Laryngeal squamous cell carcinoma is a health concern originating within the larynx, commonly known as the voice box. This cancer develops from the flat, skin-like cells lining the larynx.
What is Laryngeal Squamous Cell Carcinoma?
The larynx, or voice box, is a hollow tube in the neck, above the trachea. It functions in breathing, voice production, and protecting the airway during swallowing.
Squamous cell carcinoma begins in the flat, thin cells known as squamous cells. These cells cover the vocal cords and other parts of the larynx. Most laryngeal cancers are of this type, developing through a multi-step process.
Recognizing the Signs and Causes
Several factors increase the risk of developing laryngeal squamous cell carcinoma. Tobacco use, including smoking and chewing, is a primary risk factor. Excessive alcohol consumption also significantly contributes to the disease, and the combination of tobacco and alcohol use further elevates this risk. Human papillomavirus (HPV) infection and chronic irritation are additional contributing factors.
These factors can lead to genetic alterations in the cells lining the larynx, initiating the multi-step process of cancer development. Common signs include hoarseness or voice changes that do not improve after a few weeks. Other symptoms may involve pain or difficulty swallowing, known as dysphagia, a persistent sore throat, ear pain, or a lump in the neck.
How It Is Diagnosed
The diagnostic process for laryngeal squamous cell carcinoma begins with a physical examination and a review of symptoms and medical history. If a healthcare provider suspects an issue, they may perform an indirect laryngoscopy, which involves using a small hand mirror and light to examine the larynx. A flexible or fiber optic laryngoscopy, where a flexible tube with a camera is inserted through the nose, allows for a more detailed view.
If a suspicious area is identified, a direct laryngoscopy with a biopsy is often performed. This procedure, usually done under general anesthesia, involves inserting a rigid tube to visually inspect the larynx and collect a tissue sample. The biopsy is then examined by a pathologist to confirm the presence of cancer cells and determine the specific type. Imaging tests, such as CT scans, MRI, and PET scans, are used to assess the cancer’s extent and whether it has spread to nearby tissues or distant sites, a process known as staging.
Managing the Condition
Treatment plans for laryngeal squamous cell carcinoma are tailored to each individual, considering the cancer’s stage, location, and overall health. Treatment modalities include surgery, radiation therapy, and chemotherapy. Surgical options range from partial laryngectomy, which removes part of the voice box, to total laryngectomy, involving complete removal of the larynx.
Radiation therapy uses high-energy rays to destroy cancer cells, while chemotherapy uses drugs to kill cancer cells throughout the body. These treatments may be used alone or in combination. Newer options, such as targeted therapy and immunotherapy, are also available. Targeted therapy drugs, like cetuximab, attack cancer cells by targeting proteins that help them grow. Immunotherapy, including drugs like pembrolizumab and nivolumab, stimulates the body’s immune system to fight cancer cells. A multidisciplinary team of specialists, including surgeons, oncologists, and radiation oncologists, develops the most effective treatment strategy.
Life After Diagnosis
After treatment for laryngeal squamous cell carcinoma, ongoing follow-up care is important to monitor for any recurrence and manage potential long-term effects. This typically involves regular check-ups, which may include physical exams and laryngoscopies. Imaging tests, such as CT or PET scans, might also be used to ensure the cancer has not returned. These appointments gradually become less frequent over time, often extending for at least five years.
Rehabilitation, including speech and swallowing therapy, is often an important part of recovery, helping individuals adapt to changes in voice and swallowing function. Prognosis varies depending on factors such as the cancer’s stage at diagnosis, its location, and how well it responded to treatment. Adopting healthy lifestyle changes, such as quitting smoking and reducing alcohol intake, can improve overall health and help prevent recurrence or the development of new cancers.