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| '''For patient information click [[{{PAGENAME}} (patient information)|here]]'''{{Infobox_Disease | | '''For patient information click [[{{PAGENAME}} (patient information)|here]] |
| | Name = {{PAGENAME}}
| | {{Laryngeal cancer}} |
| | Image = Larynx cancer 01.jpg
| | {{CMG}} {{AE}} {{OK}}, {{Faizan}} |
| | Caption = Larynx cancer.
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| | DiseasesDB =
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| | ICD10 = {{ICD10|C|32||c|30}}
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| | ICD9 = {{ICD9|161}}
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| | MeshID = D007822
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| {{Editor Help}} | | {{SK}} Cancer of larynx, Malignant tumor of larynx, Laryngeal carcinoma, Squamous cell carcinoma of the larynx, SCC of the larynx, Voice box cancer |
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| ==Overview== | | ==[[Laryngeal cancer overview|Overview]]== |
| '''Laryngeal cancer''' may also be called '''cancer of the larynx''' or '''laryngeal carcinoma'''. Most laryngeal cancers are [[squamous cell carcinoma]]s, reflecting their origin from the [[squamous cell]]s which form the majority of the laryngeal [[epithelium]].
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| [[Cancer]] can develop in any part of the [[larynx]], but the cure rate is affected by the location of the tumor. For the purposes of tumour [[Cancer staging|staging]], the larynx is divided into three anatomical regions: the [[glottis]] (true vocal cords, anterior and posterior commissures); the supraglottis ([[epiglottis]], [[arytenoids]] and [[aryepiglottic folds]], and [[Vocal folds#False vocal folds|false cords]]); the subglottis.
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| Most laryngeal cancers originate in the [[glottis]]. Supraglottic cancers are less common, and subglottic tumours are least frequent.
| | ==[[Laryngeal cancer historical perspective|Historical Perspective]]== |
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| Laryngeal cancer may spread, either by direct extension to adjacent structures, by [[metastasis]] to regional cervical [[lymph node]]s or more distantly, through the blood stream. Distant metastates to the lung are most common. | | ==[[Laryngeal cancer classification|Classification]]== |
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| ==Incidence== | | ==[[Laryngeal cancer pathophysiology|Pathophysiology]]== |
| 5 in 100,000 (12,500 new cases per year) in USA. <ref name=AMN>{{cite web | author = Samuel W. Beenken, MD | title =Laryngeal Cancer (Cancer of the larynx)| work =Laryngeal Cancer (Cancer of the larynx) | url=http://www.health.am/cr/laryngeal-cancer/ | publsiher=Armenian Health Network, Health.am | accessdate=2007-03-22}}</ref> The American Cancer Society estimates that 9,510 men and women (7,700 men and 1,810 women) will be diagnosed with and 3,740 men and women will die of cancer of the larynx in 2006.
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| Larynx Cancer is listed as a "rare disease" by the Office of Rare Diseases (ORD) of the National Institutes of Health (NIH). This means that Larynx Cancer, or a subtype of Larynx Cancer, affects less than 200,000 people in the US population. <ref name=NIH>{{cite web | title =Annual Report on the Rare Diseases and Conditions Research| url=http://rarediseases.info.nih.gov/ | publsiher=National Institutes of Health | accessdate=2007-03-22}}</ref>
| | ==[[Laryngeal cancer causes|Causes]]== |
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| Each year, about 2,200 people in the UK are diagnosed with cancer of the larynx (laryngeal cancer). <ref name=UK>{{cite web | title =Causes of laryngeal cancer| url=http://www.cancerbackup.org.uk/Cancertype/Larynx/Causesdiagnosis/Causes | publsiher=Cancerbackup-cancerbackup.org.uk | accessdate=2007-03-22}}</ref>
| | ==[[Laryngeal cancer differential diagnosis|Differentiating Laryngeal cancer from other Diseases]]== |
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| ==Causes== | | ==[[Laryngeal cancer epidemiology and demographics|Epidemiology and Demographics]]== |
| There is no single cause of laryngeal cancer. It is likely that several factors combine to cause it. Not all of these factors are known, but research is going on all the time into the possible causes.
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| Smoking, and heavy drinking of alcohol (especially spirits) greatly increase the risk of developing cancer of the larynx.
| | ==[[Laryngeal cancer risk factors|Risk Factors]]== |
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| Cancer of the larynx occurs mainly in middle-aged and older people, but it can occur in younger people who started smoking at an early age. It is more common in men than in women.
| | ==[[Laryngeal cancer screening|Screening]]== |
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| ==Risk factors == | | ==[[Laryngeal cancer natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
| [[Image:Tumor Laryngis-01.jpg|thumb|left|200px|Larynx cancer - endoscopic view.]] | |
| Smoking is the most important risk factor for laryngeal cancer. Heavy chronic consumption of [[alcohol]], particularly alcoholic spirits, is also significant. When combined, these two factors appear to have a synergistic effect.
