Larynx
Larynx is also known
as voice box, located between the pharynx and the trachea. Its function
is to ensure the airways are open and when we breath and talk and closed
when we swallow to ensure no food gets into the trachea.
Larynx Cancer or Laryngeal Cancer
Larynx
cancer is also known as cancer of the larynx or laryngeal carcinoma and
can develop in any part of the larynx. Most larynx cancers are squamous cell carcinomas as a result of uncontrolled multiplication of transformed malignant cells in the laryngeal epithelium originated in the glottis.
Symptoms of Larynx (Voice Box) Cancer
1. Hoarseness or other voice changes
Due to malignant cells have invaded the vocal cords.
2. A cough that doesn't go away or stridor
Due to blocking of the airway
3. Breathing difficulties
Tumor has grown large enough to block off the air way
4. Ear pain
Tumor has pressed onto the nerve
5. A lump or mass in the neck or throat
Cancer gas invaded the nearby lymph nodes in the neck and throat.
6. Coughing up of blood
Breaking off of some malignant cells
7. Etc.
Causes and risk factors of Larynx (Voice Box) Cancer or Laryngeal Cancer1. Smoking
The
risk of larynx cancer is 30 time higher in smoker compared to never
smoke people. it may be due to high levels of carcinogens accumulated in
the surface of the larynx lining for the
prolonged period of time. Secondhand smoke is also considered as a cause of non smoker.
2. Alcohol
Risk
of larynx cancer is twice in heavy drinking compared to non or moderate
drinking. In a controlled case of study of Combined effect of tobacco
and alcohol on laryngeal cancer risk, researchers found that both
cigarette smoking and alcohol drinking are independent risk factors for
laryngeal cancer. Heavy consumption of alcohol and cigarettes determined
a multiplicative risk increase, possibly suggesting biological synergy.
3. Aging
The
risk of larynx cancer increases with age. Most cases of the cancer are
detected usually detected in people between 50 and 75 years.
3. Gastroesophageal reflux disease (GERD)
In
GERD, the stomach acid backs up into the esophagus, causing a burning
pain. It any be caused by prolonged period of acid damaging to the
larynx. In some studies, researchers found that irritation from
longstanding GERD increases the risk of larynx cancer.
4. Poor nutrition
Poor
nutrition induces the risk of all kinds of diseases due to weakened
immune system, including larynx cancer. Some researchers suggested that
not getting enough vitamins might be a risk factor.
5. Human papillomavirus (HPV)
HPV
infection of the larynx may increase the risk of laryngeal cancer.
Although, infectious theory may be required further study, but prolonged
period of larynx infection increases the risk of cancer found in some
patients.
6. Race
Larynx cancer is developed twice as often among people of African descent than among Caucasians.
7. Gender
Men are at risk of larynx cancer than women. It may be due higher percentage of men are smokers and heavy drinkers.
9. Weakened immune system
People with weaken immune systems due to diseases or poor nutrition are at risk to develop laryngeal cancer.
10. Toxic exposure
Inhaling or exposed to wood dust, asbestos, or many types of chemicals that can increase the risk of larynx cancer.
11. Voice overused
Occupation required to use their voice most of the time can damage the vocal cord, leading to cancerous polyp.
12. Mouthwash used
A
review of 200 patients with oral cancer researcher found that 10 of the
11 patients who did not smoke or drink alcohol frequently used
mouthwash high in alcohol content, but further study showed that there
is no link of mouth wash with high alcohol content and larynx cancer.
13. Etc.
Diagnosis and tests
Physical
exam is always important and to be done by your doctor as if you are
having some of above symptoms and your doctor suspect that there may be
larynx problem to check any abnormality of the neck, thyroid, larynx,
and lymph nodes, including swellings and lumps.
In fact, not all abnormalities are cancerous.
1. Indirect laryngoscopy
By
using a small, long-handled mirror, your doctor will examine your
throat for any abnormality, including your vocal cords through the a
reflected image on a mirror.
