The above pictures show cancer of the voice
box. The picture on the left is a cancer of the epiglottis or top of the
voice box. The middle picture is a cancer of the true vocal cords and the
picture on the far right is a cancer of the sub-glottis or below the vocal
cords. Search barnesandnoble.com for
Quitting Smokingfor larynx Cancer
Excellent Book: Living With The End In Mind
Search PubMed for Larynx Cancer Sometimes
the cancer requires removing the voice box in a procedure called a
laryngectomy.
In this procedure the food tube or
esophagous
is separated from the airway
and the wind pipe is brought out through the neck. The patient on the
right had a
laryngectomy
to treat a recurrent cancer
after radiation therapy
Mouse over the picture to see his stoma!!!
Play to Hear Patient's Preop Voice:
A T1 squamous cell carcinoma involving the anterior portion of the right true vocal cord. The patient had a 35 pack year history of smoking.
A recurrent cancer involving the anterior true vocal cord. The patient was a 40 year old who smoked and had been treated 6 years previously with full course radiation therapy for a laryngeal cancer.
A T1 squamous cell carcinoma of the left true vocal cord. The patient was a 84 year old patient had a 75 pack year history of smoking and had quit 4 years ago.
A verrucous carcinoma on the right true vocal cord.
A T1a (involves only one vocal cord) squamous cell carcinoma on the right true vocal cord. This patient was a 56 yr old male with a 80 pack year history of smoking.
A squamous cell carcinoma involving the right true vocal cord and aneterior left true vocal cord. This 40 year old patient did not smoke.
A T1 squamous cell carcinoma on the mid right true vocal cord in a 73 yr old male with a 30 pack year history of smoking. The patient quit smoking 15 years ago.
A large T1b Cancer on both true vocal cords and anterior commissure in a 72 yr old male with a 150 pack year history of smoking. The patient quit smoking 8 years ago.
The function of a larynx with a T1b Cancer on both true vocal cords and anterior commissure in a 90 yr old male with a 37 pack year history of smoking. The patient quit smoking 40 years prior to diagnosis.
Two T1 squamous cell carcinoma on the left and right true vocal cords.
A T1b Squamous Cell Carcinoma involving the right and left true vocal cords. This patient was a 56 yr old male with a 80 pack year history of smoking.
A T2 squamous cell carcinoma (cancer) on the left true vocal cord extending to the anterior commisure and onto the petiolus of the epiglottis. The patient was a 56 yr old male with a 80 pack year history of smoking.
A larynx with a T2 squamous cell carcinoma involving the right true vocal cords and arytenoid. The cancer also extends onto the supraglottis. the patient was a 68 year old patient had a 30 pack year history of smoking and quit smoking 20 years ago.
A large T2 squamous cell carcinoma (cancer) on the supraglottis that involves the mucosa of more than one sub-structure (false vocal cords, aryepiglottic fold, arytenoid, suprahyoid and infrahyoid epiglottis). This patient was 63 years old and had a 80 pack year history of smoking.
A large T2 carcinoma of the supraglottis. It involved both the right true vocal cord and aryepiglottic fold.
A large T3 Squamous Cell Carcinoma of the larynx in a 57 yr old male with a 52 pack year history of smoking.
A large T3 squamous cell carcinoma of the larynx in a 50 yr old female with a 30 pack year history of smoking. The cancer involves the left true and false vocal cords and fixes the left true vocal cord.
A T4 cancer on the supraglottis, glottis and pyriform sinus. This patient was 56 years old and had a 40 pack year history of smoking.
Smoking is by far the major risk factor for developing laryngeal
cancer. The use of alcohol and smoking further increases the risk of
cancer of the larynx, oral cavity, and esophagus.
Video
of a biopsy of a laryngeal
cancer
in a patient who
smoked:
Video
of the function of a larynx after
part of the vocal cord is removed in
the treatment of larynx cancer.
Video of a Larynx
Cancer
Somerset is located in south central
Kentucky, in the hills of Appalachia. Since my practice started in
Somerset, I have evaluated 68 patients with invasive cancer (squamous cell
carcinoma) of the voice box (larynx). 65 patients smoked. 64
patients had a 20 pack year, or greater, history of smoking (smoking 1/2 pack per day
for 40 years). Two patients had severe GE Reflux and in one patient the
cause of the cancer was unknown.
The average age was 64 years. The
average length of smoking was 61 pack years. (A pack year is one pack per day smoked in
one year, or one-half pack per day smoked over two years.) 14 patients had
quit smoking. Four patients had quit more than 25 years prior to developing
the cancer. Exposure to the carcinogens in tobacco can cause permanent
genetic damage in the cells and tumors can develop years later. Fifteen of
these patients were treated with a total laryngectomy, or had to have their
voice box removed.
The
picture on the left shows a T1 squamous cell carcinoma of the vocal cord in a patient who
had a 35 pack year history of smoking. The picture to the far right shows
the immediate post-operative appearance of the vocal cords after surgical
biopsy and removal of the leukoplakia. This patient will be treated with
full course radiation therapy and should have greater than a 90% chance of cure.
Shown below are the pre and post biopsy views of a patient with two T1 squamous cell carcinomas of the true vocal cords. The patient was treated with
vocal cord stripping and radiation therapy.
How Fast
Can A Cancer Grow ??
If you are hoarse for more than four
weeks, you definitely need to have your voice box (larynx)
examined by a doctor. Cancers usually grow slowly, but can sometimes grow
fast. Below are five pictures of a patient who is five years status
post-radiation therapy for
laryngeal
cancer. The two pictures on the
left show an absence of a mass in the voice box. The three on the right were
taken one month later and show that a large tumor has developed, possibly
arising from his lower throat (hypopharynx).
Click On Pictures To Enlarge
Patients with head and neck cancer that
smoke are more likely to develop spread of the cancer to their lymph
nodes and once in the nodes the cancer is more likely to spread into the
soft tissues.
View Article's Abstract
Distribution of the Number of Pack Years Smoked to
the Development of Laryngeal Cancer in 65 Patients, All of Whom Were
Smokers.
In the group of smoking
patients only one had less than a 20 pack year history of smoking.
This patient had a 5 pack history. One can achieve a 20 pack year
history by smoking a half a pack per day for 40 years. Thus, if someone
smokes more a half a pack per day or more he will have an far greater
chance of developing cancer.
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