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The larynx is another name for the voice box. It is a structure that sits at the top of the windpipe (trachea) and contains the vocal cords.
Causes or larynx cancer
We don't know the exact causes of larynx cancer, but several risk factors have been identified. These include:
- smoking and heavy drinking of alcohol (cigarettes and alcohol contain chemicals that increase your risk of developing larynx cancer
- exposure to certain chemicals like paint fumes, wood dust and soot
- acid reflux (when bile from the stomach comes back up into the wind pipe)
- diet (a poor diet may increase your risk of developing larynx cancer)
The symptoms of cancer of the larynx may include:
- persistent hoarseness and difficulty speaking
- a lump in your throat or neck
- difficulty swallowing
- constant earache
It may be that experiencing one or more of these symptoms may have led you to consult your doctor in the first place. It is important to remember that these symptoms can mean you have a condition other then cancer. Viral conditions such as laryngitis produce similar symptoms.
There are a series of tests and investigations which can be done to confirm or rule out a diagnosis of larynx cancer, and to find out whether the cancer has spread to other parts of your body. The tests will also check your general health.
Your GP may refer you to an ear, nose and throat (ENT) specialist for examination. They may use a small mirror or a nasendoscope (a flexible telescope) to view the inside of your throat.
If your throat needs to be examined in more detail, then the specialist may recommend you are examined under general anaesthetic. This will normally be a day procedure and you will not need to stay in hospital overnight. The doctor may also take a biopsy, a small sample of tissue, from any suspicious areas for further examination.
You may have other tests, which include a CT scan or MRI scan.
The information from these tests is used to assess the size of the cancer and how far it has spread. This is called ‘staging’. Your doctors need to know the extent of the cancer to help them decide on the most appropriate treatment for you.
Cancer of the larynx can be treated by radiotherapy, surgery and chemotherapy on their own or in combination. The team of doctors and nurses looking after you will plan your treatment based on your age, health and the type of tumour you have. This means that patients with the same type of cancer might have different treatment plans.
Small tumours in the larynx may be successfully treated with radiotherapy alone. You may also have radiotherapy after surgery to destroy any cancer cells left behind. Radiotherapy helps stop the cancer from coming back.
The main side effects of radiotherapy to your larynx are:
- sore mouth
- dry mouth
- hoarse voice
Men can permanently lose hair on the areas of their throat being treated, however, the hair on your head will be unaffected. You may find that your voice is weaker or you lose the ability to talk completely, although this is a temporary effect.
Your mouth or throat may become dry and sore. It may become necessary for you to eat foods that are soft in texture or have a high water content. Your doctor will be able to prescribe painkillers, mouthwashes and saliva substitutes to help relieve these symptoms.
Larger tumours often require more treatment and it may be necessary to remove part of the larynx or remove it completely.
Depending on the size of the cancer, you may need to have part of your larynx removed (a partial laryngectomy) or all of your larynx removed (a total laryngectomy).
The procedures and the extent and effects of surgery will be explained to you by your doctor beforehand. If you have any questions or do not understand the information that has been given to you, do not hesitate to ask questions or ask for the information to be given again in a different way. Your doctor or nurse will try to make sure you understand everything before consenting to treatment.
If only part of your larynx is removed, you should be able to speak once you have recovered from the operation. Your voice will be weaker then before as some of your vocal cords will have been removed.
A total laryngectomy means that your larynx is removed completely and this results in no connection between your mouth and lungs. As part of this procedure the surgeon will create an opening in the lower part of your neck to help you breathe. This opening is called a tracheostomy.
Following the operation you will breathe and communicate in different ways.
Chemotherapy is treatment with anti-cancer drugs. It may be used to reduce the size of the tumour before surgery, which is called neo-adjuvant chemotherapy, or you may have chemotherapy after your surgery to help prevent the cancer from coming back.
Having and being treated for larynx cancer will have an effect on your life. Other things which you should be aware of include:
Your doctor will ask you to attend hospital at regular intervals during and after your treatment. You will be given a clinic appointment and these will probably become less frequent as time passes. Each time the doctor will examine you and ask you how you are feeling. Blood tests or X-rays may be repeated to check your recovery.
If you are worried about anything between your appointments, for example any unexplained aches and pains, please contact your hospital doctor.
Your family doctor will also have been sent details of your treatment and progress. It is important that you discuss anything unusual and don't worry needlessly. Please use your clinic appointment to discuss any concerns you may have about your recovery and return to your usual lifestyle.
If you have your larynx removed, the opening in your throat (tracheostoma) will require special care. This is because the air you breathe will no longer be filtered by the mouth and the nose but will go straight into the lungs. You will also find that your sense of smell might be affected.
There are tips and techniques that can help and these will be explained to you by your speech therapist who is part of the team looking after you.
It can be very difficult losing the ability to speak. You will have a speech therapist to help you as part of your treatment after your operation. Your speech therapist will be able to explain the different voice restoration techniques and recommend one that will be suitable for you.
Oesophageal speech, or a small valve known as a voice prosthesis, are among the options your speech therapist may recommend. You may be given an electrolarynx, a device that produces an artificial voice when pressed against the chin.