Laryngeal Tumors & Cancer
Laryngeal cancer is not as well known by the general public as some other types of cancer, yet it is not a rare disease. The American Cancer Society estimates that in 2005 almost 10,000 new cases of laryngeal cancer will be diagnosed, and close to 3,800 people will die from laryngeal cancer in the United States. Even for survivors, the consequences of laryngeal cancer can be severe with respect to voice, breathing, or swallowing. It is fundamentally a preventable disease though, since the primary risk factors for laryngeal cancer are associated with modifiable behaviors.
Risk Factors Associated With Laryngeal Cancer
Development of laryngeal cancer is a process that involves many factors, but approximately 90 percent of head and neck cancers occur after exposure to known carcinogens (cancer causing substances). Chief among these factors is tobacco. Over 90 percent of laryngeal cancers are a type of cancer called squamous cell carcinoma (SCCA), and over 95 percent of patients with laryngeal SCCA are smokers. Smoking contributes to cancer development by causing mutations or changes in genes, impairing clearance of carcinogens from the respiratory tract, and decreasing the body’s immune response.
Tobacco use is measured in pack-years, where one pack per day for one year is considered one pack-year. Two pack-years is defined as either one pack per day for two years, or two packs per day for one year (Longer terms of pack years are determined using a similar ratio.) Depending upon the number of pack-years smoked, studies have reported that smokers are about 5 to 35 times more likely to develop laryngeal cancer than non-smokers. It does seem that the duration of tobacco exposure is probably more important overall to cancer causing effect, than the intensity of the exposure.
Alcohol is another important risk factor for laryngeal cancer, and acts as a promoter of the cancer causing process. The major clinical significance of alcohol is that it potentiates the effects of tobacco. Magnitude of this effect is between an additive and a multiplicative one. That is, people who smoke and drink alcohol have a combined risk that is greater than the sum of the individual risks. The American Cancer Society recommends that those who drink alcoholic beverages should limit the amount of alcohol they consume, with one drink per day considered a limited alcohol exposure.
Other risk factors
Other risk factors for laryngeal cancer include certain viruses, such as human papilloma virus (HPV), and likely acid reflux. Vitamin A and beta-carotene may play a protective role.
Signs and Symptoms of Laryngeal Cancer
Signs and symptoms of laryngeal cancer include: progressive or persistent hoarseness, difficulty swallowing, persistent sore throat or pain with swallowing, difficulty breathing, pain in the ear, or a lump in the neck. Anyone with these signs or symptoms should be evaluated by an Otolaryngologist (Ear, Nose and Throat Doctor). This is particularly important for people with risk factors for laryngeal cancer.
Treatment of Laryngeal Cancer
The primary treatment options for laryngeal cancer include surgery, radiation therapy, chemotherapy, or a combination of these treatments. Remember that this is a preventable disease in the vast majority of cases, because the main risk factors are associated with modifiable behaviors. Do not smoke and do not abuse alcohol!
Copyright © 2015 American Academy of Otolaryngology–Head and Neck Surgery. Reproduction or republication strictly prohibited without prior written permission.
Precancerous Laryngeal Lesions
Precancerous laryngeal lesions are defined as morphological alterations of the mucus membrane in the throat cause by chronic irritation or illness.
Many malignant tumors in the larynx develop from these precancerous laryngeal lesions. This means that early detection and excision of these lesions can prevent more serious issues in the future.
These lesions are often associated with a condition of the larynx called dysplasia. Smokers, heavy drinkers, and people with acid reflux are at a greater risk for this condition.
There are three classes of precancerous laryngeal lesions:
- Class 1: Mild Dysplasia
- Class 2: Moderate Dysplasia
- Class 3: Severe Dysplacia and carcinoma
The risk of cancer is lowest for those with class one lesions and highest for those with class 3 lesions. Treatment for lesions will depend on the severity of the condition.
Recurrent Respiratory Papilomatosis
Recurrent respiratory papillomatosis is a rare condition that is characterized by the growth of tumors in the respiratory tract. Tumors generally occur around the larynx and vocal cords, but they can also affect the trachea, bronchi, and lungs.
This rare disease is caused by the human papilloma virus (HPV). This disease can affect adults and children. There is significant evidence that recurrent respiratory papillomatosis (RPP) results when the mother s transmits HPV to the child during birth. In some cases birth via cesarean section can prevent transmission of the disease.
The most common symptom of RPP is a weak, hoarse, or strained voice. RPP can also cause people to have difficulty breathing, especially during exercise.
RPP is diagnosed by an ear, nose, and throat physician who examines the larynx.
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