Laryngeal CA Mangaser

Perpetual Help College of Manila
1240 V. Concepcion Street. Sampaloc Manila

College of Radiologic Technology
“LARYNGEAL CANCER”
A case presented to Perpetual Help College of Manila
In partial fulfillment of the requirements
for the subject Radiation Therapy
By:
Sarah Faye C. Mangaser
March 20, 2019
1|P a ge
TABLE OF CONTENTS
I. Introduction -------------------------------------------------------- 3
II. Anatomy ------------------------------------------------------------- 5
III. Etiology -------------------------------------------------------------- 7
IV. Epidemiology ------------------------------------------------------ 8
V. Diagnosis ----------------------------------------------------------- 12
VI. Signs and Symptoms ------------------------------------------- 15
VII. Treatment ----------------------------------------------------------- 17
VIII. Pathophysiology ------------------------------------------------- 20
IX. Prognosis ---------------------------------------------------------- 21
X. Case Study Reference ----------------------------------------- 24
2|P a ge
Introduction
Background of the study
Normally, the cells that make up the body reproduce themselves in an orderly fashion and have
specific life spans. Dead and worn-out tissues are replaced, injuries are repaired and the body stays
healthy. When exposed to some substances, like certain chemicals and viruses, some susceptible cells
undergo changes in their genes called mutations. The substances that cause these genetic mutations
are called carcinogens. Examples of carcinogens, also called cancer initiating or promoting substances,
are numerous chemicals in cigarette smoke, viruses that cause chronic infection of the liver and the
uterine cervix, hormones such as estrogen, and ultraviolet rays from the sun. These cellular genetic
mutations if left unchecked will eventually enable the cells to behave in a manner totally different from
normal cells. They keep on reproducing, live much longer, and can spread and reproduce in other parts
of the body. Cancer cells serve no useful purpose and when too numerous and widespread, they cause
serious damage and death.
Although carcinogens are capable of initiating cellular genetic mutations, the body is also quite
capable of repairing these mutations. When the mutations are so extensive that repair is no longer
possible, the body can get rid of these rogue cells. If the rogue cells cannot be killed, the body is often
successful in keeping them at bay. These defence mechanisms are also referred to as cancer protecting
mechanisms. These mechanisms are in peak fighting form in any healthy person. The major promoters
of health are healthy diet, physical fitness and possibly less stress.
Lately, non-genetic factors that cause the genes to express themselves differently (epigenetic
factors) have been recognized to also play important roles in the initiation/promotion/protection of
specific types of cancer and other diseases. Epigenetic factors also respond to pressures in the external
and internal environment.
Laryngeal cancer occurs when normal cells change and grow uncontrollably. These cells form a cancerous
tumor in the larynx or voice box, which is located in your neck.
3|P a ge
The larynx has 3 main parts:
Glottis. This is where the vocal cords are.

Supraglottis. This is located above the vocal cords.
Subglottis. This is below the vocal cords, where the larynx connects to the trachea.
When you breathe in, air travels through your larynx, down the trachea, and into your lungs. The air
travels the other way when you breathe out. The vocal cords are relaxed when you breathe, and air moves
between them without making any sound. When you talk, the vocal cords tighten up and move closer together.
Air from your lungs is forced between them and makes them vibrate, producing sound. Your tongue, lips, and
teeth turn this sound into words.
Just behind the trachea and the larynx is the food pipe or esophagus. This is a collapsible tube that
carries food from your mouth to your stomach. The openings of the esophagus and the larynx are very close to
each other. A flap called the epiglottis covers the larynx to keep food from going down the wrong tube when you
swallow.
If cancer cells spread outside the larynx, they usually spread first to the lymph nodes, also called lymph
glands, in the neck. Cancer cells can also spread to the back of your tongue, other parts of your throat and neck,
and even other parts of your body, including the lungs and the spine. When cancer cells from the larynx spread to
distant parts of the body, it is called metastatic laryngeal cancer.
4|P a ge
Anatomy and Physiology

