COMPS: Laryngectomy (O8) & Cancer (O9) Flashcards
History: Who developed the the type of incision used for laryngectomy today? What year?
Von Langenbeck, in 1875.
Who performed the first laryngectomy surgery in North America? In what year?
Lange, in 1879
How many successful laryngeal transplants in the WORLD have there been?
TWO! And one was performed at UC Davis.
What is the “incidence” and “prevalence”?
Incidence- how many NEW cases there are in a given period of time (usually a year).
Prevalence- how many people are living with the disease within a specific period of time.
What type of cancer is the biggest killer in the U.S.?
Lung cancer
Laryngeal cancer is less than __% of all cancers diagnosed in the U.S. each year, but about __% of all head and neck cancers.
2%, 25%
What color does cancer appear on the vocal folds?
white
Name some clubs that you could recommend to your laryngectomy patient.
the Lost Chords Club
Whisper Clubs
Look Whose Talking Now
In any 24-hour period, roughly __ billion cells die off and are replaced.
3 billion
What is “apoptosis”?
What is “metastasis”?
- planned cell death.
- when a cell migrates to a place it shouldn’t be and starts to duplicate instead of dying off. Regarding cancer, this is known as ‘spreading.’
What is “necrosis”?
cell death due to damage or disease.
Cancer is _____ cell life and occurs when there is _____ to a cell’s suicide program (apoptosis).
abnormal; damage
What 5 things can cause cancer? (general)
- Inheritance
- Chemicals (teratogens)
- Carcinogens
- Viruses
- Radiation
What are 4 risk factors for laryngeal cancer?
- Smoke (esp. tobacco smoke)
- Alcohol
- Poor nutrition
- GERD
What are two symptoms of glottic cancer?
- Hoarseness (1st sign)
2. Persistent cough
Most laryngeal cancers begin on the ______ ______.
vocal folds
Symptoms of supraglottic cancer (the pharynx, nasopharynx, and oropharynx)
- sore throat, feeling of painful lump in throat, or cough that does not go away.
- trouble or pain when swallowing (dysphagia)
- prolonged/persistent ear pain
- Dyspnea/stridor (rough, difficult breathing)
- Unexplained weight loss (general cancer symptom)
what does “T” “N” and “M” stand for?
Doctors classify and treat laryngeal cancer based upon 3 primary catetories:
- T- “tumor,” primary site and size of tumor
- N- “Node involvement”
- M- “Metastasis”
Define the following: Tx T1 T2 T3 T4
Tx: tumor has been identified but cannot yet be assessed. Need a visual eval such as MRI in order to find it.
T1: tumor is in place and is confined, small, and sitting on the structure’s surface.
T2: Tumor is large but still confined, arytenoids still work.
T3: More tissue is involved; tumor has invaded more than the VF tissue and is potentially in the cartilage; arytenoids have stopped working.
T4: Tumor is sizable and has gone through multiple tissue layers; larynx probably immobile. Dysphagia and breathing problems are present.
Define the following:
N0 Nx N1 N2 N3
N0– no lymph node involvement.
Nx– in the nodes, but difficult to assess degree of involvement.
N1– Cancer has spread to the ipsilateral side of lymph nodes in neck (1 or 2 nodes only).
N2– Ipsilateral, BUT larger number and larger tumor in the lymph nodes.
N3– Bilateral spreading to the lymph nodes (both sides of neck)
Define the following:
M0
Mx
M1
M0 – none; no spreading (first look in lungs, then brain)
Mx – Likely metastasis but cannot assess it.
M1 – There is most definitely metastasis.
• Metastasis of laryngeal cancer most commonly goes down to the lungs, but can go up to the brain.
What are the 4 types of cancer?
- Carcinoma: occurs in cells that line the surfaces of the body (e.g., digestive tract, laryngeal cancer)
- Sarcoma: arises in connective tissues (tendons, muscles and bones)
- Lymphoma: arises in the lymph nodes.
- Leukemia: blood cancer and the bood-forming systems such as bone marrow.
What is “Leukoplakia”?
benign growths of thick, whitish patches on the surface of the vocal folds (precancerous).
Appear as white tissue patches with purplish/reddish edges.
Pts may sound hoarse, low-pitched, breathy, and have reduced vocal loudness.
What may leukoplakia turn into? What does treatment involve?
squamous cell carcinoma.
treatment involves a combination of surgery, voice tx, and eliminating exposure to tissue irritants (smoking, alcohol, or vocal abuse).
What are the laryngeal cancer treatments? (3)
- Radiation therapy
- Surgery
- Chemotherapy (laryngeal cancer does not respond to chemo, so this is a LAST resort)
What are some effects of radiating the larynx?
- makes tissue very stiff, which makes spitting, swallowing, eating, and talking difficult.
- the spine is also irradiated, which affects LMNs and can cause paralysis on the ipsilateral side.
- cataracts
- increased blood pressure due to carotid artery becoming stiff.
- xerostomia
- dysphagia
- speech & esophageal effects
What is the most common type of laryngeal cancer?
Squamous Cell Carcinoma
Define Tumor grade 1, grade 2, and grade 3.
GRADE 1 (low grade): The cancer cells tend to grow
slowly, look quite similar to normal cells (are ‘well
differentiated’) and are less likely to spread than higher
grades.
GRADE 2 (moderate grade): The cells look more abnormal and are growing at a slightly quicker rate.
GRADE 3 (high grade): The cancer cells tend to grow
more quickly, look very abnormal (are ‘poorly
differentiated’) and are more likely to spread than lowgrade cancers.
