rough, and then there is hoarseness. Hoarseness and often causes the patient to seek medical attention.
In the future, as the growth of the tumor, hoarseness increases, the patient can only speak in a whisper. Along with this develops another symptom is shortness of breath. In advanced stages, pain when swallowing.
In cancer of the epiglottis and the arytenoid cartilage to the feeling of pain is preceded by a feeling of embarrassment or anything else. In the case of tumor lysis and joining secondary perichondritis pain much worse. After a time there hemoptysis, choking, joins difficulty in passing food through the esophagus.
Disintegrating the tumor emits a stench. Patients lose weight, weaken, growing cachexia. Thus, the earliest symptom of laryngeal cancer is often hoarseness. Since this symptom happens with many other diseases of the larynx, the clarification of the causes of hoarseness is possible only by laryngoscopy.
Diagnosis of Cancer of the larynx
Laryngoscopy, especially when the lesion is located on the true vocal ligament, allows to establish the presence of the tumor, even in cases when the size of her small peas. It provides the implementation of the main conditions for the fight against cancer by early diagnosis.
In the space of primary subglottic cancer is rare, occurs within some time asymptomatic and is diagnosed when it is already outside of this space. In subsequent tumor extends to the true vocal cords, as a result there is a persistent hoarseness. This symptom is typical and appears before difficulty breathing. Suggest here about the tumor may unilaterally increase the arytenoid cartilage.
Helps to recognize the tumor tracheoscopy. When the spread of cancer to adjacent organs - throat, the tongue, the esophagus will join new symptoms: inability to swallow, obstruction of the esophagus. The condition of the esophagus turns using fluoroscopy and esophagoscopy.
The diagnosis of laryngeal cancer is confirmed by microscopic examination of the piece of infiltration. However, if a positive response histologist in this case, is legally binding, a negative opinion is usually considered to be doubtful.
It so happens that the histologist considers change as an inflammatory process, and laryngoscopies is determined by the tumor. This discrepancy can be explained by taking a test piece from the surface, secondary inflammatory process, the simultaneous presence of the two diseases, such as cancer and syphilis or cancer and tuberculosis. Sometimes do not help to clarify the nature of the process and repeat biopsies. Special caution should be exercised in the cases when microscopically diagnosed papilloma in elderly men.Рак гортани
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Laryngeal cancer is used combined (sequential) treatment: radiation therapy and surgery.
There are different methods of treatment of patients with cancer of the larynx. For the treatment of cancer of the larynx there are different methods of treatment. Some approaches are considered standards of therapy (treatment that exists today), some studied in clinical trials. Clinical trials are underway to improve existing therapies or to obtain data on the effectiveness of new approaches. If the results of these studies proved the advantage of the studied methods of treatment, they can become the new standard treatment. Many patients can discuss with your doctor about participating in clinical trials. In some trials the enrollment of patients not yet treated.
There are three types of standard therapy
• Radiation therapy
Radiation therapy is a method of treatment of esophageal cancer using high-frequency x-rays or other types of radiation. The method allows to achieve the complete elimination of malignant cells or slowing of tumor growth. There are 2 types of radiation therapy. During external radiation therapy beams from the apparatus, located near the patient, is directed to the tumor. In internal radiation therapy radioactive substances are gaining in needles, tubes or catheters, which are ed into the tissue near the tumor or in the tumor. The choice of method of radiation therapy depends on the type and stage of malignancy.
The effectiveness of radiation therapy increases if before treatment patient refused from Smoking. External irradiation to the region of the thyroid gland or pineal body may affect the work of the organs. To ensure normal functioning of the thyroid gland should conduct a full examination before and after treatment.
• The surgeonalgebraic method
Operation (surgical removal of the tumor) is the primary method of treatment for all stages of cancer of the larynx. Conduct the following types of surgery:
• Cordectomy: surgical removal of only the vocal cords.
• Epiglottis laryngectomy: a Surgeondemand the removal of the epiglottis.
• Hemilaryngectomy: Surgeon- demand removal of half of the larynx (voice box). If hemilaryngectomy may store voice.