2. Direct laryngoscopy
With the
use of a either a hollow medical instrument or a fiberoptic cable called
laryngoscope, inserted through your mouth or nose to check for any
abnormality that may not see by the direct laryngoscopy by applying
either local or general anesthesia.
3. Biopsy
Biopsy is a
procedure of taking sample from susceptible area or tumor found by other
tests by a small needle with local or general anesthesia. The sample
will be examined by a pathologist under microscope to review the stage
of the tumor.
4. CT scan (computerized tomography)
A CT scan
generates a large series of two-dimensional X-ray images taken around a
single axis of rotation, to create a three-dimensional picture of the
inside of the body in details.The pictures are viewed by your doctor to
see the extent of the tumors abnormalities, such as spreading of cancer
to the nearby structure and lymph nodes. This test is helped to
determine whether the abnormality is a cyst or a tumor. In some doctors,
X ray may be also ordered together with the CT scan.
5. MRI (magnetic resonance imaging)
MRI
(magnetic resonance imaging is one of many advanced technology used to
visualize internal structures cross sectional imaging of your body used
effectively in providing the better details of the metastasis of cancer
in the larynx and surrounding areas.
6. Etc.
Stages and grade of larynx cancerA.
Grading of the tumor is depended on the nature of non invasive or
invasive. Tumor which spread slowly is given a lower grade, while fast
spreading tumor is given a highest grade.
B. Stage of the larynx cancer
1. Stage 0
Larynx cancer is classified as
Stage 0. if the cancerous cell have not penetrated in deeper tissue but remain in the surface of the lining.
2. Stage I
The cancerous are no longer in the surface but have invaded into deep the lining, but still completely inside the larynx.
a. Stage IA
The cancer is not ≤ 3 mm (1/8 inch) deep and ≤ 7 mm (1/4 inch) wide.
a.1. Stage IA1: The spreading is < 3mm(1/8 inch) deep and < 7mm (1/4 inch) wide.
a.2. Stage IA2: The invasion area is ≥ 3 mm but ≤ 5 mm (about 1/5 inch) deep and &less than 7 mm (about 1/4 inch) wide.
b. Stage IB: The cancer in this stage have invaded the connective tissue of the larynx, & less than 5mm (1/5 inch).
b.1. Stage IB1:
Cancer is 4 cm large (1 3/4 inches).
b.2. Stage IB2:
Cancer is ≥ 4 cm (1 3/4 inches) but & less than 5cm (1/5 inch)
3. Stage III
The cancer cells have spread to distant tissues, but is still within the larynx
4. Stage IV
The cancerous cells has spread to the tissues immediately surrounding the larynx
5. Stage V
Stage V is the most advance stage of renal cell carcinoma as cancer cells have spread to the distant parts of the body
PreventionsA. How to prevent
1. Quit smoking
Smokers are 5 time more at risk to develop larynx cancer than non smokers.
2. Alcohol
Heaving
drinking non only damage the liver but also twice at risk than non or
moderate drinkers3. Avoid asbestos. The inhalation of asbestos fibers
can cause serious illnesses, including larynx cancer. Although asbestos
now have been banned in some countries and precarious is taken in some
others. People in the underdeveloped world still at risk of asbestos
using.
3. Nutrients and immune system
Make sure you are eating healthy to prevent poor nutritional and weakened immune system causes of larynx cancer.
4. Protect your sound
If you are in occupation required a lot of talking and singing, please take time to stop.
5. Etc.
B. Diet
Your are directed to my previous article of 100+ most healthier foods at
http://healthy-foods-index.blogspot.com/
1. Fruits
In
a study of nutrient-based dietary patterns and laryngeal cancer:
evidence from an exploratory factor analysis, researchers suggested that
diets rich in animal products and animal fats are directly related, and
those rich in fruit and vegetables inversely related, to laryngeal
cancer risk.
2. Freeze dried strawberry
In study of 36
participants consumed 60 grams of freeze dried strawberries daily for
six months and completed a dietary diary chronicling their strawberry
consumption. The results showed that 29 out of 36 participants
experienced a decrease in histological grade of the precancerous lesions
during the study.
