Laryngeal cancer is a malignant neoplasm that develops from the epithelial tissue of the laryngeal mucosa. This disease is characterized by invasive growth and metastatic potential, mainly affecting the vocal cords (vocal localization accounts for about 60-70% cases). The pathogenesis of the disease is associated with a multi-stage process of malignancy of epithelial cells under the influence of various carcinogenic factors. Histologically, squamous cell carcinoma is most common (90-95% cases), less common are adenocarcinoma and other forms.
History of the disease and interesting historical facts
The first documented description of laryngeal cancer dates back to the 17th century, when Italian physician Giovanni Morgagni described a clinical case of a patient with a tumor of the vocal cords. In the 19th century, Theodor Billroth made a significant contribution to the study of the disease, performing the first successful laryngectomy in 1874. Interestingly, it was for laryngeal cancer that radiation therapy was first used in the early 20th century. “The development of microsurgical technologies in the 1970s significantly improved treatment outcomes,” notes a study published in the journal Head & Neck Oncology.
Epidemiology
According to WHO, about 180,000 new cases of laryngeal cancer are registered annually worldwide. The incidence rate is 2-3 cases per 100,000 population. There is a pronounced gender dimorphism: men get sick 4-6 times more often than women. The highest incidence rates are observed in the age group of 50-70 years. Mortality from this disease fluctuates between 25-30%.
- In Eastern European countries, incidence rates are higher than the global average
- There is a tendency towards an increase in the incidence of the disease among women.
- Five-year survival rates are 60-70% with early diagnosis
Genetic predisposition to this disease
Studies show the role of mutations in the TP53, CDKN2A and NOTCH1 genes in the development of laryngeal cancer. Polymorphisms of the genes of detoxification enzymes (CYP1A1, GSTM1) are also associated with an increased risk. "Mutations in the p53 gene are detected in more than 50% cases of squamous cell carcinoma of the larynx," - indicates the work published in the journal Cancer Research. Hereditary predisposition plays a lesser role compared to acquired mutations.
Risk factors for the development of this disease
Major risk factors include:
- Smoking tobacco (increases risk by 5-25 times)
- Alcohol consumption (synergistic effect with smoking)
- Occupational hazards (asbestos, nickel, chromium)
- Chronic laryngitis and reflux esophagitis
- Human papillomavirus (especially types 16 and 18)
Diagnosis of this disease
Key symptoms include hoarseness, pain when swallowing, and a foreign body sensation. Key diagnostic methods:
- Laryngoscopy and biopsy
- CT and MRI of the neck
- Ultrasound of regional lymph nodes
- Complete blood count and biochemical markers
Differential diagnosis is carried out with benign formations, tuberculosis and other malignant neoplasms.
Treatment
The therapeutic strategy depends on the stage of the disease:
- Surgical treatment (laryngectomy, partial resection)
- Radiation therapy (dose 60-70 Gy)
- Chemotherapy (cisplatin, 5-fluorouracil)
- Targeted therapy (cetuximab)
“Combination treatment provides better results in locally advanced forms,” the ESMO clinical guidelines emphasize.
List of drugs used to treat this disease
- Cisplatin
- Carboplatin
- 5-fluorouracil
- Paclitaxel
- Doxorubicin
- Cetuximab
Disease monitoring
Follow-up visits include regular check-ups every 3 months for the first year after treatment. Prognosis depends on the stage: 5-year survival is 80-90% for stage I and 30-40% for stage IV. Possible complications include:
- Relapse of the disease
- Metastasis
- Consequences of treatment (dysphagia, hypophonia)
Age-related features of the disease
In young patients (under 40 years), the disease is more aggressive, despite a more favorable anamnesis. In older patients, there is a higher prevalence of concomitant pathology, which limits the possibilities of radical treatment. "Age over 65 years is an independent prognostic factor," the Journal of Geriatric Oncology study states.
Questions and Answers
- What are the first signs of laryngeal cancer? The main early symptom is hoarseness of the voice, which persists for more than 2 weeks.
- Is it possible to completely cure laryngeal cancer? With early diagnosis and adequate treatment, complete recovery is possible.
- How does smoking affect the risk of disease? Smoking increases the risk of developing laryngeal cancer by 5-25 times.
- How often should you have a preventive examination? An annual examination by an ENT specialist is recommended for those at risk.
- How to eat during treatment? A gentle diet is necessary, excluding hot and spicy foods.
Advice from Dr. Oleg Korzhikov
Many patients are interested in disease prevention. The first thing I recommend is complete cessation of smoking and limiting alcohol consumption. People often ask about the safety of electronic cigarettes – they also contain carcinogens. It is important to undergo regular preventive examinations, especially if there are chronic diseases of the larynx. If hoarseness of the voice occurs for more than 2 weeks, be sure to consult a specialist. Also, many underestimate the importance of a healthy lifestyle and proper nutrition in the prevention of cancer.
