Can any laryngeal cancer be operated on?
The possibility of operating on any type of laryngeal cancer will depend on the criteria of the therapeutic team. What must be evaluated is whether surgery is the best procedure, that is to say, if it is the type of treatment that provides the patient with the best chances of cure at the lowest cost for the functions of the larynx: voice, breathing and swallowing.
What does the surgery consist of?
Surgery consists of resecting the tumor with safe margins, in order to try to avoid a possible recurrence. The technique used depends on the stage of the lesion and where it is located. The larynx has three parts: supraglottis, glottis and subglottis. Depending on the area in which the tumor is located, the surgery will be different and so will its sequelae. The problem in relation to the supraglottis is that its removal conditions the patient’s ability to swallow well again. The epiglottis is a cartilage that protects the entrance of bodies into the trachea when we eat or drink. Without the epiglottis, food can pass into the trachea with the consequent risk of developing pneumonia. If a resection of the glottis, the vocal cords, is carried out, dysphonia is fundamentally produced.
Are there different ways of approaching the tumor?
The tumor can be approached through the mouth, which is known as transoral or endoscopic surgery, or with open surgery by making an incision in the neck. There are occasions when the tumor in the larynx can be removed endoscopically, but then it is necessary to open the neck to treat possible extensions (metastasis) in the lymph nodes.
Are there different types of surgery?
The types of surgery for laryngeal cancer are divided into two: partial and radical. Partial surgery seeks to resect the tumor, with safe margins, while trying to preserve the functions of the larynx (speaking, swallowing and breathing), without the need to perform a tracheotomy. Radical surgery, on the other hand, is indicated in those cases in which resection of the tumor requires complete removal of the larynx and therefore the need for a permanent tracheostomy.
Is laser surgery equally effective?
Laser surgery allows, in those cases in which it is indicated, to remove the lesion through the mouth. The patient’s recovery is faster and therefore the hospital stay is shorter. The effectiveness in terms of survival should be similar to open surgery, although the final results depend on the experience of each surgeon to avoid recurrences.
In which cases should the vocal cords or part of the larynx be removed?
In those cases in which, once the lesion has been confirmed by biopsy, the removal is necessary to obtain the necessary oncological safety margins.
Is the postoperative period long?
The postoperative period can last 24 hours in the case of resection of a small vocal cord tumor with laser, or several weeks in the case of an extensive tumor with cervical metastases and reconstruction needs.
What care should be taken after the operation?
It is essential that patients who have undergone surgery for laryngeal cancer stop smoking and use alcohol responsibly in order to avoid recurrence.
Readaptation to life after surgery will depend on the type of surgery performed. There are patients in whom the only adaptation necessary will be to accept their voice changes. Others will need to follow rehabilitation strategies to adapt to a new way of swallowing food. Patients who have undergone radical surgery, who have a permanent tracheostoma, will need rehabilitation to be able to speak again and care to avoid respiratory problems related to the tracheostoma.
The patient must have regular check-ups to ensure that there are no recurrences. Recurrences are more frequent in the first 18 months after surgery. For this reason, during the first two years, patients have monthly or bimonthly check-ups. If there is any change in the tone of the voice, or if there is a lump in the neck, it is recommended that the patient go immediately for consultation.