Laryngeal Cancer

 Laryngeal Cancer

Laryngeal cancer is known as cancer of larynx or laryngeal carcinoma.

Cancer laryer inner walls of larynx are lined with cells called squamous cells called squamous cell carcinomas.

Causes and Risk Factors

1. Smoking

Important risk factor for laryngeal cancer.

2. Alcohol

Drinking alcohol 

3. History of head and neck cancer

4. Occupation

Sulfuric acid and nickel increased risk of laryngeal cancer.

Asbestos worker also in high risk.

5. Age

6. GERD (gastroesophageal reflux disease)

7. Gender

8. Race

Pathophysiology

Due to the etiological factor 

Progressive accumulation of genetic alterations in the cells

Transformation of squamous cells of larynx 

DNA damage, mutation of genes

TNM Classification of Laryngeal Cancers 

T - Describing the extent of the primary tumor 

N - Describing spread to the lymph node 

M - Describing the spread to other organs

Staging of Laryngeal Cancers

Stage 0

Carcinoma in situ

Stage l

Stage ll

Stage lll

Stage lV

Clinical Manifestations

1. Hoarseness (voice change)

2. Pain in throat

3. Dysphagia; difficulty in swallowing 

4. Odynophagia; painful swallowing

5. Hot potato voice

6. Haemoptysis

7. Ear pain

8. Stridor

9. Dysphonia

10. SOB (shortness of breath)

11. Swollen lymph node

Diagnostic Evaluation

1. Physical examination

Physical exam of neck and throat.

Tenderness

Check for abnormal areas.

2. Indirect Laryngoscopy

Using small long handed mirror to check abnormal areas of ocal cord.

3. Direct Laryngoscopy

Visualisation of the larynx through laryngoscope.

4. Endoscopy

To look organ and tissue inside body to check for abnormal areas.

5. CT scan

To reveal tumors.

6. MRI (magnetic resonance imaging)

7. Biopsy

Removing tissue to look for cancer cells called biopsy.

8. Barium swallow

A deries of X- ray of esophagus and stomach called upper GI series.

Management

1. Radiation therapy/radiotherapy

Radiation to kill cancer cells.

2. Surgery

1. Supraglottic laryngectomy

2. Hemi laryngectomy

3. Partial laryngectomy

4. Total laryngectomy

Roval of laryngeal structure.

5. Cordectomy

Remove vocal cord only.

6. Thyroidectomy

Remove all part of thyroid gland.

7. Chemotherapy

Used to kill cancer cells or by stopping growth of bacteria.

8. Chemoprevention drug

Used to reduce risk of developing cancer.

9. Radiosensitizers

This drugs make rumor cells more sensitive to radiation therapy.

Combine radiation therapy with radiosensitizers kil more tumor cells.

Nursing Diagnosis

1. Ineffective breathing pattern related to accumulation of secretions as evidence by inability to cough.

2. Altered nutrition; less than body requirement related to impaired sallowing/ difficulty in swallowing/ Pain in swallowing.

3. Impaired verbal communication related to presence of tracheostomy tube.

4. Anxiety related to disease conditions