Throat Cancer

The term ‘throat cancer’ is commonly used for cancers involving the larynx (voice box) and the hypopharynx (upper part of food passage). These cancers are generally caused by the habit of smoking or chewing tobacco and maybe curable if detected early. Cancer of the throat is common in our country, accounting for over 12% of all cancers. Dr Umanath Nayak is a specialist providing the best throat cancer treatment in India.

Patients initially present with either change in voice (larynx) or pain during swallowing (hypopharynx) but as the disease advances, they can develop breathing difficulty, obstruction to swallowing or blood in their sputum. In some cases, they may only present with a lump in the neck and primary cancer may be silent.

A. Cancer of Larynx:

1. Early cancer of the larynx (first and second stages) is treated either by radiation therapy or by a surgical procedure called trans-oral laser surgery, which involves cutting out cancer with a laser beam directed through an endoscope.
2. In moderately advanced cancer of the larynx (third stage) although surgery in the form of total laryngectomy results in a higher percentage of cure than other forms of treatment, considering the psychological impact of the loss of the normal voice and the presence of a permanent stoma, a non-surgical option—chemoradiation (radiation therapy along with chemotherapy)—is initially recommended to preserve the larynx. If this treatment fails, the option of surgery is then considered.
3. In advanced stages (fourth stage), cancer of the larynx is still curable, though it may require a total laryngectomy (a surgical procedure involving the removal of the entire voice box). Following surgery, radiation with or without chemotherapy is generally recommended 4-6 weeks later to further consolidate the results of treatment.

B. Cancer of Hypopharynx:

Treatment policy is similar to that of cancer of the larynx, but overall results of treatment and cure rates are not as good. Early-stage disease is treated by radiation therapy and more advanced stages by surgery (total laryngectomy and pharyngectomy) and post-operative radiotherapy. Often the pharynx (food passage) may require reconstruction using tissues from other parts of the patient’s body (skin from chest or thigh or portion of the small intestine).

C. Rehabilitation:

A person who has undergone the procedure of total laryngectomy is called a Laryngectomee. Laryngectomees do not breathe through the nose or mouth, but through an opening created in the root of the neck called the ‘stoma’. They are trained to speak using special devices called voice prosthesis which is inserted into their stoma.

The presence of the stoma and this altered method of communication make certain lifestyle modifications mandatory for laryngectomees. In recent times development of special appliances, such as the so-called Hands-free system, can help produce voice without digital occlusion.

To help laryngectomees adjust to their new lifestyle, to enhance their social and communication skills, and to help them deal with other issues connected with their day-to-day living, many cancer centers have a self-help groups, generally referred to as a ‘laryngectomee club’, for the rehabilitation of these patients. The Laryngectomee Society of the Apollo Cancer Institutes in Hyderabad is a similar voluntary self-help rehabilitation group that works towards the physical, social, psychological and emotional rehabilitation of the laryngectomees. The Society meets on the second Saturday of every month.

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