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Laser Laryngectomy

Laser Laryngectomy
New procedure to treat laryngeal cancer

The larynx (voice box) is the structure below the throat and above the trachea (windpipe). It is divided into three main parts. The vocal cords are located in the middle section, or the glottis.

The area above the vocal cords is the supraglottis. The supraglottis contains a cartilage-like flap, called the epiglottis, which closes to allow food to pass into the digestive tract instead of the lungs. The subglottis is the area located between the vocal cords and the trachea.

Cancer of the Larynx

According to the American Cancer Society, about 9,880 new cases of laryngeal cancer will be diagnosed in the U.S. this year. About 3,770 people will die from it. The cancer is 4 to 5 times more common in men than in women. Most patients are in their 60s when diagnosed.

The most important risk factor for laryngeal cancer is tobacco smoking. The more a person smokes, the greater the risk. People who drink large amounts of alcohol are also at risk. And those who smoke and drink have up to 100 times the risk as nonsmokers and nondrinkers. Some other possible risk factors include: infection with the human papilloma virus (a virus that causes warts), having a weak immune system and long-term exposure to wood dust, paint fumes and certain industrial chemicals.

One sign of the cancer is sudden or unexpected change in the voice (voice hoarseness). Patients may also experience a persistent sore throat or cough, difficulty or pain when swallowing, ear pain, a sensation of a lump in the throat, breathing problems or weight loss.

Treating Laryngeal Cancer

There are several treatments for laryngeal cancer. Depending upon the stage and spread of the cancer, a doctor may recommend one or more options. A cordectomy is the removal of part or all of the vocal cords. A partial laryngectomy is the removal of only a part of the larynx. The procedure preserves as much of the larynx as possible in an attempt to preserve speech. A total laryngectomy is the removal of the whole larynx. After a total laryngectomy, the windpipe is reattached to a hole in the neck to allow the patient to breathe (a procedure called a tracheotomy)

In addition to surgery, doctors may use chemotherapy or radiation therapy. Giving chemotherapy and radiation therapy at the same time seems to shrink tumors more effectively.

A Laser for Laryngeal Cancer

Doctors at Montefiore Medical Center are using a new laser procedure to treat some patients with laryngeal cancer. The procedure is called an Endoscopic Laser Laryngectomy. It is also being used at the Nebraska Medical Center in select cases of early stage cancers. (For more information call 559-2814.)

Instead of making a cut into the neck to get at the cancer, the surgeon places the laser device down the throat until it reaches the area of the cancer. As the laser touches the tissue, the light energy destroys the cancerous tissue. The treatment also seals off blood vessels, so there is little bleeding. Surgeons may bend and manipulate the laser to reach all areas of the cancer. The treatment allows doctors to kill the cancer while preserving as much of the voice box as possible.

Since there's no open incision, patients don't need to have a breathing tube and healing time is quick. Most patients recover within a few weeks. Some patients are able to start swallowing within two days of the laser surgery. Doctors say the laser treatment can also be used for patients who have very large tumors, enabling them to retain more laryngeal function than would be possible with other treatments.

SOURCES

Richard Smith, M.D. (featured in story), Head and Neck Surgeon, Montefiore Medical Center, Department of Otolaryngology, 3400 Bainbridge Ave., 3rd Floor, Bronx, NY 10467. (Media Contact: Jeanette Moore, (718) 920-4712.)

AUDIENCE INQUIRY

For information on laryngeal cancer:

American Cancer Society, contact your local chapter, or visit their website at http://www.cancer.org

National Cancer Institute

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