Category	Information
Definition	A type of cancer that arises from the uncontrolled growth of cells in the larynx.
Symptoms	Hoarseness, difficulty swallowing, shortness of breath, sore throat, ear pain, bloody sputum, neck lumps.
Diagnostic Methods	Physical examination, laryngoscopy, biopsy, CT, MRI, PET scans.
Treatment Methods	Surgery (partial or total laryngectomy), radiotherapy, chemotherapy, immunotherapy, targeted therapy.
Causes	Smoking, alcohol use, HPV infection, reflux disease, asbestos and other chemical exposures.
Chance of Survival	The chance of survival is good with early diagnosis and treatment; in advanced stages, treatment can be more complex and challenging.
Prevention Methods	Quitting smoking and alcohol, regular check-ups, healthy eating, HPV vaccination.
Complications	Metastasis, loss of voice, breathing and swallowing problems, fistula formation.
Follow-up and Monitoring	Regular doctor check-ups, adherence to treatment, lifestyle changes, rehabilitation programs (speech and swallowing therapy).
Staging	Stage I (early stage), Stage II (localized), Stage III (locally advanced), Stage IV (metastatic).
Biopsy Methods	Fine needle aspiration biopsy, excisional biopsy, incisional biopsy.
Treatment Plan	Personalized treatment plan based on the cancer stage and the patient’s overall health condition.

Ear, Nose, Throat, Head and Neck Surgery Specialist
Prof. Dr. Murat Topdağ

Born in Malatya in 1978, Murat Topdağ completed his primary and secondary education, then attended high school in Istanbul. He graduated from the English program of Cerrahpaşa Tıp Fakültesi. Prof. Dr. Murat Topdağ is married and has two children.

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What is Laryngeal Cancer (Larynx Cancer)?

Laryngeal cancer constitutes a significant portion of head and neck cancers. These types of cancer can originate from three main regions of the larynx: supraglottis, glottis, and subglottis. Each region has unique characteristics that affect the spread and treatment methods of the cancer. Early stages of the disease can generally be successfully managed with larynx-preserving treatments. Advanced stages, however, require more complex treatment approaches and generally have a worse prognosis.

• The most common type of laryngeal cancer is squamous cell carcinoma.
• Other rare types include sarcomas, minor salivary gland carcinomas, melanomas, and lymphomas.

Smoking is one of the most important factors that increase the risk of laryngeal cancer. Additionally, ethanol consumption, asbestos exposure, and exposure to various chemicals in the environment can also pose a risk for this type of cancer. Each subregion of the larynx has its own staging system, which plays a critical role in determining the treatment options. Primary subglottic cancers are rare and generally indicate a poor prognosis. On the other hand, the association between HPV and this type of cancer is weak, although oncogenic pathways associated with HPV have been identified in some cases.

What are the Risk Factors and Causes of Laryngeal Cancer?

In the development of laryngeal cancer, there are many factors that influence the disease progression. The use of tobacco and tobacco products is one of the most common causes of cancer. These products damage the tissues of the larynx and significantly increase the risk of cancer. Alcohol consumption is another factor that increases the risk, especially when combined with smoking, which further elevates the risk. Dietary habits also play an important role. Irregular and unhealthy eating can increase the risk of laryngeal cancer.

Other risk factors include:

1. Work environment: People working in sectors such as petroleum products, paint industry, and woodworking have a higher incidence of laryngeal cancer.
2. Reflux disease: The backflow of stomach acid into the esophagus can damage the tissues of the larynx and increase the risk of cancer.
3. HPV infection: The human papillomavirus (HPV) can contribute to the development of laryngeal cancer.

Being aware of these risk factors is of great importance for early diagnosis and preventive measures.

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Diagnosis and Symptoms of Laryngeal Cancer

Laryngeal cancer is a serious health issue that affects the vocal cords and respiratory tract. The most common symptom of this disease is hoarseness and changes in the pitch of the voice. Tumors that form on or near the vocal cords affect the quality of the voice. If these symptoms persist for more than two weeks, it is essential to consult an Ear, Nose, and Throat (ENT) specialist. Other symptoms of the disease include:

1. Splitting of the voice and abnormal changes
2. Difficulty speaking and hoarseness
3. Pain during swallowing
4. Burning and pain in the throat while breathing
5. Bloody sputum
6. Feeling like something is stuck in the throat
7. Persistent headaches
8. Pain or discomfort in the ear and neck
9. Lumps felt in the neck
10. Unexplained weight loss

As laryngeal cancer progresses, it can spread to other parts of the body. In advanced stages, lymph nodes and adjacent organs can be affected. Thus, different symptoms may be observed depending on the organs to which the cancer has spread. This situation increases the severity of the disease and the need for treatment. Early diagnosis significantly increases the success of treatment and preserves the patient’s quality of life.