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| Some other quoted risk factors are likely, in part, to be related to prolonged alcohol and tobacco consumption. These include low socioeconomic status, male sex, and age greater than 55 years.
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| People with a previous history of [[head and neck cancer]] are known to be at higher risk (about 25%) of developing a second cancer of the head, neck, or lung. This is mainly because in a significant proportion of these patients, the aerodigestive tract and lung epithelium have been exposed chronically to the carcinogenic effects to alcohol and [[tobacco]]. In this situation, a field change effect may occur, where the epithelial tissues start to become diffusely dysplastic with a reduced threshold for malignant change. This risk may be reduced by quitting alcohol and tobacco.
| | ==Diagnosis== |
| | [[Laryngeal cancer staging|Staging]] | [[Laryngeal cancer history and symptoms|History and Symptoms]] | [[Laryngeal cancer physical examination|Physical Examination]] |[[Laryngeal cancer laboratory tests|Laboratory Findings]] | [[Laryngeal cancer electrocardiogram|Electrocardiogram]] | [[Laryngeal cancer chest x ray|Chest X Ray]] | [[Laryngeal cancer CT|CT]] | [[Laryngeal cancer MRI|MRI]] | [[Laryngeal cancer echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Laryngeal cancer other imaging findings|Other Imaging Findings]] | [[Laryngeal cancer other diagnostic studies|Other Diagnostic Studies]] |
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| ==Symptoms == | | ==Treatment== |
| The symptoms of cancer of the larynx depend on the size and location the tumor. Symptoms may include the following:
| | [[Laryngeal cancer medical therapy|Medical Therapy]] | [[Laryngeal cancer surgery|Surgery]] | [[Laryngeal cancer primary prevention|Primary Prevention]] | [[Laryngeal cancer secondary prevention|Secondary Prevention]] | [[Laryngeal cancer cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Laryngeal cancer future or investigational therapies|Future or Investigational Therapies]] |
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| *[[Hoarseness]] or other voice changes
| | ==Case Studies== |
| *A lump in the neck
| | [[Laryngeal cancer case study one|Case #1]] |
| *A [[sore throat]] or feeling that something is stuck in the throat
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| *Persistent [[cough]]
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| *[[Stridor]]
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| *[[Bad breath]]
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| *[[Earache]]
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| ==Diagnosis == | |
| Diagnosis is made by the doctor on the basis of a careful [[medical history]], [[physical examination]], and special investigations which may include [[Chest X-Ray]], [[Computed tomography|CT]] or [[MRI]] scans, and tissue biopsy. The examination of the larynx requires some expertise, which may require specialist referral.
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| The [[physical exam]] includes a systematic examination of the whole patient to assess general health, to look for signs of associated conditions and metastatic disease. The neck and [[supraclavicular fossa]] are palpated to feel for cervical adenopathy, other masses, and laryngeal crepitus. The oral cavity and oropharynx are examined under direct vision. The larynx may be examined by Indirect laryngoscopy using a small angled mirror with a long handle (akin to a dentist's mirror) and a strong light. Indirect laryngoscopy can be highly effective, but requires skill and practice for consistent results. For this reason, many specialist clinics now use fibre-optic nasal endoscopy where a thin and flexible [[endoscope]], inserted through the nostril, is used to clearly visualise the entire pharynx and larynx. Nasal endoscopy is a quick and easy procedure, performed in clinic. Local anaesthetic spray may be used.
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| If there is a suspicion of cancer, [[biopsy]] is performed, usually under general anesthetic. This provides definitive [[histological]] proof of cancer type and grade. If the lesion appears to be small and well localised, the surgeon may undertake excision biopsy, where an attempt is made to completely remove the tumour at the time of first biopsy. In this situation, the pathologist will not only be able to confirm the diagnosis, but can also comment on the completeness of excision i.e. whether the tumour has been completely removed. A full endoscopic examination of the larynx, trachea and esophagus is often performed at the time of biopsy.
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| For small [[glottic]] tumours further imaging may be unnecessary. In most cases, tumour staging is completed by scanning the head and neck region to accurately assess the local extent of the tumour and any pathologically enlarged cervical lymph nodes.
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| The final management plan will depend on the specific site, stage (tumour size, nodal spread, distant metastasis) and histological type. The overall health and wishes of the patient must also be taken into account.
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| == Treatment ==
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| Specific treatment depends on the location, type, and stage of the tumour. Treatment may involve [[surgery]], [[radiotherapy]], or [[chemotherapy]], alone or in combination. This is a specialised area which requires the coordinated expertise of dedicated ear, nose and throat (ENT) surgeons ([[otolaryngologists]]) and [[oncologists]].
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| ==References==
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| <references/>
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| ==External links==
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| * [http://www.cancerhelp.org.uk/help/default.asp?page=5606 Staging cancer of the larynx]
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| {{tumors}} | | {{tumors}} |
| {{SIB}}
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| [[de:Kehlkopfkrebs]]
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| [[nl:Larynxcarcinoom]]
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| [[pl:Rak krtani]]
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