The larynx is the place where the voice is produced. So it is also called the voice box. The pharynx is the common passage for food and air. It is also known as the throat. So cancers in this site primarily affect speech and swallowing.
The tumours in the larynx and pharynx are the 9th most common cancer among all cancers in India.
Human papillomavirus vaccines can prevent the cancers that are caused due to the virus.
A detailed clinical history and a thorough clinical examination are made for each patient.
The possibility of survival depends on the cancer stage, site of involvement, grade of the tumour and the patient's compliance with the treatment. The survival of patients with cancer is generally denoted as 5-year survival, wherein the percentage of people surviving at the end of 5years after a cancer diagnosis is noted down. This is given in the tabular column below.
5 year survival rate for Laryngeal and Pharyngeal Cancers.
|Laryngeal and Pharyngeal|
Treatment options For Pharyngeal tumours
Oropharyngeal and Hypopharyngeal cancers are commonly treated by definitive radiation in the early stage and by chemoradiation in the advanced stage. Surgery for these patients is used in very select situations in early lesions amenable for robotic resection and advanced stage as a part of salvage therapy.
Treatment options For Laryngeal cancers
Early-stage treatment options include surgery or radiotherapy, selected based on which option will give the best functional outcome in terms of voice. In the advanced stage, chemoradiation is commonly used since it provides the best functional outcome. Surgery is used in the advanced stages when the thyroid cartilage is involved, recurrence after radiotherapy and a dysfunctional larynx.
Chordectomy, Partial laryngectomy, Total laryngectomy.
Chordectomy involves the removal of a part of the vocal cord under magnification with a microscope. LASER is generally used for extra precision
Partial laryngectomy involves the removal of a part of the larynx. As a result, there will be a change in voice. After that, however, the patient will be able to speak.
Total Laryngectomy involves total removal of the voice box. A hole is made through the windpipe (Tracheostomy) for breathing. The patient will however lose his voice and need additional procedures or training or devices to produce sound.
The pharynx is excised with a margin of apparently normal tissue. Depending on the tumour size, the tumour in the pharynx may be excised along with the larynx ( Laryngopharyngectomy) or maybe excised along with the oesophagus (Laryngopharyngo oesophagectomy). The defect is then immediately reconstructed as a free flap from the thigh or the intestines.
Malignant tumours in the pharynx and larynx spread to the lymph nodes in the neck. So, along with the tumour, the lymph nodes in the neck are also removed. This is called lymph node dissection. The lymph nodes removed are sent for biopsy to know whether they are involved in malignancy. This lymph node dissection helps remove the affected lymph nodes and allows us to decide on the subsequent treatment whether chemotherapy or radiotherapy is needed.
A hole is made in the neck through the windpipe through which the patient can easily breathe and prevent the food from entering the windpipe. The tracheostomy will be permanent in the case of total laryngectomy and temporary when partial laryngectomy is done.
Gastrostomy / Feeding tube-
Since the significant part of the surgery involves the food pipe and windpipe, the patient will not be able to eat immediately due to pain. We would also need time for the surgical wound to heal. Hence, we pass a tube through the nose into the stomach or directly into the stomach for feeding purpose and improve nutrition since it will also enhance healing. It will be removed once the patient can eat normally.