How is Laryngeal Cancer Diagnosed?

The first step in diagnosing laryngeal cancer is evaluating the patient’s symptoms by an Ear, Nose, and Throat (ENT) specialist. The specialist listens to the patient’s medical history and conducts a comprehensive physical examination. This stage reveals potential risk factors and symptoms. If there is doubt, the doctor may request special examinations such as laryngoscopy. A laryngoscope is used to examine the inner part of the larynx in detail, allowing visualization of the laryngeal structure. If an abnormal condition is detected, a definitive diagnosis via biopsy is performed. In this procedure, a small piece of tissue is taken from the suspicious area and examined under a microscope.

Imaging methods used during the diagnostic process:

1. Neck ultrasound
2. Computed Tomography (CT)
3. Magnetic Resonance Imaging (MRI)
4. Positron Emission Tomography (PET)

These methods are vital in determining the spread and stage of the disease. Each provides valuable information about the size of the cancer and whether it has spread to other parts of the body. This information plays an important role in determining and managing the patient’s treatment plan.

Stages of Laryngeal Cancer

Supraglottic Cancer Stages:

• Stage 1: The cancer is limited to the supraglottic region and does not affect the vocal cords.
• Stage 2: The cancer has spread from the supraglottic region to the vocal cords and may restrict the movement capability of the vocal cords.
• Stage 3: In this stage, there are two situations:
  • The cancer remains within the larynx, but the vocal cords can no longer move.
  • The cancer has spread to lymph nodes on the same side of the neck that are smaller than 3 cm.

Glottic Cancer Stages:

• Stage 1: The cancer is located only between the vocal cords in the glottis region.
• Stage 2: The cancer has penetrated beyond the vocal cords into the upper or lower part of the glottis region, sometimes to both parts. This spread may restrict the movement of the vocal cords.
• Stage 3: The cancer is located only within the larynx and the vocal cords can no longer move, or the cancer has spread to adjacent areas of the larynx. Additionally, the cancer may have spread to lymph nodes on the same side of the neck that are smaller than 3 cm.

Subglottic Cancer Stages:

• Stage 1: The cancer is located only within the subglottis and has not spread to the vocal cords.
• Stage 2: The cancer has spread from the subglottis to the vocal cords and may impede the normal movement of the vocal cords.
• Stage 3: The cancer remains only within the larynx and the vocal cords can no longer move. Additionally, the cancer has spread to lymph nodes on the same side of the neck that are smaller than 3 cm.

General Stage 4 of Larynx Cancer (Final Stage of Laryngeal Cancer):

• Stage 4A: The cancer has grown into nearby anatomical structures around the larynx, such as important anatomical structures. Lymph nodes may be affected, but in a limited number and specific size.
• Stage 4B: The cancer has spread to lymph nodes on both sides of the neck or to important blood vessels opposite to the tumor. There is extranodal spread.
• Stage 4C: The cancer has metastasized to other parts of the body. This is the most advanced and severe stage of cancer and requires aggressive treatment strategies.

Treatment Methods Applied in Laryngeal Cancer Treatment

Laryngeal cancer is a disease where treatment options are determined specifically based on the individual’s condition. Treatment is shaped according to the location, size, and spread of the tumor. In this process, the patient’s age and overall health condition are also taken into account. Generally, four main methods are preferred in cancer treatment.

1. Surgical Treatment: Depending on the spread of the disease, the entire larynx or a part of it is removed. In patients where intervention is done in the early stage, a portion of the larynx is removed, whereas in advanced stages, the entire larynx may be removed. A hole called a tracheostomy is opened to facilitate breathing. This hole can sometimes be permanent. If cancer cells have spread to the lymph glands, the lymph glands are also cleaned.
2. Radiotherapy: High-energy rays are used to target cancer cells. This method is applied in the form of daily doses of radiation. In early-stage cancers, it is preferred as an alternative to surgery, while in advanced stages, it can be used as an adjuvant treatment.
3. Chemotherapy: Used in advanced stages of cancer, before and after surgery or when cancer recurs. In cases where surgery is not possible, it is combined with radiotherapy to apply an organ preservation protocol.

Treatment of laryngeal cancer requires a multifaceted approach. Depending on the patient’s condition and the stage of cancer, different treatment methods can be used together. Each treatment method is specifically planned based on the patient’s overall health condition and the characteristics of the cancer.

Recovery Process After Surgery

After a major operation, the patient usually wakes up in the intensive care unit. Shortly after, they return to a normal room. The one-on-one nursing care in the intensive care ensures close monitoring of the patient’s condition. Similar intensive nursing care continues in the high-dependency recovery unit. In this process, the surgeon and the anesthetist closely monitor the patient’s progress. Intensive care units can be noisy and chaotic, which can be confusing for some patients.