3. Tomato
In study of Tomatoes, tomato-rich
foods, lycopene and cancer of the upper aerodigestive tract,
researchers stated that our study provides evidence of strong protective
e€ect of tomatoes, tomato-rich foods and lycopene, and UADC.
4. Soy
In
study of Flavonoids, Proanthocyanidins, and Cancer Risk: A Network of
Case-Control Studies From Italy, researchers found that intakes of
flavonoids, flavanones, and flavonols were found to be inversely related
to oral and laryngeal cancers.
5. Cruciferous vegetables
Research
found that cruciferous vegetables such as broccoli, cabbage,
cauliflower and brussel sprout contain high amount of phytochemicals,
sulforaphanem, indole-3-carbinol and diindolylmethane have shown
inhibition of certain cancerous cells.
6. Etc.
C. Nutritional supplements
1. Antioxidants
Antioxidants
are one the proven to be effective in prevent cancer cause of oxidation
stress. You are directed to my previous article for in depth
discussion.
You are directed to my previous article for in depth discussion. Visit http://the-anti-aging-guide.blogspot.com/2011/03/anti-aging-guide.html
2. Antioxidants
In
a case-control study of micro-nutrients and laryngeal cancer risk in
Italy and Switzerland, researchers found that independently from smoking
and alcohol consumption, the intake of several micro-nutrients,
including selected antioxidants, is inversely related to laryngeal
cancer
risk.
3. Vitamin A, C and zinc
Association of
vitamin A, vitamin C and zinc with laryngeal cancer to assess the levels
of vitamin A, vitamin C and zinc in laryngeal cancer patients and
healthy controls, researchers found that serum vitamin A, zinc and
plasma vitamin C levels were significantly lower in laryngeal cancer
patients as compared to the controls.
4. Selenium
In study of
laryngeal cancer and blood selenium levels researchers found that lower
blood selenium levels in this latter group of laryngeal cancer patients
may be a consequence of their disease rather than its cause.
5. Quercetin
In study of effects of quercetin on human laryngeal cancer Hep-2 cells, researchers found that Quercetin could effectively inhibit the proliferation of Hep-2 cells and its mechanism is probably related to the apoptosis.
6. Etc.
Treatments
A. Conventional medicine
Treatments
in larynx cancer may result of the way you look, breathe, and talk, it
is for your benefit that you should consider all the option treatments
and expect what will happen after so shock and stress after a
diagnosis of cancer can be prevented. You may also want to get second
opinion from other expert. Please ask as many questions as you can your
doctor will be happy to answer all your concerns before treatments.
Removing the tumor, surrounding tissue and muscles may cause difficulty
in neck movement. If a tracheostomy (surgery to create an artificial
airway in the trachea) was performed, the stoma is usually permanent.
Larynx
cancer usually treated with combination of surgery, radiotherapy and
chemotherapy depending to the stage and grade of the tumor.
1. Surgery
Depending
to the stage and grade of the tumor. In this surgery, a tracheostomy
tube, is needed keeps the new airway open and a new airway called stoma
(opening on the chest made during surgery by your surgeon) to allow air
to enter and leaves the trachea and lungs.
a. Total laryngectomy
Completely remove the larynx.
b. Partial laryngectomy
In this surgery, only parts of rlarynx is removed.
b.1. Supraglottic laryngectomy
In this surgery, only the top part of larynx is removed.
b.2. Cordectomy:
In this surgery, one or both vocal cords are removed.
c. Side effects
Surgery and anesthesia risks and complication
2.
Radio therapy By using high-energy x-rays or other types of radiation,
radiation therapy kills breast cancer cells and keep them from growing
or regrowing. If the cancer is small in size, cancer can be cured. If
the cancer is large, radiation therapy can be used to control local bad
symptoms. Treatments are usually given 5 days a week for 4 to 8 weeks.
a. In general, radiotherapy is used for small tumors or patients who cannot have surgery.
b.
In other case, if surgery can not be performed due to the stage of the
tumor, radiotherapy can be used to shrink the tumor to make surgery
possible
c. Side effects
c.1. Fatigue
c.2. Chest pain
c.3. Heart problem
c.4. Short of breath
c.5. Skin discoloration or pinkness, irritation
c.6. Etc.
