LARYNGECTOMY FAQ'S

 What IS laryngeal cancer anyway?
(from the American Cancer Society)

The larynx is often called the "voice box" or "Adam's apple." It is divided into three levels -- the glottis (or the vocal cords), the supraglottis (the area above the vocal cords including the epiglottis), and the subglottis (the area below the vocal cords).

The larynx has several functions. The most obvious is the production of sound for speaking. Another, even more important function is the protection of the airway during swallowing. The vocal cords not only come together to change the sound and pitch of your voice, but they also close tightly when you swallow. This keeps food and saliva from entering your lungs and causing pneumonia or blockage of breathing tubes. The vocal cords naturally open when you breathe so that air can get in and out of your lungs.

The hypopharynx is the part of the esophagus or food pipe that immediately surrounds the larynx. This area is where food enters the esophagus as it passes through the neck and chest into the stomach. The hypopharynx has reservoirs called the pyriform sinuses that guide food around the larynx and into the esophagus. 

There are several types of cancers that can develop in the larynx and hypopharynx. About 95% of these cancers develop from squamous cells. These thin, flat cells form the epithelium (lining layer) of the larynx and hypopharynx. Cancers beginning in this layer of cells are called squamous cell carcinoma or squamous cell cancer. Most squamous cell cancers of the larynx and hypopharynx do not form suddenly. Instead, they begin as precancers that are called dysplasia, squamous intraepithelial neoplasia, or laryngeal intraepithelial neoplasia (LIN). Most of these precancers never develop into actual cancers. They go away without any treatment, especially if the factors (such as smoking) that cause precancers and cancers are stopped.  Some precancers eventually develop into carcinoma in situ (CIS). In this is the earliest form of cancer, the cancer cells replace the lining layer but they do not spread to deeper areas of the tissue or to other parts of the body. Some of these very early cancers may go away on their own, and most can be cured by stripping (cutting away the lining layer) or destroying it with a laser beam. If CIS is not treated, about 30% will become an invasive squamous cell cancer that might destroy the nearby tissues and spread to other parts of the body. 

Some areas of the larynx and hypopharynx have tiny glands beneath their lining layer. These glands produce mucus and saliva to lubricate and moisten the area. Cancer rarely develops from the cells of these glands, but when it does, these cancers are called adenocarcinoma, adenoid cystic carcinomas, and mucoepidermoid carcinomas. 

The shape of the larynx and hypopharynx depends on a framework of connective tissues. Cancers such as chondrosarcomas or synovial sarcomas can develop from connective tissues of the larynx or hypopharynx but this is very, very rare. 

Because cancers forming in glands and connective tissues of the larynx or hypopharynx are so rare, they are not discussed further here.. This nformation refers only to the common
type of larynx and hypopharynx cancer -- squamous cell cancer.


KEY STATISTICS

The American Cancer Society estimates that during 1999, 10,600 new cases of laryngeal cancer (8,600 in men and 2,000 in women) will be diagnosed and 4,200 people (3,300 men and 900 women) will die of this disease in 1999. The estimated number of new cases of hypopharyngeal cancer is approximately 2,500.

When patients newly diagnosed with larynx and hypopharynx cancers are carefully examined, about 15% will have another cancer in nearby areas such as the mouth, esophagus, or lung. Another 10% to 20% will develop a cancer in one of these organs at a later time. For this reason, it is very important that patients with larynx and hypopharynx cancer understand the value of follow-up examinations for the rest of their lives and of avoiding risk factors like smoking and drinking.

REVISED 06/14/99