How is laryngeal cancer cured?

Throat cancer treatment is a complex process that requires an individual approach to each patient and a lot of practical experience of doctors. Difficulties here already begin with the fact that from the point of view of medicine, "throat cancer" does not exist, because "throat" is a common definition of the neck region, which is located in front of the spinal column.

• Types of treatment
• Chemotherapy
• Radiation treatment
• Surgery
• Prognosis and further treatment

Anatomically, this includes the larynx, pharynx, part of the esophagus, vocal cords, nerve and vascular bundles, muscles, connective and epithelial tissue. And a malignant tumor has a chance to develop in any of the listed parts, showing different symptoms and representing a different degree of threat.

When describing malignant lesions of the throat, doctors most often mean laryngeal and pharyngeal tumors. For neoplasms in other organs and tissues, other definitions apply. Therefore, in this article, talking about how to treat throat cancer, we will talk primarily about cancers of the larynx.

Types of treatment

The techniques that are used to cure this disease are selected taking into account the location of the tumor in the throat, size, stage of development, presence or absence of metastasis. An important role is played by the patient's age, general condition, concomitant pathologies, etc.

The main methods of therapeutic effects are:

• pharmacological therapy with specific drugs;
• radiation exposure to ionizing radiation;
• surgical removal of the tumor.

In most cases, throat cancer can be cured only with the combined use of these techniques. So, radiation and chemotherapy are used before surgery with the aim of cytoreduction - the maximum reduction in the number of cancer cells in the patient's body. This allows you to significantly reduce the amount of surgical intervention. And after surgical treatment of laryngeal cancer, adjuvant (prophylactic) therapy with pharmacological drugs is prescribed in 100% of cases. Such an effect is necessary in order to destroy all malignant cells remaining in the tissues after surgical removal of the tumor.

Important! In the early stages of tumor development, only conservative techniques (radio and chemotherapy) are used. This makes it possible to cure up to 85-90% of early stage cancers.

Chemotherapy

The effect of specific cytostatic drugs on a malignant tumor is based on their disruption of the processes of cell division. As a result, the cancer cell loses its ability to multiply and, after some time, dies. The effectiveness of chemotherapy is due to the fact that malignant cells divide much faster and more often, and in addition, have a significantly higher metabolic rate than healthy cells. This means that cancer cell elements absorb molecules of chemotherapy drugs much more intensively, which means that the effect of such treatment on them will be much more pronounced.

These drugs are administered systemically - orally as tablets or intravenously as an injection. They affect all organs and tissues of the patient, inevitably (albeit much less than cancerous ones) damaging healthy, not degenerated cells. This leads to the development of side effects:

1. Violation of the mechanisms of hematopoiesis with a decrease in the number of white and red blood cells. A decrease in the number of leuko- and lymphocytes in the blood inhibits the immune functions of the body, therefore, against the background of chemotherapy, the risk of developing infectious diseases increases.
2. Loss of hair, which is explained by the fact that the cells of the hair follicles have a very high metabolic rate. This means that they absorb an increased amount of cytostatic drugs from the blood and suffer from them to a greater extent than other cells of the body (except for cancer cells).

Important! Hair loss from chemotherapy is reversible. After the cancer process is stopped, and the remaining degenerated cells are destroyed, the drug intake is canceled, the hair follicles gradually regenerate and re-grow hair.

3. Adverse effect on the gastrointestinal tract. These include persistent nausea, sometimes accompanied by vomiting, diarrhea, ulceration of the oral mucosa, etc.
4. Violations of tactile and gustatory sensitivity. The appearance of tingling, itching and other sensations in the limbs.
5. General manifestations in the form of fatigue, weakness, a sharp deterioration in appetite and weight loss.

Radiation treatment

Radiation therapy for laryngeal cancer, like chemotherapy, is based on the fact that tumor cells have a much higher metabolic rate than healthy ones, which means that they absorb significantly large doses of ionizing radiation. This radiation damages the internal cellular structures and eventually leads to cell death. Modern approaches to radiation treatment involve the use of special radiosensitizing drugs - compounds that promote the absorption of radiation. Such drugs are administered to the patient a few days before the onset of radiation exposure, and these substances accumulate in significant quantities in cancer cells, and not in normal cells.

In almost all oncological pathologies, including throat cancer, treatment with ionizing radiation is an integral part of complex therapy. It is often combined with the use of pharmacological drugs. In addition, radiotherapy is used after surgery to suppress local and distant metastases, as well as individual remaining malignant cells.