Larynx
5|P a ge
Anatomy
The larynx is a tough, flexible segment of the respiratory tract connecting the pharynx to the trachea in
the neck. It plays a vital role in the respiratory tract by allowing air to pass through it while keeping food and drink
from blocking the airway. The larynx is also the body’s “voice box” as it contains the vocal folds that produce the
sounds of speech and singing.
The larynx is a short, epithelium-lined tube formed by nine pieces of cartilage and several ligaments that
bind them together.
It is located along the body’s midline in the neck region deep to the skin and the muscles of the neck and
anterior to the esophagus and cervical vertebrae. At its superior end, it borders the hyoid bone and the
laryngopharynx.
The most superior region of the larynx is the epiglottis, a leaf-shaped flap of elastic cartilage covered with
epithelium. It connects to the larynx on its tapered inferior end and, except for a brief moment while swallowing,
extends its wider superior end slightly into the pharynx just posterior to the tongue. During the process of
swallowing, the epiglottis folds over to cover the glottis and prevents food from blocking the airway.
Inferior to the epiglottis is the glottis region of the larynx, which contains the vocal folds. The largest
cartilage in the larynx, the thyroid cartilage, supports the glottis. The thyroid cartilage is semicircular in shape
with a prominent ridge extending from its anterior surface. This ridge is larger in males than in females and is
visible through the skin of the neck, forming the structure known as the Adam’s apple. The thyroid cartilage is
connected on its superior surface to the hyoid bone by a wide ligament known as the thyrohyoid membrane. The
thyroid cartilage also anchors the anterior ends of the vocal folds, which attach to the inside of the thyroid
cartilage at the body’s midline.
Physiology
In the process of swallowing, the larynx plays an important role in the direction of food into the esophagus.
The epiglottis normally resides in an upright position just anterior to the lumen of the larynx. In this position, it
6|P a ge
allows air to pass freely through the larynx during inhalation and exhalation. When food or liquid in the mouth is
swallowed, the food pushes the epiglottis posteriorly, flipping its free edge over to cover the glottis and block the
swallowed substances from entering the larynx. The food then safely passes on to the esophagus, at which point
the epiglottis flips back to its resting position.
Occasionally, a person may choke when food gets past the epiglottis or sticks to a structure within the
pharynx and blocks the airway. The vocal folds contract to catch the blockage before it passes into the trachea.
Coughing pushes air out of the lungs to force the blockage out of the airway.
Sounds are produced in the larynx by the movement of air through the larynx and by the vocal folds, a
pair of movable folds in the mucous membrane. The vocal folds are connected to the thyroid cartilage on their
anterior ends and the arytenoid cartilages on their posterior end. Air exhaled from the lungs passes through the
larynx and vibrates the vocal folds. Several sets of muscles move the arytenoid cartilages and the cricothyroid
joint to adjust the position and tension of the vocal folds and thereby control the pitch of sound made by the
larynx.
Etiology
We don’t know what causes each case of laryngeal or hypopharyngeal cancer. But we do know many of
the risk factors for these cancers and how some of them cause normal cells to become cancer.
Scientists believe that some risk factors, such as tobacco or heavy alcohol use, cause these cancers by
damaging the DNA of the cells that line the inside of the larynx and hypopharynx.
DNA is the chemical in each of our cells that makes up our genes – the instructions for how our cells
function. We usually look like our parents because they are the source of our DNA. But DNA affects more than
how we look. Some genes have instructions for controlling when cells grow and divide into new cells. Genes that
help cells grow and divide are called oncogenes. Genes that slow down cell division or cause cells to die at the
right time are called tumor suppressor genes. Cancers can be caused by DNA changes that turn on oncogenes
or turn off tumor suppressor genes.
7|P a ge
Some people inherit DNA mutations (changes) from their parents that greatly increase their risk for
developing certain cancers. But inherited gene mutations are not believed to cause very many cancers of the
larynx or hypopharynx.
Gene changes related to these cancers usually happen during life, rather than being inherited.
