Throat cancer

Larynx cancer symptoms: this is how the disease manifests itself

The symptoms of larynx cancer depend on where exactly in the neck area the tumor is located. That is why it is not that easy (at least for laypeople) to recognize cancer of the larynx. Especially since some early-stage laryngeal cancer signs are not specific. This means that they also occur with other illnesses (e.g. a cold ).

Doctors divide the larynx into three regions in which cancer can typically manifest itself in the following symptoms:

The supraglottic region that lies above the level of the vocal folds. If the ulcer is here, the person concerned often has problems swallowing, the feeling of having a foreign body in the throat or pain that can radiate into the ears.

The glottic region that is level with the vocal cords. Throat cancer tumors occur most frequently here, with more than 60 percent. They make themselves noticeable in persistent hoarseness, scratching the throat, throat clearing and chronic cough. Difficulty breathing with audible breathing sounds or even shortness of breath can occur later.

The subglottic region that lies below the level of the vocal folds. Tumors grow here the least, at less than one percent. But when it does, symptoms appear relatively late here. This is when the tumor has become so large that it presses on the vocal folds and the person concerned sounds hoarse, or the sheer size of the tumor causes breathing difficulties.

Apart from the situation-specific symptoms , it can happen that the person affected noticeably loses weight due to the cancer of the larynx.

Note: Always take symptoms that may indicate throat cancer seriously. The earlier the doctor has the opportunity to make a diagnosis, the greater the chances of successful therapy.

Larynx cancer: life expectancy depends on the time of diagnosis

Whether larynx cancer is fatal or can be cured depends heavily on when the doctor discovers it. Unfortunately, many patients do not go to the examination until the tumor has grown noticeably and ignore the early signs. There is no time to lose!

If the doctor diagnoses larynx cancer at an early stage, in the so-called pre- or early stage, the prognosis is better. The disease can then often be treated successfully. If, on the other hand, daughter tumors (metastases) have already formed in the lymph nodes, the likelihood of recovery is reduced: the more lymph nodes are affected, the more difficult it is to cure the larynx cancer. Glottic tumors have the best prognosis, while subglottic tumors have the worst.

In order to assess the courses

 of the cancer of the larynx or to determine its stage and to be able to suggest an appropriate therapy, doctors classify the cancer using a uniform evaluation table , the TNM classification . It stands

T for the size and extent of the primary tumor

N for the number and location of the affected lymph nodes and

M for the presence and location of distant metastases in other organs

Numbers are added to this information: T1, for example, stands for a primary tumor that is smaller than two centimeters; T4 for a tumor that has already spread to neighboring areas of the body (e.g. bones). In colloquial terms, this final stage would be terminal cancer of the larynx. When first diagnosed, most ulcers are in the earliest stages in which throat cancer has a real chance of recovery.

Expressed in numbers: According to statistics, 42 percent of the tumors in men are still in stage T1 at diagnosis. In 21 percent they are in T2, 20 percent in T3. In men, 17 percent of tumors are in the latter stage when the doctor detects them.

In women, 38 percent of larynx tumors are in the earliest stage T1 at the time of initial diagnosis. 24 percent are already in T2, 23 percent in T3. In 15 percent of women, the tumor has already reached the end stage T4.

With early diagnosis and treatment, the five-year survival rate for larynx cancer is 62 percent for men and 65 percent for women. This rate describes how many people are still alive five years after the diagnosis. Patients in whom the throat cancer has not returned five years after treatment (relapse) are considered cured.

There are different statistics about how high the probability is that a new ulcer will grow in patients who have had the tumor removed. The risk is between ten and 20 percent. In nine out of ten cases, this happens within the first two years after removal.

Larynx cancer: causes and risk factors

According to the current state of science, there are various risk factors for throat cancer.

Age seems to be one of them. Most people with throat cancer are between 60 and 70 years old. For men the average is 66 years old, women are 65 years old on average. The fact that people get larynx cancer at the age of 30, on the other hand, is rather the exception.

However, the greatest risk factors for developing throat cancer are smoking and excessive alcohol consumption. According to the national treatment guideline, chronic smoking (20 cigarettes a day for more than 20 years) or excessive chronic alcohol consumption (women have more than an eighth of wine a day, men a quarter of a wine) increase the risk of developing larynx cancer, each by six times. Those who do both have a 30 times higher chance of developing larynx tumors. Quitting smoking can reduce the risk of throat cancer. This also applies to people who have been smoking for years. However, this does not happen immediately: the risk of those who have regularly consumed alcohol and tobacco for many years only seems to level off again after ten to 15 years at the original risk of non-smokers or non-drinkers.

In addition to smoking and alcohol, exposure to asbestos is considered a risk factor for throat cancer.

Larynx cancer: diagnosis by the doctor

There is no nationwide screening program in Germany to detect throat cancer at an early stage. If there is a suspicions of cancer of the larynx - or another tumor in the upper respiratory tract and food tract - the doctor first inspects the mouth and throat, as far as it is accessible. He often looks at and feels his ears and nose and uses various instruments, such as special mirrors, to better examine the relevant regions.

Then, especially if the patient has been hoarse for more than four weeks, they will do a laryngoscopy, during which they will examine the larynx with a mirror or an endoscope. If larynx cancer is actually present, the doctor gets a first impression of its size and extent. Then he will perform a biopsy under local anesthesia . That means he takes a piece of the tissue to have it analyzed in the laboratory.

As part of a so-called panendoscopy, the doctor examines the entire area of the upper airways and food passages for possible second tumors. Then he can make an exact statement about how far the cancer has already grown.

The doctor then uses an ultrasound device to examine the patient's lymph nodes . If they are swollen, this can be an indication that the larynx cancer has already spread and metastasized. If this is the case, the doctor takes cells from the lymph nodes in order to examine them and thus check whether it is actually larynx cancer metastases.

In addition, the attending physician examines the patient, depending on the previous diagnosis, using imaging methods such as computed tomography (CT) or magnetic resonance imaging ( MRT ) in order to find out, for example, the growth and exact spread of the larynx cancer.

If you have cancer of the larynx, it is also useful to analyze the blood values. They give the doctor an indication of the patient's overall health. This helps him to recommend or reject certain diagnostic and therapeutic procedures. However, the cancer itself cannot be detected in the blood.