Radiation therapy is an aggressive effect that, in addition to cancer cells, inevitably affects healthy tissues. In this regard, side effects arise:

1. Dry mouth and lack of fluid in the body in general. An increase in the amount of fluid in the patient's diet or the use of special rehydration solutions will help to cope with this violation.
2. Sore throat.
3. Disruption of recovery processes and delayed tissue healing, for example, after dental operations. For this reason, oncologists recommend sanitizing the oral cavity before starting radiation therapy.
4. The tendency to develop caries. This side effect is minimized by careful oral hygiene during the entire period of radiation treatment.
5. General symptoms in the form of weakness, increased fatigue, a slight increase in body temperature.
6. Voice changes.
7. Skin disorders in the area of ​​radiation exposure in the form of redness, irritation, etc.

Important! Treatment of laryngeal cancer with ionizing radiation affects the thyroid gland in 100% of cases. Therefore, before radiation therapy, it is imperative to conduct a complete examination of the structure and functions of this organ.

Traditionally, laryngeal cancer is treated with external radiation exposure, in which the radiation source is outside the patient, and the radiation passes through healthy tissues before reaching the tumor. But today there are more modern methods that involve the introduction of a radiation source (in the form of, for example, a metal grain) directly into the tumor. This significantly reduces the required dose of radiation without losing the effectiveness of treatment, which means that it also reduces the risk of side effects.

Surgery

Surgical removal of a tumor node is the most common and most effective way to get rid of laryngeal cancer. On the one hand, all structures of the throat have good surgical accessibility - there is no need to carry out deep abdominal surgeries. On the other hand, the proximity and tightness with which the anatomical formations in the throat are located complicate surgical treatment, because for a complete resection of the tumor, it is often necessary to partially or completely excision of important organs.

The volume of the intervention is determined by the stage of the cancer process and the size of the neoplasm. There are several basic techniques:

• cordectomy is the most sparing operation, which affects only the vocal cords if a malignant tumor develops on them;
• upper laryngectomy - surgical intervention to excision of the upper part of the larynx;
• hemilaryngectomy - a significant surgical impact, implying excision of at least half of the larynx;
• total laryngectomy - an intervention for the complete removal of the larynx with the formation of a respiratory tracheostomy (holes in the trachea).

Laryngeal cancer surgery also has some side effects:

1. Painful sensations, which are first relieved by anesthetics, and then go away on their own a few days after the operation.
2. Swelling of the throat tissue. This is also a temporary phenomenon that passes on its own. But before the swelling subsides, the patient will have to feed first by the intravenous route, and then with the help of liquid food mixtures supplied through a tube that is inserted through the nose directly into the stomach.
3. Intense mucus production. This is a normal reaction of the mucous membranes of the respiratory system to surgery. Excess mucus is removed from the bronchial tree using special aspiration probes. The probe is inserted either through the patient's nose or through the tracheostomy, if it was made during the operation.
4. Violation of sensitivity on the skin of the neck. This side effect occurs as a result of damage to the small nerve fibers responsible for sensation in the neck. Such damage is inevitable due to the high density of nerves and blood vessels in this area. But this numbness is temporary and disappears completely six months or a year after the operation.
5. Formation of a tracheostomy - an artificial opening on the anterior surface of the neck. This approach is used mainly in total interventions with almost complete removal of the larynx - a tracheostomy is necessary for the patient to breathe normally. A tracheostomy requires special care, and in addition, it imposes certain restrictions on the patient, for example, the inability to use sound speech. There are permanent and temporary variants of the tracheostomy. In the latter case, after a while, a repeated operation is performed to close it.

Important! In the surgical treatment of laryngeal cancer, the patient's vocal function is almost always impaired. But in most cases, after undergoing special rehabilitation measures, the voice can be restored.

Prognosis and further treatment

The main factor determining the success of therapeutic measures for laryngeal cancer is the timeliness of referral to the ENT and the initiation of treatment. In the early stages of a tumor, it is almost always possible to get rid of it without surgery. But the longer its development continues, the higher the risk of involvement of vital organs and the spread of metastases to other areas of the body. And this significantly worsens the prognosis and treatment results.

While the treatment lasts and after its completion, the patient must follow a number of recommendations:

1. Changing your diet. The patient's diet is developed by a specialist nutritionist, and includes a balanced combination of all nutrients, as well as a sufficient amount of vitamins.
2. It is necessary to reduce, and it is better to completely abandon the use of sour, fried, salty foods, as well as the use of a large amount of seasonings.
3. The patient is completely prohibited from smoking and taking any alcoholic beverages.
4. Hypothermia and excessive exposure to sunlight should be avoided.
5. Any procedures that increase the local temperature in the neck area (compresses, etc.) are prohibited.
6. Do not use substances that enhance cellular metabolism (preparations based on aloe, mummy, compounds containing propolis, etc.), as they can stimulate the development of tumor elements.

Even a successfully cured cancer of the larynx presupposes dispensary observation of the patient for the entire subsequent period of his life. Such supervision is carried out by oncological specialists and ENT doctors. A prophylactic examination must be carried out every month for the next 5 years and every six months thereafter. This will allow timely identification and treatment of long-term complications or recurrences of the malignant process.