These acquired mutations often result from exposure to cancer-causing chemicals, like those found in tobacco
smoke. An acquired change in the p16 tumor suppressor gene seems to be important in laryngeal and
hypopharyngeal cancers, although not all these cancers have this change. Several different gene changes are
probably needed for cancer to develop, and not all of these changes are understood at this time.
Inherited mutations of oncogenes or tumor suppressor genes rarely cause these cancers, but some
people seem to inherit a reduced ability to detoxify (break down) certain types of cancer-causing chemicals.
These people are more sensitive to the cancer-causing effects of tobacco smoke, alcohol, and certain industrial
chemicals. Researchers are developing tests that may help identify such people, but these tests are not yet
reliable enough for routine use.
Some forms of human papillomavirus (HPV) are important causes of some throat cancers (including
cancers of the hypopharynx). The outlook for people with these cancers appears to be better than for people
whose cancers are the result of tobacco or alcohol use.
Epidemiology
Based on 16,492 cancer cases recorded at the Central Tumor Registry of the Philippines from July 1968
to June 1973, an epidemiologic analysis was conducted. Age-adjusted incidence rates for cancer of all sites in
the Philippines, the United States, and Japan were similar. Cancers of the lung and breast were the leading sites
in males and females, respectively. Age-specific incidence rates by each site were compared for the Philippines,
the United States, and Japan. Cancers of the oral cavity, nasopharynx, liver, lung, breast, cervix, ovary, and
8|P a ge
thyroid and malignant lymphoma occurred with higher frequency in the Philippines. The more education people
had, the more likely they were to develop cancers of the lung, pancreas, bladder, prostate, breast, and ovary,
whereas cancers of the stomach, skin, esophagus, oropharynx, tongue, and mouth were more common in
individuals who had not completed high school. Among smokers, neoplasms of the lung, larynx, tongue, mouth,
liver, esophagus, and oropharynx occurred with significantly higher frequency. Epidemiologic implications and
significance of these results for cancer control were discussed.
9|P a ge
10 | P a g e
11 | P a g e
Diagnosis
If you have symptoms of laryngeal cancer, such as a hoarse voice and pain when swallowing, your GP
will ask about your symptoms and recent medical history.They may also examine the inside and outside of your
throat for abnormalities, such as lumps and swellings.
If laryngeal cancer is suspected, you'll probably be referred to the ear, nose and throat (ENT) department
of your local hospital for further testing.
12 | P a g e
The National Institute for Health and Care Excellence (NICE) recommends that anyone aged 45 or over
with persistent unexplained hoarseness or an unexplained lump in their neck should have an appointment with
a specialist within 2 weeks.
The main tests that may be carried out in hospital are described below.
1. Nasendoscopy is a procedure used to get a clear view of your larynx.
During the procedure, a small, flexible tube with a light and video camera at one end (endoscope) is inserted
into one of your nostrils and passed down the back of your throat. The images from the endoscope are displayed
on a monitor. You'll usually be awake while this is carried out and it may feel uncomfortable. A local
anaesthetic spray is sometimes used to numb your nose and throat beforehand, so you don't feel any pain.
2. Laryngoscopy
If it wasn't possible to get a good view of your larynx during a nasendoscopy, or a possible problem is spotted,
you may have a further test called a laryngoscopy.
Like a nasendoscopy, this procedure involves using an endoscope to examine your larynx. However, the
endoscope used during a laryngoscopy is longer and inserted through the mouth. This allows the larynx to be
seen in greater detail.
A laryngoscopy can be very uncomfortable, so it's usually carried out under general anaesthetic (where
you're asleep). You should be able to leave hospital as soon as you've recovered from the effects of anaesthetic,
which is usually the same day or the day after.
3. Biopsy
During a nasendoscopy or laryngoscopy, your doctor may use small instruments to remove a sample of cells
from your larynx so it can be examined for signs of cancer. This is known as a biopsy.
13 | P a g e
Alternatively, if you have a lump in your neck, a needle and syringe can be used to remove a tissue sample.
This is known as fine needle aspiration.
Further testing
If the results of the biopsy show you have cancer and there's a risk it may have spread, you'll probably be referred
