LARYNGECTOMY FAQ'S

Doc, Did you get it ALL?
(by Glenn E. Peters M.D., Director, Division of Otolaryngology
Head and Neck Surgery, University of Alabama at Birmingham,
Birmingham, Alabama, USA)

By far and away, the question that I am most frequently asked is "Doc, did you get it all?" I thought I might just explain this concept and let everyone know that the "get it all" really doesn’t apply to cancer , i.e. malignancies. Let’s start by reviewing just what a cancer is in the first place. A cancer is a lesion that has the capacity to act in a lethal fashion and ultimately result in the death of the patient. Cancers come about when a group of cells, for whatever reason, looses their normal control mechanisms and begin to grow out of control. As a result of this growth and loss of regulation some groups of these cells take on new genetic characteristics and become further programmed to carry out certain specialized functions. One of the most important new functions is the ability to invade the surrounding lymphatics and blood vessels and ultimately spread to other parts of the body. Therefore, cancers are programmed to spread.

The ability of a cancer to metastasize or spread to other organs can occur at any time during a lesion’s development and growth. We usually see this happen with larger tumors, but even the smallest and earliest cancers possess this genetically programmed ability to metastasize.

Surgery and radiation therapy are designed to take care of the tumor that exists locally in the head and neck area. Unfortunately, at this time, there does not exist any form of therapy that can address cells that might get out and set up shop at other sites. The best we can hope for is early detection of any new sites of possible spread. That is why a program of close and careful follow up and surveillance is so important.

So, in summary, we hope to eradicate tumors in the head and neck area with surgery and radiation. Most times we can get everything, that we can see and feel, out.- But does that mean that we "got it all"? Most times it does indeed mean just that—but remember that we are dealing with a disease that by its very nature is designed to spread. So adopt a healthy life style and keep those follow up appointments.