As soon as the patient wakes up, a pulse oximeter is placed on their finger to measure their pulse and blood oxygen levels.

• Oxygen masks are used when respiratory support is needed.
• Nurses regularly check the blood pressure.

After surgery, the ability to speak may temporarily be lost. In this case, pen and paper are provided for communication. Breathing tubes may be placed depending on the complete or partial removal of the larynx. These tubes are critical for breathing and nutrition.

• Intravenous fluid supplementation is provided.
• Liquid nutrition is provided via a gastrostomy or nasogastric tube.
• Wound drains reduce the risk of infection and speed up healing.
• A catheter is used for urination.

Pain is normal in the first week after surgery and painkillers are regularly given. These painkillers should be taken on time to get the best result. Mobility is gradually increased under the supervision of a physiotherapist. Wound care is performed with dressing or protective spray.

The ability to eat and drink returns approximately one week later. Speech and tongue therapists work to ensure safety during the eating process. The first foods are usually soft foods and a dietitian manages this process. Taste and smell senses may be affected, so speech and tongue therapists guide in this matter.

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Dietary and Lifestyle Changes for Post-Surgery Patients

After treatment for laryngeal cancer, difficulty swallowing may occur, making eating very difficult. In this case, patients are recommended to follow a carefully managed diet plan after radiotherapy and surgery to facilitate the eating process. Doctors usually prescribe strong painkillers to support the swallowing process. Additionally, alternatives such as nasogastric tubes or PEG tubes may be offered for liquid nutrition. Throughout the treatment process, it is necessary to avoid acidic fruit juices and spicy foods because these can cause burning in the throat.

Soft diets can help minimize throat pain in patients. The following foods are suitable for this diet:

• Pureed vegetables
• Soft desserts like yogurt and pudding
• Boiled or steamed fish

To alleviate dry mouth experienced after radiotherapy, it may be helpful to carry a water bottle or mouth spray. Maintaining a moist oral environment can make eating easier. Generally, the consumption of soft foods is recommended during the recovery process, allowing patients to swallow food more easily and meet their nutritional needs.

Due to the weakened sense of smell, taste loss may also occur, making foods with more intense flavors preferable. Adding strong flavors to meals can enrich the eating experience. The use of garlic, lemon juice, and spices are effective ways to add extra flavor to meals.

To prevent weight loss, it is beneficial to eat regular and small meals. Additionally, vitamin, protein, and carbohydrate supplements prescribed by the doctor support daily food intake. These drinks are available in various flavors and provide the necessary energy. In addition to supplement drinks, protein or carbohydrate powders can be added to foods and drinks, allowing patients to meet their daily nutritional requirements more effectively.

FAQ

Where does Laryngeal Cancer spread to?

Laryngeal cancer is a disease that tends to spread to other parts of the body from its starting point. Initially, cancer cells infiltrate the tissues surrounding the larynx. Then, they reach the lymph nodes in the neck through the lymphatic system. During this process, cancer cells can also enter the bloodstream and spread to more distant parts of the body, especially to:

• Lungs
• Liver
• Bones

This spread of cancer is called metastasis and makes the treatment process more complicated. Early diagnosis is crucial in preventing the spread of cancer to other parts of the body. Therefore, it is vital to seek medical assistance immediately when symptoms of laryngeal cancer are noticed. This way, the risk of the disease spreading can be reduced and the chance of treatment can be increased.

Laryngeal cancer can be a life-threatening condition, but with early diagnosis and appropriate treatment methods, it can be manageable and offers hope for patients. Generally, one of the most important factors affecting the course of this disease is the ability to diagnose it early. In cases of early-stage laryngeal cancer, treatment options are broader and the chance of overcoming the disease increases. Treatment methods include surgical intervention, radiotherapy, and chemotherapy. Since each patient is different, the treatment plan is tailored individually. Additionally, avoiding harmful habits like smoking during the treatment process is of great importance for successfully treating the disease. Therefore, although laryngeal cancer can be fatal, it can be controlled with the right treatment approaches, and a hopeful future is possible for patients.

Which Department or Doctor Should I Go to for Laryngeal Cancer?

Laryngeal cancer is a serious health issue that affects both respiratory and vocal functions. This condition starts in the cells of the larynx. The success of the treatment process is directly related to early diagnosis. Patients should consult an ENT (Ear, Nose, and Throat) department at the first sign of symptoms. ENT specialists perform the necessary examinations and tests to make the correct diagnosis. They also determine the treatment plan. Treatment methods include surgical interventions, radiotherapy, and chemotherapy. Especially in early stages, the chance of successful treatment is very high. Therefore, it is vital to consult an ENT doctor immediately when symptoms are noticed. This process prevents the progression of the disease and promotes a healthy life.

