Of laryngeal cancer in the first place cancer (cancer laryngis). Laryngeal cancer affects mostly men between the ages of 40 to 70 years: 100 males accounted for 8 women.
In the etiology of cancer of some importance attached to a number of diseases of larynx, which are called precancerous. They are:
papilloma, long-existing
leukoplakia of the mucous membrane and its dyskeratosis
pachydermia
fibroma on the basis of a wide
branchial cysts and other causes laryngeal ventricles
chronic inflammatory processes that are not inferior treatment due to syphilis, alcoholism, and smoking.
The most reliable is a malignancy of papillomas. Intermediate form between precancerous diseases and cancer is the so-called "carcinoma in situ classification of cancer of the larynx allows for a localization and tumor stage. This is dictated by the peculiarities of its course depending on the place of defeat, which in turn is explained by the anatomical structure of the larynx, in particular her lymphatic system.
Distinguish the following three basic larynx:
The upper, or vestibular, larynx, which includes-epiglottic ligament drew with guttural side, the false vocal cords, epiglottis and ventricles morganievy.
The average department - the area of the true vocal cords.
The lower, or subglottic, Department of the larynx.
I stage. Tumor or ulcer, limited mucosal and submucosal layer, and not extending beyond a single department of the larynx.
Stage II. Tumor or ulcer, and limited mucosal and submucosal layer, is entirely a larynx, but does not go beyond it. The mobility of the larynx is preserved. In the regional areas of metastasis can not be determined.
Stage III: a) The tumor moves to the underlying tissues, causing stiffness corresponding half of the larynx, but does not extend beyond any one of the department; b) the tumor spread to other departments of the larynx. The presence of single or multiple moving regional metastases or solitary metastasis limited mobility.
Stage IV: a) extensive tumor occupying most of the larynx with infiltration of the underlying tissues; b) the tumor, germinating in the adjacent organs; a) fixed lymph node metastases in the neck, and d) a tumor of any size in the presence of distant metastases.
Symptomatology laryngeal cancer depends on the stage and location of it. Swelling on the epiglottis or false vocal cords can be a long time does not manifest itself, for the patient to remain unnoticed. Conversely, the localization on the true vocal cords early phonation breaks: first, changing timbre of his voice, it becomes rough, and then the hoarseness. Hoarseness and often causes the patient to see a doctor.
In the future, to the extent of tumor growth, increased hoarseness, the patient can speak only in whispers. At the same time develop other symptoms - shortness of breath. In advanced stages, pain on swallowing.
In cancer of the epiglottis and the arytenoid cartilage is preceded by a feeling of pain sensation of awkwardness or something outside. In the case of the collapse of the tumor and attach secondary perihondrita pain much worse. After a while there is coughing up blood, choking, difficulty in passing joins the food down the esophagus.
Decomposing the tumor produces a stench. Patients lose weight, become weak, growing cachexia. Thus, the earliest symptom of laryngeal cancer is often hoarseness. Since this is a symptom and many other diseases of larynx, the elucidation of the causes of hoarseness is possible only by laryngoscopy.
Laryngoscopy, especially in the localization of tumors on the true vocal cords, allows us to establish the presence of tumor, even in cases when the size of small peas no more. In this way, provided the main conditions to fight the cancer process - early diagnosis.
In the primary subglottic cancer is rare, occurs for some time without symptoms and is diagnosed when the leaves are already out of this space. Subsequently, the tumor extended to the true vocal cords, so that there is persistent hoarseness. This symptom is characteristic and appears earlier than the shortness of breath. Lead one to believe there may be a tumor-sided increase of arytenoid cartilage.
It helps to recognize the tumor traheoskopiya. In the propagation process of cancer to adjacent organs - throat, the tongue, esophagus - attached new symptoms: inability to swallow, esophageal obstruction. The state of the esophagus becomes clear by X-ray and esophagoscopy.
The diagnosis of laryngeal cancer confirmed by microscopic examination slices infiltrate. However, if a positive answer histology in this case is critical, then a negative opinion is generally considered doubtful.
It so happens that the pathologist sees change as an inflammatory process, and the laryngoscope is determined by the tumor. This discrepancy may be explained by taking a test piece from the surface, a secondary inflammatory process, the simultaneous presence of two diseases such as cancer or cancer and syphilis, and tuberculosis. Sometimes it does not help to clarify the nature of the process and re-biopsy. Special caution must be when microscopically diagnosed papilloma in an elderly man.
Laryngeal cancer used combined (sequential) treatment: radiation therapy and surgery.
