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LARYNGEAL CANCER created by KIRAN K. KARETHA

Detailed presentation on laryngeal cancer covering anatomy, types, risk factors, staging, symptoms, diagnostic methods, and management including surgery, radiation, chemotherapy, targeted therapy, and immunotherapy.

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LARYNGEAL CANCER Presented By: MS. KIRAN K. KARETHA M.Sc (N), MSN (CCN)
INTRODUCTION •The larynx is an organ located between the pharynx and trachea. It plays an important role in: •Voice production (phonation) •Breathing •Protecting the airway during swallowing •Laryngeal cancer is one of the most common head and neck cancers and occurs more frequently in men over 50 years of age, especially those with a history of tobacco and alcohol use.
DEFINITION •Laryngeal cancer is a malignant tumor of the larynx characterized by the uncontrolled growth of abnormal cells within the laryngeal tissues. • It most frequently occurs as squamous cell carcinoma and is strongly associated with tobacco use and alcohol consumption.
TYPES OF LARYNGEAL CANCER 1. According to Location A. Supraglottic Cancer Supraglottic laryngeal cancer arises from the upper part of the larynx, above the true vocal cords.
CONTI.. •Accounts for approximately 30–35% of laryngeal cancers. •Rich lymphatic drainage leads to early spread to cervical lymph nodes. •Voice changes occur later because the true vocal cords are initially unaffected. •Often diagnosed at a more advanced stage than glottic cancer.
CONTI.. 2. Glottic Laryngeal Cancer •Glottic laryngeal cancer originates from the true vocal cords, which form the middle part of the larynx.
CONTI.. •Most common type, accounting for approximately 60–70% of cases. Sparse lymphatic drainage results in less frequent early lymph node metastasis. • Produces symptoms at an early stage because even a small lesion affects vocal cord vibration. •Frequently diagnosed early, making treatment more successful.
CONTI.. 3. Subglottic Laryngeal Cancer Subglottic laryngeal cancer develops in the lower part of the larynx, extending from below the true vocal cords to the upper border of the trachea.
CONTI.. •Rarest type, accounting for approximately 5% of laryngeal cancers. •Symptoms appear late because the tumor can grow without affecting the voice initially. •Often invades surrounding structures before diagnosis. May spread to lymph nodes and adjacent tissues.
CAUSES AND RF Tobacco use (smoking and smokeless tobacco) Alcohol consumption Human papillomavirus (HPV) infection Occupational exposure (asbestos, wood dust, chemicals) Increasing age Male gender
CONTI.. Previous head and neck cancer Poor nutrition Gastroesophageal reflux disease (GERD) Family history and genetic susceptibility Exposure to radiation Weakened immune system (immunosuppression)
STAGES Stage 0 (Carcinoma in Situ) Cancer is limited to the inner lining of the larynx. No invasion into deeper tissues. No lymph node or distant metastasis.
CONTI.. Stage I Tumor is confined to one part of the larynx. Vocal cords usually move normally. No lymph node involvement or distant metastasis.
CONTI.. Stage II Tumor has spread to more than one adjacent area of the larynx or an adjacent region. Vocal cord movement may be impaired. No lymph node or distant metastasis.
CONTI.. Stage III Tumor is confined to the larynx with vocal cord fixation, or Tumor has spread outside the larynx, or Spread to one nearby lymph node (≤3 cm). No distant metastasis.
CONTI.. Stage IVA Tumor invades nearby structures (e.g., thyroid cartilage, trachea, thyroid gland, esophagus, tongue muscles). OR spread to one or more regional lymph nodes. No distant metastasis.
CONTI.. Stage IVB Tumor invades major structures (e.g., prevertebral space, carotid artery, mediastinum) or Extensive regional lymph node involvement. No distant metastasis.
CONTI.. Stage IVC Cancer has spread to distant organs such as the lungs, liver, or bones. Distant metastasis is present.
CLINICAL MANIFESTATION Persistent hoarseness of voice (most common symptom) Change in voice quality Sore throat that does not heal Difficulty swallowing (dysphagia) Painful swallowing (odynophagia)
CONTI.. Coughing up blood (hemoptysis) Difficulty breathing (dyspnea) or noisy breathing (stridor) Lump or swelling in the neck Ear pain (referred otalgia) Feeling of a lump in the throat (globus sensation)
CONTI.. Bad breath (halitosis) Unexplained weight loss Fatigue and weakness Airway obstruction in advanced disease Persistent cough
DIAGNOSTIC EVALUATION History and Physical Examination Head and Neck Examination Laryngoscopy Flexible Fiberoptic Laryngoscopy
CONTI.. Biopsy Contrast-Enhanced CT Scan of the neck MRI Scan of the neck PET-CT Scan (to detect metastasis and recurrence) Chest X-ray or CT Chest (to assess lung metastasis or synchronous lung cancer)
CONTI.. Blood Investigations (CBC, liver function tests, renal function tests, coagulation profile) Pulmonary Function Tests Speech & Swallow evaluation
MANAGEMENT The management of laryngeal cancer depends on the site, stage (TNM), tumor size, vocal cord function, and the patient's general health. The main goals are to eradicate the cancer, preserve the voice and swallowing function whenever possible, and prevent recurrence.
CONTI.. 1. Surgery Surgery is the primary treatment for many early and advanced laryngeal cancers. a. Endoscopic Laser Surgery Performed through the mouth using a laryngoscope and laser. Removes small, early-stage tumors while preserving the larynx. Short hospital stay and rapid recovery.
CONTI.. b. Partial Laryngectomy Removes only the cancerous part of the larynx. The remaining larynx is preserved, allowing speech and swallowing. Suitable for selected Stage I and II cancers.
CONTI.. c. Total Laryngectomy Removal of the entire larynx. A permanent tracheostomy (opening in the neck) is created for breathing. Voice rehabilitation is required using an electrolarynx, esophageal speech, or a tracheoesophageal voice prosthesis. Usually performed for advanced tumors or recurrent disease.
CONTI.. d. Tracheostomy Performed to maintain the airway when there is severe airway obstruction.
CONTI.. 2. Radiation Therapy Radiotherapy uses high-energy X-rays to destroy cancer cells. Primary treatment for early-stage laryngeal cancer to preserve the voice. Given after surgery (adjuvant therapy) if margins are positive or lymph nodes are involved. Combined with chemotherapy for advanced cancers.
CONTI.. 3. Chemotherapy Chemotherapy destroys rapidly dividing cancer cells. Common Drugs Cisplatin Carboplatin 5-Fluorouracil (5-FU) Docetaxel
CONTI.. 4. Targeted Therapy Targeted therapy specifically blocks molecules involved in cancer growth. Drug Cetuximab
CONTI.. 5. Immunotherapy Immunotherapy helps the immune system recognize and destroy cancer cells. Drugs Pembrolizumab Nivolumab
LARYNGEAL CANCER created by KIRAN K. KARETHA