Is Laryngeal Cancer Genetic or Contagious?

Laryngeal cancer is a complex disease that arises from a combination of genetic factors and environmental influences. Genetic predisposition can play an important role in the development of the disease. However, there is no information that laryngeal cancer is a contagious disease. Cancer develops as a result of mutations and DNA damage at the cellular level. These processes are not contagious between people. Especially, risk factors that can increase the risk of laryngeal cancer include:

• Long-term use of tobacco and alcohol,
• Infections with certain viruses,
• Excessive consumption of processed foods, and
• Poor nutrition

These environmental factors can trigger the development of cancer in genetically susceptible individuals. However, direct transmission of cancer from one person to another is not possible. Therefore, prevention and treatment strategies for laryngeal cancer should focus on managing risk factors and early diagnosis.

What Happens if Laryngeal Cancer is Not Treated?

If laryngeal cancer is not treated, it leads to serious health problems. Initially, tumors damage the vocal cords, causing hoarseness. Then, it can block the respiratory tract, making breathing difficult. It also causes difficulty swallowing, which can lead to nutritional problems. In advanced stages:

• The cancer spreads to nearby lymph nodes and adjacent organs.
• It causes pain and discomfort in the throat.

As a result, untreated laryngeal cancer is life-threatening. This condition deteriorates the patient’s overall health and significantly reduces the quality of life. Early diagnosis and treatment are crucial in preventing these serious consequences. Therefore, it is vital to seek medical help immediately when symptoms are noticed.

Does Laryngeal Cancer Go Away on Its Own?

Laryngeal cancer does not show signs of spontaneous recovery and is a serious health issue that requires specialized treatment. First, after the diagnosis is made, the treatment process begins. Treatment methods include surgical interventions, radiotherapy, and chemotherapy. Each treatment method is specifically planned based on the patient’s condition. During this process, patients must strictly follow their doctor’s advice. Additionally:

• Regular check-ups
• Healthy eating
• Avoiding harmful habits such as smoking and alcohol consumption

must be taken. Early diagnosis is crucial in combating the disease. Therefore, it is necessary to consult a specialist immediately when symptoms of laryngeal cancer are noticed. It is essential to act consciously and purposefully and fully comply with the treatment process to overcome this serious health issue.

At What Ages is Laryngeal Cancer Seen?

Laryngeal cancer holds an important place among head and neck cancers. The average starting age in men is 66 and in women 63. This disease becomes more common as age increases. Especially, smoking and alcohol use are among the main causes of laryngeal cancer. Symptoms of the disease include:

• Persistent hoarseness
• Sore throat
• Difficulty swallowing

As age increases, the body’s resistance decreases and the effects of harmful habits accumulate, increasing the risk of cancer in these age groups. Therefore, it is of great importance for elderly individuals to undergo regular health checks and reduce risk factors. Avoiding harmful habits like smoking and alcohol consumption can reduce the risk of laryngeal cancer.

How Long Does a Laryngeal Cancer Surgery Take?

The duration of laryngeal cancer surgery varies depending on the type of procedure performed. Endoscopic surgery is usually completed within a few hours. Partial laryngectomy may take a similar amount of time. However, total laryngectomy can take longer, sometimes exceeding a few hours. Since the duration varies per patient, the doctor will provide specific time information.

Is Laryngeal Cancer Detected in Blood Tests?

No, laryngeal cancer cannot be detected with blood tests. Blood tests are not suitable for diagnosing or staging this disease. However, they can be performed to assess the patient’s overall health condition. Other methods such as laryngoscopy or biopsy are necessary for detecting laryngeal cancer.

How Long Does Radiotherapy for Laryngeal Cancer Last?

Radiotherapy for laryngeal cancer typically lasts between three to seven weeks. The treatment is carried out daily from Monday to Friday. The duration may vary depending on the cancer stage and the patient’s overall health condition. Additionally, if radiotherapy can be combined with other treatments, the duration may be extended.

What Percentage of Disability Reports are Given After Laryngeal Cancer Surgery?

The percentage of disability reports given after laryngeal cancer surgery varies. Depending on the severity and stage of the disease, this rate is usually determined to be at least 40%. However, depending on specific circumstances, the rate may increase or decrease.

Is There a Chance of Survival in Stage 4 Laryngeal Cancer?

Yes, there is a chance of surviving stage four laryngeal cancer. The five-year relative survival rate is approximately 44%.

It is misleading to self-diagnose by looking at images or photos of laryngeal cancer, so please consult your doctor in case of suspicious symptoms.