What is laryngeal carcinoma?

Laryngeal carcinoma is also colloquially called laryngeal cancer and describes a malignant growth on the larynx. Laryngeal cancer is one of the most common tumour diseases of the throat area in Germany, affecting mainly men over the age of 50. Depending on where the tumour is located, different symptoms can occur. The location of the tumour also determines the respective form of therapy.

How does a laryngeal carcinoma develop?

A laryngeal carcinoma is a malignant form of tumour in which healthy cells are destroyed by the infiltration of the laryngeal carcinoma of the larynx. In advanced stages, laryngeal carcinoma can also spread metastases to other parts of the body. The larynx, as an organ in the throat, separates the trachea and the oesophagus. The voice is produced with the help of the larynx.

What risk factors contribute to the development of laryngeal carcinoma?

Smoking is probably one of the main risk factors for developing laryngeal carcinoma, which is why statistically more and more women are affected by the disease. But regular alcohol consumption also increases the risk of laryngeal carcinoma. Patients who both smoke and drink alcohol are therefore more likely to develop laryngeal carcinoma.

In addition to these two risk factors, viruses can also contribute to the development of laryngeal carcinoma. Other risk factors are pollutants such as asbestos, arsenic, chromium, nickel and benzpyrene. Scientists also suspect that a hereditary predisposition can favour the development of laryngeal cancer.

What are the different types of laryngeal cancer?

Doctors distinguish between different types of laryngeal carcinoma, depending on which part of the larynx the tumour has formed:

• Supraglottic carcinoma: located above the vocal fold level and accounts for over 30 per cent of all laryngeal carcinoma cases. This cancer is usually only diagnosed when metastases have already formed in the lymph nodes of the throat. These can usually be felt on the outside of the neck.
• Glottic carcinoma: or also called vocal cord carcinoma, because it affects the vocal fold level (this is where the vocal cords and the stellate cartilage are located). More than 65 per cent of all laryngeal carcinoma cases are glottic carcinoma, but it is usually diagnosed at an early stage because of the noticeable initial symptoms.
• Subglottic carcinoma: located below the vocal fold level and accounts for less than 1 per cent of all laryngeal carcinoma cases

What are the symptoms of laryngeal carcinoma?

The symptoms of laryngeal cancer depend on the location of the tumour. Frequent throat clearing or hoarseness that lasts for a long time can be the first warning signs of laryngeal cancer. Other rather non-specific symptoms of laryngeal carcinoma can be distinguished depending on the type of tumour:

• Symptoms of supraglottic carcinoma can include swallowing difficulties and an unpleasant foreign body sensation in the throat accompanied by pain. The feeling of pain can be so strong that it radiates into the ears. Only when the tumour has also affected the vocal folds can hoarseness occur.
• Symptoms of glottic carcinoma are persistent hoarseness, accompanied by a harsh or breathy sound in the voice, an unpleasant scratching in the throat, frequent throat clearing and/or chronic coughing. In an advanced stage, breathing difficulties with audible breathing sounds may occur. Breathlessness (dyspnoea) may also occur.
• Symptoms of subglottic carcinoma develop relatively late, when the tumour has already developed a certain size that can lead to breathing difficulties. The possible fixation of the vocal folds caused by the tumour can also lead to hoarseness.

People should see an ear, nose and throat specialist if they suddenly develop hoarseness that lasts longer than two to three weeks. This may be a symptom of a tumour in the vocal fold area.

How is laryngeal cancer diagnosed?

If a laryngeal carcinoma is suspected, the larynx is first examined, for example by means of a laryngoscopy or a laryngoscopy. In direct laryngoscopy, a spatula and a small lamp are used to search the larynx for any changes. With indirect laryngoscopy, the doctor uses a mirror and a magnifying glass to take a closer look at the vocal folds and their mobility, as well as the other parts of the larynx.

A microlaryngoscopy offers a more precise way to examine the larynx. The procedure takes place under anaesthetic and allows the doctor to take a tissue sample (biopsy), which is then examined in the laboratory. Once the results of the biopsy are available, the doctor can make a definite diagnosis of laryngeal cancer. The results of the blood test support the diagnosis.

How is laryngeal carcinoma treated?

The treatment method depends on the type of tumour, its size, the stage of the cancer and the patient's general state of health. In general, the following treatment options can be considered:

• Surgery: may involve partial removal (partial laryngectomy) or complete removal of the larynx (laryngectomy). In the case of a laryngectomy, independent breathing is no longer possible, which is why the patient needs an artificial breathing opening (tracheostoma) after the operation.
• Radiation and chemotherapy: are usually used at an early stage of the cancer or are used for patients whose general health does not allow surgery.

What is the prognosis for laryngeal cancer?

Laryngeal cancer is one of the most common tumours of the throat. As with other types of cancer, the later the tumour is diagnosed, the poorer the chances of a cure. Nevertheless, the number of deaths from this disease is limited. Only about 1.5 percent of all male patients die from laryngeal cancer, compared to only one percent of women.