Symptoms
Depending on their localization, the individual forms of cancer differ in their symptoms. The carcinoma of the vocal cords (glottis carcinoma) is located in the area of the vocal cords and thus quickly causes hoarseness. Since this leading symptom of laryngeal cancer often occurs early, the prognosis for vocal cord carcinoma is relatively good.
In some cases, laryngeal cancer can lead to shortness of breath if the tumor has grown too large. Supraglottic laryngeal carcinoma also leads to hoarseness of a rough voice and possibly a feeling of pressure in the throat. However, the symptoms appear late and this type of tumor metastasizes early into adjacent lymph nodes.
For this reason, the prognosis of supraglottic laryngeal carcinoma is significantly worse. Subglottic laryngeal carcinoma is a very rare form and does not cause any specific symptoms due to its location below the vocal folds. In later stages of laryngeal cancer, shortness of breath, pain and a feeling of pressure in the throat may occur. The transglottic carcinoma and hypopharyngeal carcinoma also lead to hoarseness, shortness of breath or a feeling of pressure. This depends on the exact localization.
Diagnosis laryngeal cancer
Throat cancer is often diagnosed only when the symptoms appear. In this case, the history of smoking and alcohol consumption as well as the description of the symptoms are important for further diagnosis. Imaging procedures such as computer tomography can detect throat cancer and determine its position.
In addition, affected lymph nodes can be detected by their size on CT. In order to get an exact picture of the spread of the tumor, however, laryngoscopy is essential. In this procedure, a small camera is moved forward to the larynx and the larynx is examined closely.
Since the examination is unpleasant and the unsuppressible gag reflex occurs in many patients, the throat is anaesthetized with an anaesthetic spray. To determine the exact type of tumor, a small sample is taken from the tumor (biopsy) and histologically examined. In most cases, only surgery with removal of the larynx is possible.
The larynx can be removed completely or only partially. In early tumor stages, the removal can be performed with a laser while preserving the organs. In later stages the larynx must be completely removed.The removal of the entire larynx (laryngectomy) has considerable consequences for affected patients.
These include first and foremost the loss of the voice. Through much training with a speech therapist, the so-called esophageal replacement language can be learned. In addition, there are electronic speech aids that make speech possible.
In both cases, however, the voice is no longer comparable with the original voice and it requires a lot of training to learn to speak again. Furthermore, the trachea and the oesophagus must be completely separated to avoid constant aspiration (swallowing of food or saliva). This leads to a drying of the nasal mucous membrane with a loss of the sense of smell.
Each operation is followed by radiation (radiotherapy) and/or chemotherapy. If the tumor is still small, an attempt can be made to treat it without surgery but only with chemo- and radiotherapy. If the tumor has spread further into adjacent organs or lymph nodes, these must also be removed in a neck dissection.
Glottis carcinoma: The vocal fold tumor is divided into different stages. These depend on the spread of the tumor and determine the treatment options. Stage T1 describes a tumor which is limited to the vocal folds.
If necessary, the anterior and posterior commissure is also affected, the mobility of the vocal folds is preserved. If the tumor affects only one vocal fold, this is described by stage T1a; if both vocal folds are affected, it is referred to as stage T1b. In stage T2 the tumor has spread to the area above and/or below the vocal fold (supraglottis and/or subglottis). The vocal fold mobility is restricted.