for further testing to assess how widespread the cancer is. The tests may include:
o A computerised tomography (CT) scan – a series of X-rays are taken to build up a more detailed three-
dimensional picture of your larynx and the surrounding tissue
o A magnetic resonance imaging (MRI) scan – a strong magnetic field and radio waves are used to
produce a more detailed image of your larynx and the surrounding tissue
o A PET-CT scan – a CT scan is used to take pictures of the inside of your body after you've been injected
with a mildly radioactive substance that helps to show cancerous areas more clearly
o An ultrasound scan – high-frequency sound waves are used to check for signs of cancer in the lymph
nodes (glands found throughout the body) near the larynx
Staging and grading
After these tests have been completed, your doctor should be able to tell you the extent of the cancer.
This is known as the stage and grade of the cancer.
Healthcare professionals use a system called the TNM system to stage laryngeal cancer. T describes
the size of the tumour, N describes whether cancer has spread to the lymph nodes and M gives an
indication of whether the cancer has spread to other parts of the body.
 The T stage is given as a number from 1 to 4 – Small tumours confined to one part of the larynx are
described as T1 tumours and large tumours that have grown into tissues outside the larynx are
described as T4.
14 | P a g e
 The N stage is given as a number from 0 to 3 – N0 means the lymph nodes are not affected, whereas
stages N2 to N3 mean that 1 or more lymph nodes are affected.
 The M stage is given as either M0 or M1 – M0 means the cancer has not spread to other parts of the
body and M1 means that it has.
There are also three different grades (1 to 3) used to describe laryngeal cancer. Lower-grade cancers,
such as grade 1, tend to grow more slowly and are less likely to spread. Higher-grade cancers, such as grade
3, grow quickly and are more likely to spread.
Signs and Symptoms
Hoarseness or voice changes
Laryngeal cancers that form on the vocal cords (glottis) often cause hoarseness or a change in the voice.
This can lead to them being found at a very early stage. People who have voice changes (like hoarseness) that
do not improve within 2 weeks should see their health care provider right away.
For cancers that don’t start on the vocal cords, hoarseness occurs only after these cancers reach a later
stage or have spread to the vocal cords. These cancers are sometimes not found until they have spread to the
lymph nodes and the person notices a growing mass in the neck.
Other symptoms
Cancers that start in the area of the larynx above the vocal cords (supraglottis), the area below the vocal cords
(subglottis), or the hypopharynx do not usually cause voice changes, and are therefore more often found at later
stages.
15 | P a g e
Symptoms of these cancers may include:
 A sore throat that does not go away
 Constant coughing
 Pain when swallowing
 Trouble swallowing
 Ear pain
 Trouble breathing
 Weight loss
 A lump or mass in the neck (due to spread of the cancer to nearby lymph nodes)
Many of these symptoms are more likely to be caused by conditions other than laryngeal or hypopharyngeal
cancer. Still, if you have any of these symptoms, it is very important to have them checked by a doctor so that
the cause can be found and treated, if needed.
16 | P a g e
Treatment
The treatment for laryngeal cancer largely depends on the size of the cancer. The main treatments are
radiotherapy, surgery and chemotherapy.
Most hospitals use multidisciplinary teams (MDTs) of specialists that work together to decide the best way
to proceed with your treatment.
Members of your MDT will probably include a surgeon, a clinical oncologist (a specialist in non-surgical
treatment of cancer), and a specialist cancer nurse who will be responsible for co-ordinating your care.
Your cancer team will recommend what they think is the best treatment option, but the final decision will be
yours.
Before visiting hospital to discuss your treatment options, you may find it useful to write a list of questions
you'd like to ask your care team. For example, you may want to find out the advantages and disadvantages of
particular treatments.
Your treatment plan
Your recommended treatment plan will depend on the stage of the cancer. If you have early-stage
laryngeal cancer, it may be possible to remove the cancer using surgery (endoscopic resection)
or radiotherapy alone. This may also be the case with slightly larger cancers, although a combination of surgery
and radiotherapy is sometimes required.
In later-stage laryngeal cancer, more extensive surgery may be needed. Radiotherapy