3. Chemotherapy
a.
Chemotherapy is most use to treat with advance stage of larynx cancer,
as it has spread to a distant parts of the body by using drugs taken
by mouth or injected into a vein or muscle of the patient to stop the
growth of or to kill cancer cells. Chemotherapy can be used combination
with radio therapy and surgery.
b. Side effects
b.1. Nausea
b.2. Vomiting
b.3. Hair loss
b.4. Fatigue
b.5. Anemia
b.6. Mouth sores taste and smell changes
b.7. Infection
b.8. Etc.
B. Traditional Chinese medicine
1. Chen Pi
Chen
Pi is also known as Tangerine Peel. The acrid, bitter and warm herb
has been used in TCM as antibiotic agent and to stimulate blood
vessels, inhibit movements of digestive tract and f uterine muscles,
improve digestion, etc. as it regulates stomach qi, invigorates spleen
Qi, dries damp, transforms phlegm and prevents stagnation, etc. by
enhancing the functions of lung and spleen channels. In vitro study
Researcher found that Hesperidin in Chen pi inhibits anti oxidative
effect in preventing oxidation cause of cell DNA althernation.
2. Niu Bang Zi
Niu
Bang Zi is also known as great burdock fruit. The acrid, bitter and
cold herb has been used in TCM as antibiotic, antipyretic, anti tumor
agent and to lower blood sugar, get rid of toxins, etc. as it clears
heat, disperses wind-heat, remove toxins, etc. by enhancing the
functions of lung and stomach channels. In studies researchers found
that have arctigenin, a chemical in Niu Bang Zi, does in fact slow tumor
growth.
3. Jie Geng
Jie geng is also known as Platycodon
Root. The acrid, bitter and neutral herb has been use in TCM as
anti-inflammatory, anti ulcers agent and to inhibit cough, treat
bronchitis, sore throat etc., as it stimulates the lung in dispersing
and descending functions, transforms phlegm, etc., by enhancing the
functions of the lung channels.
The Researchers found that Saponins
in Jie Geng have been shown to very significantly augment the
cytotoxicity of immunotoxins and other targeted toxins directed against
human cancer cells.
4. Xia Ku Cao
Xia Ku Cao is also known as
Common Selfheal Fruit-Spike. The acrid, bitter and cold herb has ben
used in TCM as diuretic, antibiotic agent and to treat hypertension and
arteriosclerosis, acute tonsillitis, amnesia, whoooing cough etc., as
it disperses Liver-Fire and nodules, treat hypotension, etc. by
enhancing the functions of liver and gallbladder channels.
Researchers found that cyasterone in Xia Ku Cao showed anti tumor activity.
5. Etc.
Speech therapies after surgery
If
treatment involves total removal of the larynx, a tracheostomy (surgery
to create an artificial airway in the trachea) is then performed to
improve breathing, patient will have to learn how to speech again with
the help of below speech therapies.
1. Esophageal Speech
Esophageal
Speech is also known esophageal voice. It is type or method of speech
production using the oscillation of the esophagus. In this method,
learner takes air in through the mouth, traps it in the throat, then
released in a controlled manner to create sound used to produce speech.
2. Artificial Larynx
An
artificial larynx is a medical device was introduced in the 1940s, used
to produce clearer speech by those who have lost their original
voicebox as a result of larunx cancer. It is considered as one of more
difficult method to master that requires training and practice.
3. Tracheoesophageal Puncture (TEP)
Tracheoesophageal
Puncture (TEP), generally perform during the surgery of the removal of
larynx, is a surgically created hole between the trachea (windpipe) and
the esophagus with the help of a voice prosthesis is inserted into this
puncture to keeps food out of the trachea but allows air into the
esophagus for oesophageal speech. When speak, the person inhales air
through a permanent breathing hole in the neck into the lungs with the
cover of the stoma by a finger, air is directed from the tracheax into
the esophagus to produce speech.
4. Etc.
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