Abstract
Head-and-neck cancer is a term used generally to explain malignancies located in the oral and nasal cavities. Hypopharyngeal, laryngeal, nasopharyngeal, Oral and oropharyngeal, paranasal sinus, salivary gland and nasal cavity cancer are common types of HNCs. This paper describes laryngeal cancer, which is one type of HNC, in terms of facts and figures, causes and symptoms, diagnosis and treatment. The salient facts include: 1100 cases of laryngeal cancer are reported annually, accounting for 25% of HNCs; Laryngeal cancer is associated with smoking and the risk is increased through alcohol consumption; Diagnosis is done through mirror exam or physical exam; symptoms include persistent coughing, sore throat and changes in vocal cords and the treatment methods vary from chemotherapy to radiation treatment depending on origin and extent of spread of the disease.
Introduction
Head-and-Neck Cancer is a general term used to explain malignancies found in the oral and nasal cavities. Head-and-neck cancer is the world’s 8th most prevalent cancer and a significant contributor to cancer mortality [3]. In 2013, an estimated total of 53, 640 people (14340 women and 39,300 men) will develop HNCs in the US. This may lead to about 11520 deaths this year alone. Globally, approximately 550,000 HNC cases are reported annually [5]. There is a male predominance in number of patients. This is attributed to the number of men who smoke being more than the number of women who smoke (ratio 4:1). Smoking and alcohol are the main causes associated with HNCs [4, 13]. This paper describes laryngeal cancer in terms of causes, symptoms, treatment and how diagnosis can be made.
Types of HNCs
There are several types of HNCs: hypopharyngeal, laryngeal, nasopharyngeal, Oral and oropharyngeal, paranasal sinus, salivary gland and nasal cavity cancer. The naming of these HNCs depends on the location of the malignant cells. The most common types of HNCs are laryngeal, oral cavity and oropharynx cancer. This paper describes laryngeal cancer.
Laryngeal Cancer: Facts and Figures
The larynx, also known as the voice box, is an organ located in the throat. It is fundamental in speech, swallowing and breathing. Every year, there are 1100 new cases of cancer of the larynx, accounting for 25% of HNCs and 1% of the total number of cancers [9]. One-third of laryngeal cancer patients die from the disease. This cancer is most common in people between the ages of 60 and 70 [6]. Like other HNCs, laryngeal cancer begins in the flat and squamous cells.
Causes and symptoms
The disease is associated with smoking and the risk is multiplied by alcohol consumption [4]. Continued exposure to carcinogens may lead to a stepwise accumulation of epigenetic and genetic changes in head-and-neck squamous cells [9]. Laryngeal cancer cells spread when they break away from the tumor. They may reach lymph nodes through lymph vessels or blood vessels [8]. Symptoms associated with laryngeal cancer include persistent (more than 3 weeks) hoarseness, neck lump, voice changes, and small anomalies in vocal folds. In addition, a sore throat and trouble swallowing may be related to the cancer [9]. Other symptoms that are not specific to the cancer are persistent earache, cough and troubled breathing.
Diagnosis
People experiencing associated symptoms that are unaccounted for should go for a mirror exam or physical exam. The doctor should examine the throat and feel the neck for lumps or swelling. Other test may include indirect laryngoscopy, MRI, direct laryngoscopy, CT scan, chest X-ray and biopsy [10]. Indirect laryngoscopy is the use of a small mirror attached to a long handle to view the pharynx, movement of vocal cords and the throat. Direct laryngoscopy is the use of a lighted tube (rigid or flexible) to view the throat. More recently, research has been done to examine the feasibility of using an electronic nose to sniff out HNC cells [2]. The breath of laryngeal cancer patients has volatile compounds which are emitted due to cellular oxidative stress [3].
Treatment of Laryngeal cancer
Patients whose diagnosis of laryngeal cancer is done early may be treated through surgery or by way of radiation therapy [2]. In addition, a combination of treatments may be used. Chemotherapy and radiation treatment are combined together. This is what is known as aggressive treatment [6,8]. Targeted therapy may also be used for those patients whose diagnosis is done late [7]. Treatment choice depends on general health, origin of the cancer and extent of spread. Patients may be referred to specialists such as medical or radiation oncologists and otolaryngologists.
Conclusion
Head-and-Neck Cancer is a general term used to explain malignancies found in the oral and nasal cavities [1]. HNCs include hypopharyngeal, laryngeal, nasopharyngeal, Oral and oropharyngeal, paranasal sinus, salivary gland and nasal cavity cancer. Laryngeal cancer begins in the flat and squamous cells [12]. It is associated with smoking and the risk is increased through alcohol consumption [11]. Treatment is dependent on extent of sickness, health of the individual and the origin of the cancer.
References
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