and chemotherapy will probably be used in combination. In some cases, the entire larynx may have to be
removed. A medication called cetuximab may be used in cases where chemotherapy is not suitable.
These treatments are described below.
17 | P a g e
Radiotherapy
Uses controlled doses of high-energy radiation to destroy cancerous cells. It can be used as a treatment
on its own for early-stage laryngeal cancer, or it can be used after surgery to stop cancerous cells returning. It's
sometimes combined with chemotherapy.
The energy beams used during radiotherapy have to be precisely targeted to your larynx. To ensure the
beams are directed at the exact area, a special plastic mask will be made to hold your head in the right position.
A mold of your face will be taken, so that the mask can be made before treatment starts.
Radiotherapy is usually given in short daily sessions from Monday to Friday, with a break from treatment
at the weekend. The course of treatment usually lasts for 3 to 7 weeks.
18 | P a g e
As well as killing cancerous cells, radiotherapy can affect healthy tissue and has a number of side effects,
including:
o sore, red skin (similar to sunburn)
o mouth ulcers
o dry mouth
o loss of taste
o loss of appetite
o tiredness
o feeling sick
Your MDT will monitor any side effects and treat them when possible. For example, protective gels can be
used to treat mouth ulcers, and medicines are available for a dry mouth.
Radiotherapy can sometimes cause your throat tissue to become inflamed. Severe inflammation can cause
breathing difficulties. Contact your key worker or visit your local accident and emergency (A&E) department as
soon as possible if you have difficulty breathing.
Most side effects should pass within a few weeks of treatment finishing.
19 | P a g e
Pathophysiology
Laryngeal cancer starts in the cells of the larynx (voice box). A cancerous (malignant) tumour is a group of
cancer cells that can grow into and destroy nearby tissue. It can also spread (metastasize) to other parts of the
body.
The larynx is part of the respiratory system. It is the tube that connects the throat to the windpipe (trachea).
The vocal cords are 2 bands of muscle in the middle of the larynx that make sounds and help you speak. The
larynx helps keep food and fluids from entering the windpipe. The larynx plays an important role when we
breathe, swallow and speak.
Cells in the larynx sometimes change and no longer grow or behave normally. These changes may lead
to non-cancerous (benign) conditions such as chronic laryngitis and vocal cord nodules. They can also lead to
non-cancerous tumours such as vocal cord polyps and laryngeal papillomatosis.
Changes to cells of the larynx can also cause precancerous conditions. This means that the abnormal
cells are not yet cancer but there is a higher chance that they will become cancer. The most common
precancerous condition of the larynx is dysplasia.
But in some cases, changes to laryngeal cells can cause cancer. Most often, laryngeal cancer starts in
flat, thin cells called squamous cells. These cells cover the inside of the larynx. This type of cancer is called
squamous cell carcinoma of the larynx. Laryngeal cancer can develop anywhere in the larynx. It often starts in
the middle of the larynx, close to the vocal cords. Most squamous cell cancers begin as dysplasia.
Rare types of laryngeal cancer can also develop. These include minor salivary gland cancers, sarcomas,
melanomas and lymphomas.
20 | P a g e
Prognosis
Survival Rates for Laryngeal and Hypopharyngeal Cancers
Survival rates can give you an idea of what percentage of people with the same type and stage of cancer
are still alive a certain amount of time (usually 5 years) after they were diagnosed. They can’t tell you how long
you will live, but they may help give you a better understanding of how likely it is that your treatment will be
successful.
Keep in mind that survival rates are estimates and are often based on previous outcomes of large
numbers of people who had a specific cancer, but they can’t predict what will happen in any particular person’s
