Laryngeal and Hypopharyngeal Cancer
Laryngeal cancer occurs in the larynx (also known as the voice box or "Adam's apple"). The hypopharynx surrounds the larynx and is part of the esophagus. In 2007, the American Cancer Society estimates that about 24,000 people in the United States will be diagnosed with laryngeal and hypopharyngeal cancer.
Both laryngeal and hypopharyngeal cancer are more common in men than women. Tobacco use is the greatest risk factor for both types of cancer. Other risk factors include:
- alcohol use
- exposure to asbestos and other cancer-causing airborne chemicals
- malnutrition and vitamin deficiencies, particularly Plummer-Vinson syndrome, a rare iron deficiency
Symptoms of laryngeal and hypopharyngeal cancers include persistent hoarseness, sore throat or cough, pain or difficulty swallowing, ear pain, and difficulty breathing.
Surgery is the main treatment for laryngeal and hypopharyngeal cancers. Our co-chief of the Division of Head and Neck Oncology, Dr. Christopher M. Shaari, is highly skilled in surgical techniques that spare the vital functions of speech and swallowing.
There are several types of surgery to treat laryngeal or hypopharyngeal cancer:
- total laryngectomy (removal of the entire larynx and creation of a hole called a stoma, through which the patient breathes)
- transesophageal puncture (TEP), sometimes performed during a laryngectomy, which creates a communication between the windpipe and esophagus and restores the ability to force air from the lungs into the mouth
- partial laryngectomy
- neck dissection (removal of the lymph nodes in the neck if the cancer has spread to them)
- total or partial pharyngectomy (removal of all or a portion of the hypopharynx; several reconstructive procedures can be done to rebuild it and improve the ability to swallow)
- tracheotomy (an opening made in the neck to bypass a large tumor that cannot be removed completely to allow the patient to breathe more comfortably)
- gastrostomy tube (a feeding tube placed into the stomach if the cancer doesn't permit the patient to swallow)
Three-dimensional conformal radiotherapy can be used as the primary treatment, as an adjuvant (addition) to surgery to kill cancerous cells that may remain, or as a palliative treatment to ease painful symptoms of the cancer. Radiation oncologists at the Cancer Center also use brachytherapy (involving implanting rice-like seeds of radiation into the tumor) to treat laryngeal cancer and preserve the patient's ability to speak.
Chemotherapy may be combined with three-dimensional conformal radiotherapy to treat a cancer that has metastasized or as a palliative therapy to ease pain resulting from a tumor that is too large to be completely removed or one that has not been able to be controlled with radiation therapy alone.