Throat cancer is a malignant tumor that develops from epithelial tissue. Oncopathology of the throat may be due to the development of a tumor process from other tissues, which leads to the development of equally serious diseases, such as adenocarcinoma and sarcoma. However, they account for significantly fewer cases of disease. Throat cancer accounts for up to 95-98% of all throat cancers. The life prognosis of such patients depends on the following factors:
- localization of the process;
- stage of the disease;
- the timing of the appropriate treatment.
Characteristics of pharyngeal cancer
The pharynx and larynx are not equally affected by the malignant process. The development of oncopathology of the pharynx is noted in rare cases. In addition, early diagnosis is characteristic of pharyngeal cancer. A preliminary diagnosis can be made already with pharyngoscopy, a study available in every medical institution. Often, dentists who have found a pathological focus on the throat mucosa refer patients to an otolaryngologist.
Despite the early diagnosis of pharyngeal cancer, the lesion of its upper section is characterized by a difficult prognosis.
This is due to the anatomical proximity of the location of the pathological focus to the structures of the brain. The death of patients occurs as a result of damage to vital centers.
Laryngeal cancer classification
Compared to other organs that make up the upper respiratory tract, the larynx is most often affected by the tumor process. In addition, due to the anatomical features, the disease is characterized by a rather late diagnosis.
Like any oncopathology, laryngeal cancer in its development goes through 4 stages, reflecting the degree of damage to the body by the pathological process. The stage of the malignant process is determined according to the international TNM system. T - tumor, its size, prevalence within the larynx, N - the presence of metastases in regional lymph nodes, M - further spread of the metastatic process in the body.
The assessment of the state of the malignant process is carried out according to a four-point system, from 0 to 3. If the first stage corresponds to T1N0M0, then the fourth stage of the disease can be characterized by T3N3M3. These designations indicate the growth of a tumor that spreads to all parts of the larynx. In addition, the fourth stage is also characterized by metastatic lesions of the cervical lymph nodes and metastasis to other organs.
Laryngeal cancer is also classified according to the location of the lesion. The larynx consists of three sections, the vocal cords, the upper and lower sections. To carry out therapeutic measures, it is important to establish the exact location of the tumor. The defeat by the malignant process of the upper, supraglottic section, is characterized by the most dubious prognosis. This section contains a large amount of loose tissue, adipose tissue, and lymphatic vessels, which facilitates the spread of the tumor and its metastasis.
The most favorable localization of the process for treatment is the middle section of the larynx, which is represented by the vocal cords.
In this section, there is no concentration of lymphatic or blood vessels that contribute to the spread of the tumor process. The disease can develop rather slowly, within the vocal cords. In addition, good prognostic results are achieved with timely surgical intervention, which is chordectomy.
The operation consists in removing the vocal cord, which is possible with an isolated local lesion of one of them. Life expectancy with such timely treatment is almost 100%. However, such an operation is shown only in the initial stages of the disease. With the development of the third stage of laryngeal cancer and the spread of the process, such intervention is no longer sufficient. In this case, we will talk about a more extensive removal of the affected area.
The lower larynx is involved in the malignant process only in 2% of cases. However, this localization of laryngeal cancer is characterized by late diagnosis. The disease is masked for a long time by inflammatory processes. Due to the worn out symptoms, most patients go to see a doctor no earlier than the third stage.
Diagnosis of the disease
Depending on the stage of the process, the laryngoscopic picture of the disease changes. At the first stage of cancer of the larynx, a lesion that is insignificant in area is determined, affecting the epithelial layer of any part of the larynx. It looks like a tubercle protruding against the background of unchanged epithelial tissue. With the growth of the tumor deep into the epithelium, the tubercle may not be detected. In this case, the evidence of the development of a malignant process is the injection of vessels in a limited area.
With the development of the process, there is a change in the laryngoscopic picture. Stage 4 throat cancer is characterized not only by an increase in the affected area. On the surface of the tumor, there are crater-shaped depressions covered with a whitish coating, or bleeding ulceration sites. The appearance of these signs indicates the disintegration of the tumor, which is a negative prognostic sign.
With any localization of the primary focus at the fourth stage of the process, the vocal cords are also affected.
They lose their mobility, up to complete immobilization. The glottis is sharply narrowed by the tumor process.
Biopsy value
Biopsy is critical in establishing the diagnosis and stage of the process. The study consists in the extraction of a pathologically altered tissue site and its further examination under a microscope. The material is taken by an ENT doctor with direct or indirect laryngoscopy, microscopic examination is carried out by a pathologist.
In the case of laryngeal cancer, the specialist must not only confirm or deny the malignant nature of the disease. He also gives a conclusion about what kind of cancer we are talking about, squamous cell keratinizing, or non-keratinizing cancer. This clarification is important not only for the development of correct treatment tactics, but also in relation to life projections.
The course of keratinizing squamous cell carcinoma is more favorable.
This disease is characterized by slow growth, rarely metastasizes, which helps to lengthen the life expectancy of patients.
Signs of damage to the body
Thus, the most unfavorable course is characterized by squamous cell non-keratinizing cancer, stage 4 of throat cancer, especially when the process is localized in the upper larynx. With this course, signs develop, indicating the involvement of the whole organism in the process. Atypical cells in the course of their life have a destructive effect on healthy cells and tissues, leading to the development of cancer intoxication.
Clinical signs are not only local changes, indicating a lesion of the throat, but also symptoms of damage to the whole body:
- sharp malaise;
- weakness;
- emaciation;
- shortness of breath at rest;
- pallor of the skin;
- anemia;
- headache;
- sleep disturbance.
Draws on the patient's appearance. He is emaciated, adynamic, can moan in pain. The skin is pale, earthy.
Throat symptoms
A mandatory symptom that characterizes the fourth stage of a malignant process in the throat is pain.
At first, patients notice pain only when swallowing. Over time, the nature of the pain becomes permanent, it can be given to the ear.
Taking painkillers is not able to relieve pain. Increased pain when swallowing leads to a change in the patient's diet. First, he excludes coarse food, then refuses to eat.
The manifestation of the disease, in addition to severe pain syndrome, are
- dry paroxysmal cough;
- hemoptysis;
- asthma attacks;
- inability to pronounce sounds, aphonia;
- putrid odor from the mouth;
- the presence of enlarged packages of lymph nodes.
The fourth stage of laryngeal cancer is characterized by metastasis to distant organs. More often than others, the bronchi, lungs, brain, spine are affected. In this regard, the clinical signs of the disease may also be due to the localization of the metastatic process.
Therapeutic activities
The patient's condition is assessed as serious. The only possible therapeutic measures for such patients are the use of chemotherapy drugs, radiotherapy, symptomatic treatment aimed at maintaining vital functions. The choice of the method of treatment is limited by the serious condition of the patient and the spread of the process throughout the body. The overall forecast is disappointing. The cause of death is
- cancer wasting, cachexia;
- asphyxia due to tumor growth and laryngeal stenosis;
- bleeding caused by the invasion of a tumor of large vessels of the neck;
- pulmonary insufficiency.
The life expectancy of such patients does not exceed several months.