case. These statistics can be confusing and may lead you to have more questions. Talk with your doctor about
how these numbers may apply to you, as he or she is familiar with your situation.
What is a 5-year relative survival rate?
A relative survival rate compares people with the same type and stage of cancer to people in the overall
population. For example, if the 5-year relative survival rate for a specific stage of laryngeal or hypopharyngeal
cancer is 80%, it means that people who have that cancer are, on average, about 80% as likely as people who
don’t have that cancer to live for at least 5 years after being diagnosed.
Where do these numbers come from?
The American Cancer Society relies on information from the SEER* database, maintained by the National
Cancer Institute (NCI), to provide survival statistics for different types of cancer.
The SEER database tracks 5-year relative survival rates for laryngeal and hypopharyngeal cancer in the
United States, based on how far the cancer has spread. The SEER database, however, does not group cancers
using AJCC TNM stages (stage 1, stage 2, stage 3, etc.) for laryngeal or hypopharyngeal cancer. Instead, it
groups cancers into localized, regional, and distant stages:
21 | P a g e
 Localized: There is no sign that the cancer has spread outside of the larynx (or hypopharynx).
 Regional: The cancer has spread outside the larynx (or hypopharynx) to nearby structures or lymph
nodes.
 Distant: The cancer has spread to distant parts of the body, such as the lungs.
5-year relative survival rates for laryngeal and hypopharyngeal cancers
These numbers are based on people diagnosed with cancers of the larynx or hypopharynx between 2008
and 2014. For laryngeal cancers, survival rates differ based on which part of the larynx the cancer started in
(supraglottis, glottis, or subglottis).
22 | P a g e
23 | P a g e
Case Study Reference
American Cancer Society. Cancer Facts & Figures 2016. Atlanta, Ga: American Cancer Society; 2016.
American Cancer Society. Cancer Facts & Figures 2017. Atlanta, Ga: American Cancer Society; 2017.
American Joint Committee on Cancer. Larynx. In: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer;
2010: 57-62.
American Joint Committee on Cancer. Pharynx. In: AJCC Cancer Staging Manual. 7th ed. New York, NY:
Springer; 2010: 41-49.
Atkinson JC, Harvey KE, Domingo DL, et al. Oral and dental phenotype of dyskeratosis congenita. Oral Dis.
2008;14:419-427.
Benninger MS, Gillen J, Thieme P, Jacobson B, Dragovich J. Factors associated with recurrence and voice
quality following radiation therapy for T1 and T2 glottic carcinomas. Laryngoscope. 1994 Mar;104(3 Pt 1):294-8.
Bonner JA, Harari PM, Giralt J, et al. Radiotherapy plus cetuximab for squamous-cell carcinoma of the head and
neck. N Engl J Med. 2006;354:567-578.
Caporaso N, Dodd KW, Tucker MA. New Malignancies Following Cancer of the Respiratory Tract. In: Curtis RE,
Freedman DM, Ron E, Ries LAG, Hacker DG, Edwards BK, Tucker MA, Fraumeni JF Jr. (eds). New
Malignancies Among Cancer Survivors: SEER Cancer Registries, 1973-2000. National Cancer Institute. NIH
Publ. No. 05-5302. Bethesda, MD, 2006. Accessed on 4/18/2014 at
http://seer.cancer.gov/archive/publications/mpmono/MPMonograph_complete.pdf.
Carvalho AL, Nishimoto IN, Califano JA, Kowalski LP. Trends in incidence and prognosis for head and neck
cancer in the United States: A site-specific analysis of the SEER database. Int J Cancer. 2005;114:806-816.
24 | P a g e
Forastiere AA, Goepfert H, Maor M, et al. Concurrent chemotherapy and radiotherapy for organ preservation in
advanced laryngeal cancer. N Engl J Med. 2003;349:2091-2098.
Forastiere AA, Zhang Q, Weber RS, et al. Long-term results of RTOG 91-11: a comparison of three nonsurgical
treatment strategies to preserve the larynx in patients with locally advanced larynx cancer. J Clin Oncol.
2013;31(7):845-852. Epub 2012 Nov 26.
Furusaka T, Matsuda A, Tanaka A, Matsuda H, Ikeda M. Superselective intra-arterial chemoradiation therapy

