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Laryngeal Cancer
By peace | July 15, 2006
The American Cancer Society (ACS) says that about 4,000 people die of cancer of the larynx each year. The larynx is also called the voice box. It is located at the top of the windpipe and is about 2 inches long. The walls of the larynx are made of cartilage and it is the large front part that forms the so-called Adam’s apple. Inside the larynx are two muscles that make up our vocal cords.
The larynx (or voice box) is a short passageway shaped like a triangle that is just below the pharyx in the neck. The pharynx is a hollow tube about five inches long that starts behind the nose and goes down to the neck to become part of the esophagus (the tube that goes to the stomach).
Air passes through the pharynx and then the larynx on the way to the windpipe (trachea) and into the lungs. Food passes through the pharynx on the way to the esophagus. The larynx has a small piece of tissue over it, called the epiglottis, to keep food from going into it or into the air passages.
The larynx contains the vocal cords, which vibrate and make sound when air is directed against them. The sound echoes through the pharynx, mouth, and nose to make a person’s voice. The muscles in the pharynx, face, tongue, and lips help people form words with sounds to make them understandable.
There are three main parts of the larynx: the glottis (the middle part of the larynx where the vocal cords are located); the supraglottis (the tissue above the glottis); and the subglottis (the tissue below the glottis). The subglottis connects to the trachea, which takes air to the lungs.
Cancer of the larynx is a disease in which cancerous (malignant) cells are found in the tissues of the larynx. It is most commonly found in people who smoke. If a person who smokes develops cancer of the larynx, they should stop smoking.
Risk Factors
The American Cancer Society estimates that about 10,000 new cases of laryngeal cancer are diagnosed each year. The primary risk factors for the disease are alcohol abuse and smoking.
A smoker has a 5-35 times greater risk than a nonsmoker of developing the disease, and a heavy drinker has a 2-5 times greater risk than a nondrinker of developing the disease. If a person is both a heavy drinker and a heavy smoker, the risk is even greater. Because these behavioral risk factors are more common among men than among women, men are more likely than women to develop hypopharyngeal cancer.
Other risk factors for the disease include the following:
- Age: Laryngeal cancer is most common among people in their sixties and older.
- Race: African Americans have a greater risk than whites.
- Poor nutrition: Poor eating habits are often associated with alcohol abuse and may be the reason that the incidence of hypopharyngeal cancer is greater among heavy drinkers.
- Human papillomavirus (HPV): If a woman has genital warts, in rare cases they may be spread to her baby’s larynx during birth. Children who have benign growths on their larynx have a slightly greater risk of developing laryngeal cancer later in life.
- Weak immune system: People with weakened immune systems (for example, persons with AIDS and organ transplant patients) have a greater risk of developing head and neck cancers.
Most laryngeal cancer can be prevented by not smoking or abusing alcohol.
Symptoms And Diagnosis
Hoarseness is the primary symptom of glottic cancer, cancer of the vocal cords. Symptoms of supraglottic (above the vocal cords) and subglottic (below the vocal cords) cancers include:
- a sore throat that does not go away
- pain when swallowing
- a change or hoarseness in the voice
- pain in the ear
- a lump in the neck
Cancers in the supraglottis and subglottis tend to spread more quickly than glottic cancer, because the supraglottis and subglottis contain more lymph vessels, through which cancer cells spread.
If a patient has symptoms of cancer of the larynx, the doctor will put a tube with a special light on the end of it down the patient’s throat to look at the larynx. This procedure is called laryngoscopy. If the larynx has tissue that does not look normal, the doctor will need to cut out a small piece of the tissue and look at it under the microscope to see if it contains any cancer cells. This procedure is called a biopsy, and it is the only way to confirm a cancer diagnosis. The doctor will also feel the patient’s throat for lumps.
The chance of recovery (prognosis) from laryngeal cancer depends on where the cancer is in the larynx, whether the cancer is just in the larynx or has spread to other tissues (the stage), and the patient’s general state of health.
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