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.
of a biopsy of a laryngeal
in a patient who
of the function of a larynx after
part of the vocal cord is removed in
the treatment of 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.
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.
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
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
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
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 20 packs 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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