Laryngeal Cancer at a Young Age? Manifestations and Causes

Laryngeal cancer is a serious health problem. It needs to be detected in time.

The tumour may appear in different locations in the larynx. Early detection of the tumourous process is very important because in later stages it penetrates the surrounding tissues on a wider scale.

Quite often, cancer cells metastasize to other parts of the body, such as the lungs.

Not every tumour found in the larynx is malignant, i.e. cancerous.

Benign tumours grow slowly, and they do not invade their environment, as is the case with malignancies. Benign tumours do not metastasize.

One of the benign ones is Nodulus vocalis, a nodule that forms on the vocal folds. It is known to appear in singers due to overexertion of the vocal cords, causing a vocal cord polyp. An example of a benign tumour is laryngeal papillomatosis, also called squamous papilloma of the larynx.

However, malignant tumours grow into the environment, damaging neighbouring tissue and tending to metastasize. They grow rapidly, are invasive, and spread and destroy the surrounding tissues. Laryngeal cancer most often comes from squamous epithelial cells. It is also called a malignant laryngeal epithelial tumour.

However, depending on their location in the larynx, there are several forms of this cancer. Glottic cancer usually begins with the growth of a tumour on one vocal cord, which later spreads to another and grows in depth as well as in the surrounding area. It usually metastasizes at a later point. The supraglottic form spreads from the laryngeal flap.

In Europe, among all cancers, laryngeal cancer represents about 5-7%.
It appears most often in men, especially after the age of 50.

It invasively enters the tongue and nearby parts of the pharynx. However, metastasis also occurs after a certain time and in the later stages of tumour development. This tumour is quite large, making it more difficult to remove and treat.

Subglottic cancer is the most problematic one in terms of treatment, because in this case it metastasizes relatively quickly and at the same time the tumour grows both in the direction of the trachea and upwards towards the vocal cords.

The name of the tumour is based on its location:

• on the vocal cords, i.e. the glottic form
• above the vocal cords, i.e. the supraglottic form
• the subglottic form occurs under the glottis, i.e. the opening between the vocal folds

Table: Approximate Representation of Tumour Forms

Laryngeal cancer is a very common disease in smokers and most often in men. Due to the increase in the number of women smokers, it is also rising in the case of women. Laryngeal cancer and age are also related. It is very rare in children. Its occurrence begins most commonly over the age of 40, culminating around 50-60 years of age.

Throat cancer is extremely rare in individuals who do not smoke.

The malignancy can also develop on the basis of physical, chemical and biological factors. For example, the supraglottic form of cancer has a relatively common association with alcoholism. It is less often caused by exposure to various types of radiation. The development of this type of cancer is also conditioned by a viral infection. Various fatty foods or preservatives are also a risk factor.

Risk factors for laryngeal cancer include:

• smoking
• alcohol
• the worst is a combination of alcoholism and smoking
• heavy metal contamination such as nickel, uranium, asbestos
• HPV

In people under the age of 50, the most common cause of throat cancer is sexual intercourse, especially due to multiple sex partners and oral sex.

The cause is the transmission of HPV, i.e. the human papilloma virus, mainly HPV strains 16 and 18. HPV type 6 and 11 are the cause of benign tumours.

A tumour in the larynx manifests itself based on the stage in which it is and its type. Most often it begins to manifest itself in a change of voice, constant hoarseness and the sensation of having a foreign body in the throat.

Later on, as the tumour grows, difficulty swallowing start to increase, sometimes painfully so. Difficulty breathing may become an associated problem.

Cancers also manifested by weight loss and fever for no apparent reason. Since this is a cancer of the larynx, which is used for breathing and food intake, the affected person may sometimes present with typical sensation of suffocating, coughing up blood or bleeding from the mouth.

Excessive sweating sometimes occurs. For example, the pain may radiate towards the ear. The danger also stems from the fact that the cancer is silent for a long time, i.e. it does not manifest itself. Only at a later stage does it start causing problems, hence the sensation of a foreign body in the throat and suffocating.

In most cases, the clinically silent form is the subglottic type, or subglottic tumour. The supraglottic form is known to be asymptomatic for a long time.

The most typical manifestations of laryngeal cancer include:

• hoarseness is an early manifestation of vocal cord disease
• the sensation of a foreign body in the throat
• sore throat
• shortness of breath, difficulty breathing
• difficulty swallowing, i.e. dysphagia
• coughing
• coughing u blood
• losing weight

An ENT examination is needed when hoarsenes lasts longer than 21 days.
This is because hoarseness is the most common early manifestation of vocal cord cancer.

Table: Approximate Percentages of Laryngeal Cancer

It is important that these symptoms are not overlooked, especially if they occur intensively or for a longer time.

It is important to catch the tumour as soon as possible, and therefore a person suffering from these symptoms should see an ENT (ear, nose, throat) doctor. The ENT doctor will perform a laryngoscopic examination to determine the presence of aby changes in the tumour of the larynx. The presence of the disease is also examined by palpation of the cervical nodes, i.e. manually checking the neck.

A biopsy will help determine the type of tumour. Imaging tests such as X-rays, CT and MRI are also used. An ultrasound test examines the condition of the lymph nodes. Some clinics also use autofluorescence to detect any cancerous tissues.

PET/CT is a combination of CT and positron emission tomography that uses radiopharmaceutical therapy. Learn more about this examination.

The course also varies based on the type of cancer. The glottic form of laryngeal cancer, which metastasizes at a later stage, is the slowest to spread.

In terms of prognosis, this form is the most promising.

This type most often occurs on a single vocal cord. Later on, it spreads to the other one. The most common and early symptom is constant hoarseness.

Supraglottic cancer spreads from the laryngeal flap, i.e. the epiglottis, unlike the glottic form, which begins on one vocal cord and gradually progresses. However, this form also metastasizes later.

The most aggressive form, which is the most difficult to treat, is subglottic cancer. It metastasizes very rapidly, both upwards and downwards. The disadvantage of this type is that it is asymptomatic for a long time.

However, the subglottic form is the rarest one.

Other symptoms are associated with the size and extent of tumor growth. Such as difficulty swallowing, persistent sore throat, including worsening pain when swallowing. The mass can create a sensation of having foreign body in the throat.

Of course, as the airways become narrower, breathing starts to become increasingly difficult. Bleeding from the airways or coughing up blood is less common. However, this symptom is severe and can result in death.

Metastasis in laryngeal cancer most often occurs in regional lymph nodes. In the subglottic form, it is also in the nodules that are located around the trachea. More distant areas, mainly the lungs, are metastasized as well.