for functional laryngeal preservation in advanced squamous cell carcinoma of the glottic larynx. Acta Otolaryngol.
2013;133(6):633-640. Epub 2013 Feb 11.
Gold KA, Lee HY, Kim ES. Targeted therapies in squamous cell carcinoma of the head and neck. Cancer.
2009;115:922-935.
Haddad RI, Shin DM. Recent advances in head and neck cancer. N Engl J Med. 2008;359:1143-1154.
Howlader N, Noone AM, Krapcho M, et al (eds). SEER Cancer Statistics Review, 1975-2010, National Cancer
Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2010/, based on November 2012 SEER data
submission, posted to the SEER website, April 2013.
Kikidis D, Vlastarakos PV, Manolopoulos L, Yiotakis I. Continuation of smoking after treatment of laryngeal
cancer: an independent prognostic factor? ORL J Otorhinolaryngol Relat Spec. 2012;74(5):250-4. Epub 2012
Oct 13.
Kushi LH, Doyle C, McCullough M, Rock CL, Demark-Wahnefried W, Bandera EV, Gapstur S, Patel AV, Andrews
K, Gansler T; American Cancer Society 2010 Nutrition and Physical Activity Guidelines Advisory Committee.
American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of
cancer with healthy food choices and physical activity. CA Cancer J Clin. 2012 Jan-Feb;62(1):30-67.
25 | P a g e
Kutler DI, Auerbach AD, Satagopan J, et al. High incidence of head and neck squamous cell carcinoma in
patients with Fanconi anemia. Arch Otolaryngol Head Neck Surg. 2003;129:106-112.
Mendenhall WM, Werning JW, Pfister DG. Treatment of head and neck cancers. In: DeVita VT, Lawrence TS,
Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 9th ed.
Philadelphia, Pa: Lippincott Williams & Wilkins; 2011: 729-780.
Moyer JS, Wolf GT. Advanced stage cancer of the larynx. Part A: General principles and management. In:
Harrison LB, Sessions RB, Hong WK, eds. Head and Neck Cancer: A Multidisciplinary Approach. Philadelphia,
Pa: Lippincott Williams and Wilkins; 2009: 367-384.
National Cancer Institute. Physician Data Query (PDQ). Hypopharyngeal Cancer Treatment. 12/12/2013.
Accessed at www.cancer.gov/cancertopics/pdq/treatment/hypopharyngeal/HealthProfessional on February 19,
2014.
National Cancer Institute. Physician Data Query (PDQ). Laryngeal Cancer Treatment. 2/15/2013. Accessed at
www.cancer.gov/cancertopics/pdq/treatment/laryngeal/HealthProfessional on February 19, 2014.
National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology: Head and
Neck Cancers. V.1.2012. Accessed at www.nccn.org/professionals/physician_gls/pdf/head-and-neck.pdf on
October 22, 2012.
Romesser PB, Riaz N, Ho AL, Wong RJ, Lee NY. Cancer of the head and neck. In: Niederhuber JE, Armitage
JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 5th ed. Philadelphia, Pa: Elsevier;
2014:1037-1070.
Vermorken JB, Mesia R, Rivera F, et al. Platinum-based chemotherapy plus cetuximab in head and neck
cancer. N Engl J Med. 2008;359:1116-1127.
26 | P a g e

Laryngeal CA Mangaser

Uploaded by

Document Information

Copyright

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Laryngeal CA Mangaser

Uploaded by

Copyright:

Perpetual Help College of Manila

1240 V. Concepcion Street. Sampaloc Manila

A case presented to Perpetual Help College of Manila

College of Radiologic Technology

In partial fulfillment of the requirements

for the subject Radiation Therapy

Sarah Faye C. Mangaser

March 20, 2019

The larynx has 3 main parts:

Glottis. This is where the vocal cords are.

Anatomy and Physiology

1. Nasendoscopy is a procedure used to get a clear view of your larynx.

Staging and grading

Signs and Symptoms

Hoarseness or voice changes

Symptoms of these cancers may include:

 A sore throat that does not go away

 Pain when swallowing

Your treatment plan

In later-stage laryngeal cancer, more extensive surgery may be needed. Radiotherapy

These treatments are described below.

What is a 5-year relative survival rate?

Where do these numbers come from?

5-year relative survival rates for laryngeal and hypopharyngeal cancers

Case Study Reference

Furusaka T, Matsuda A, Tanaka A, Matsuda H, Ikeda M. Superselective intra-arterial chemoradiation therapy

You might also like