• Partial laryngectomy: surgical removal of part of the larynx (voice box). In partial laryngectomee possible to save the patient's speech.
• Complete laryngectomy: surgical removal of the entire larynx. When performing this operation on the front surface of the neck of the patient to make a hole for breathing. This procedure is called a tracheostomy.
• Thyroidectomy: Removal of all or part of the thyroid gland.
• Laser surgery: the Surgeonthe algebraic procedure when using the laser beam (a narrow high-frequency stream of light rays) is used instead of a knife, carried out a bloodless cuts in tissue or to remove located on the surface of the tumor.
Even if the doctor removes the tumor, which he sees during surgery, some patients, postoperative chemotherapy and radiation therapy for the complete destruction of the remaining tumor cells. Conducted after surgery treatment is called adjuvant.
• Chemotherapy
Chemotherapy is a method of treatment of cancer using cytotoxic drugs, which are aimed at the destruction of tumor cells or malignant growth slowdown. When taking drugs inside, given intravenously or intramuscularly, the drug enters the bloodstream, destroying circulating through the body the tumor cells (systemic chemotherapy). If chemotherapy is injected directly into the spinal canal, into the affected organ or any cavity of the body such as the abdominal, it is called regional chemotherapy.
The chemotherapy is carried out before surgery or radiation therapy to reduce tumor size. This type of radiation therapy is called neoadjuvant.
In clinical studies, the search for new treatments. Information about these studies can be found on the website of the NCI (National cancer Institute, USA) or with your physician, whom you can also discuss participating in such research.
• Chemoprophylaxis
Chemoprophylaxis is based on the use of medicines, vitamins or other substances that reduce the risk of cancer or the probability of the repetition (recurrence). To prevent the development of secondary tumors in patients pernessa cancer in the head and neck are studying a drug called isotretinoin.
• Radiosensibility
Radiosensibility are drugs that increase the sensitivity of tumors to radiation therapy. The combination of radiation therapy and radiosensitisation allows you to destroy a greater number of malignant cells.
Patients can ask their doctor about participating in clinical trials.
For some patients participate in clinical trials may be the best treatment choice. Clinical trials are part of the process of cancer research. They are conducted in order to determine whether new methods of tumor treatment are effective and safe, and how they outperform the standard approaches to therapy.
Most of today's standards for the treatment of malignant tumors based on previous clinical trials. Patients participating in research, can receive standard therapy or to be among the first who receive the new treatment.
Patients participating in clinical trials also contribute to the improvement of cancer treatments in the future. Even if a clinical trial does not lead to the discovery of new effective methods of combating the disease, very often on the basis of obtained results it is possible to give answers to critical questions and to help in further study of the problem. To participate in clinical trials before, during or after anticancer treatment.
In some studies enrolling patients without previous therapy. Other tests examine the effect of the drug in patients who did not respond to conducted before this treatment. There are also research new methods of relapse prevention (returns) of the disease or reducing the side effects of the drug.
After treatment the patient should be observed by a doctor.
After treatment to assess the effectiveness of treatment may require the repetition of certain diagnostic procedures carried out earlier for the diagnosis or stage of the process. Based on the obtained results a decision on the continuation, change or termination of treatment. This procedure is called restaurovani.
Some surveys will need to be repeated at regular intervals even after completion of treatment. The data of these surveys help to assess the patient's condition and to detect recurrence (return) of the disease. This process is called a dispensary
Prevention of Cancer of the larynx
Smoking cessation dramatically reduces the risk of not only cancer of the larynx, and cancer of the lung, mouth, lip, pancreas, bladder and esophagus. Also, quitting Smoking reduces the risk of head and neck tumors in patients with cancer of the larynx. The refusal of the use of alcohol, as the combination of Smoking with a pronounced alcohol the risk of developing cancer of the larynx becomes even higher. Persons engaged in the production of sulfuric acid, Nickel, asbestos, must comply with a number of professional precautions for the prevention of cancer of the larynx. Important regular checkups and timely treatment for professional and specialized medical help with the appearance of anxiety symptoms. Regular medical supervision and treatment of potentially precancerous diseases/conditions.
