The larynx is the organ that allows us to swallow, breathe and speak. The importance of its functions goes in that order, although the larynx is always related to the voice.
Laryngeal cancer represents a small percentage of the total number of malignant tumors affecting the population. In our country approximately 4.1 cases are diagnosed per 100,000 inhabitants/year (1) (Globocan 2008). As a reference we can take breast cancer, with 61 cases per 100,000 inhabitants/year, or prostate cancer, with 57 cases per 100,000 inhabitants/year. The mortality rate of laryngeal cancer is below 50%, with an incidence of 2.1 cases per 100,000 inhabitants/year. In other words, it can be cured in 50% of cases. In comparison, that of breast and prostate cancer is 12.9 and 10.5 respectively.
What does it depend on whether laryngeal cancer can be cured?
The chances of curing this type of cancer depend on the speed of diagnosis. The fundamental thing is to go to the specialist when there are symptoms of suspicion such as hoarseness, difficulty in swallowing, the presence of a mass in the neck or discomfort in the pharynx. The population with a higher risk of suffering from laryngeal cancer are male smokers and drinkers over 45 years of age. If you belong to the risk group and these symptoms appear for more than 10 to 15 days, it is advisable to see an otolaryngologist. Unfortunately, most patients only see a specialist when the symptoms last more than 3 months.
How is laryngeal cancer diagnosed?
The diagnosis of suspicion is made by examination of the larynx with a fiberscope. This device is a small fiber optic tube that is inserted through the nose. Imaging studies, such as CT scans, are used to assess the extent of the lesion in the larynx, as well as to detect lymph node metastases, i.e. the presence of lymph nodes with tumor in the neck. For the diagnosis it is essential to perform a biopsy of the suspicious tissues, for which it may be necessary to subject the patient to general anesthesia.
All these procedures serve to determine whether or not the lesion is malignant and, if it is, what local and regional extension it has. The extent is called stage and is coded with the acronym TNM. T determines the extent of the tumor in the larynx; N the extent of the disease in the neck nodes (lymph node metastases); and M the presence of disease in other parts of the body (distant metastases). The prognosis of laryngeal cancer is mainly determined by the presence or absence of metastases in the neck nodes.
What is the most appropriate treatment?
The most appropriate treatment for each lesion will depend on its stage, the patient’s preferences and the experience of the treatment team.
The most frequently used procedures for the treatment of laryngeal cancer are surgery and radiotherapy. In the last two decades, laser and chemotherapy have also been included in the protocols for the treatment of the disease.