ผ่าตัดกล่องเสียง เลี่ยงภัยคุกคามจากมะเร็ง

<h3 style="display: none;">Use of Radiofrequency Waves to Reduce Nasal Mucosal Swelling (Radiofrequency volumetric tissue reduction: RFVTR)</h3>
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<div>Voice is important for humans as it is used to communicate, explain, and use in daily life. The source of sound in the human body is the larynx, which serves as a passage for breathing and also helps prevent food from entering the trachea. However, the larynx is one of the organs often targeted by cancer, which is a major reason for <strong><span style="color: #00826a;">“laryngectomy”</span></strong> to inhibit and avoid the threat of cancer. There are also other reasons for laryngectomy, such as surgery to change one’s voice characteristics, for example, transgender women who want to change their voice to sound female.</div>
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<h4><span style="color: #00826a;">What is the larynx?<strong><br />
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<p>Dr. Uthai Prapamontol, a specialist in head, neck, trachea, and laryngeal surgery at the Ear, Nose, and Throat Center, Phyathai 3 Hospital, explained that the larynx is an important organ located at the front of the neck with three main functions:</p>
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<li>It serves as an airway for breathing</li>
<li>It prevents food from entering the trachea during eating</li>
<li>It is an essential part in producing sound</li>
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<h4><span style="color: #00826a;">How dangerous is laryngeal cancer?<strong><br />
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<p>According to research data, laryngeal cancer accounts for about 2% of all cancers, making it one of the common cancers worldwide. Most cases are detected in elderly people aged 60 and above, and it is found 4-5 times more often in men than women. In Thailand, between 2001-2003, the incidence was about 0.3 cases per 100,000 women and 2.5 cases per 100,000 men.</p>
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<div>The organs adjacent to the larynx are the thyroid gland in front and the esophagus behind. Therefore, when laryngeal cancer occurs, the disease can easily spread to both organs, making laryngeal cancer a dangerous disease that can rapidly threaten the patient’s life.</div>
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<h4><span style="color: #00826a;">What are the risk factors for laryngeal cancer?</span><strong><span style="color: #00826a;"><br />
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<p>Dr. Uthai Prapamontol explained that the causes of laryngeal cancer are associated with various risk factors as follows:</p>
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<li>Mostly caused by smoking, which contains substances that damage the larynx and cause cancer</li>
<li>Alcohol consumption</li>
<li>Deficiency of certain nutrients, commonly found in people who lack vegetables and fruits in their diet</li>
<li>Gastroesophageal reflux disease (GERD)</li>
<li>Chronic exposure to dust from certain substances, such as wood dust or asbestos dust</li>
<li>HPV virus infection</li>
</ul>
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<h4><span style="color: #00826a;">What are the symptoms of laryngeal cancer?</span><strong><span style="color: #00826a;"><br />
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<p>Warning signs of laryngeal cancer can be observed from the following symptoms:</p>
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<li>Hoarseness</li>
<li>Sore throat</li>
<li>Cough with phlegm, possibly with blood</li>
<li>Ear pain</li>
<li>When the tumor grows large, it can block the airway, causing difficulty breathing</li>
<li>Palpable enlarged lymph nodes in the neck, painless</li>
</ul>
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<h4><span style="color: #00826a;">Which stage of laryngeal cancer is the most dangerous?</span><strong><span style="color: #00826a;"><br />
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<p>The progression of cancer is important to understand for symptom observation. The severity depends on the stage of disease spread. Dr. Uthai Prapamontol explained that laryngeal cancer can be divided into 4 stages as follows:</p>
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<li>Stage 1: The tumor is confined to one location within the larynx</li>
<li>Stage 2: The tumor spreads to two or more locations within the larynx</li>
<li>Stage 3: The tumor spreads causing vocal cords to be immobile and/or there is one small lymph node in the neck not exceeding 3 cm</li>
<li>Stage 4: The tumor spreads to the skin and/or thyroid gland and/or esophagus and/or multiple enlarged lymph nodes in the neck and/or lymph nodes larger than 6 cm and/or metastasis to other organs via the bloodstream, commonly the lungs</li>
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<div>If warning signs are observed, immediate consultation with a doctor is advised because the earlier the patient receives treatment, the higher the chance of full recovery. Conversely, if left untreated until the late stages, the risk of life-threatening complications increases.</div>
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<h4><span style="color: #00826a;">How is laryngeal cancer treated?</span><strong><span style="color: #00826a;"><br />
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<p>Dr. Uthai Prapamontol explained that there are three main treatment methods for laryngeal cancer:</p>
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<li>Surgery</li>
<li>Radiation therapy</li>
<li>Chemotherapy</li>
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<h4><span style="color: #00826a;">Surgical treatment of laryngeal cancer<strong><br />
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<p>Surgery varies depending on the cancer stage. For early-stage cancer, surgery involves removing only part of the larynx, allowing the patient to still breathe and speak using the remaining larynx. For advanced cancer, total laryngectomy is necessary, where the entire larynx is removed. Patients in this group will have a permanent tracheostomy opening at the front of the neck for breathing and will not be able to speak with a voice.</p>
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<div>Dr. Uthai Prapamontol, a specialist in head, neck, trachea, and laryngeal surgery at the Ear, Nose, and Throat Center, Phyathai 3 Hospital, further explained that laryngeal cancer surgery can be performed in various ways depending on the treatment goal and disease stage as follows:</div>
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<li>Vocal cord stripping: surgery to remove only the outer epithelial layer of the vocal cords, used only for early-stage cancer. Patients can speak and breathe normally after surgery.</li>
<li>Laser surgery: may be used only for early-stage cancer treatment.</li>
<li>Cordectomy: removal of one or both vocal cords, which may cause hoarseness after surgery, used only for early-stage cancer.</li>
<li>Partial laryngectomy: small tumors in the larynx can be treated by removing only part of the tumor and larynx, allowing a chance to speak after surgery.</li>
<li>Total laryngectomy: used for large tumors or those spreading to adjacent organs. After surgery, a tracheostomy is required for breathing, and the patient will not be able to speak.</li>
<li>Neck tissue and lymph node dissection: since cancer often spreads to neck lymph nodes, lymph node removal is necessary, with the extent depending on the disease stage.</li>
<li>Tracheostomy: if the tumor is very large or airway obstruction occurs, the patient needs a tracheostomy with a breathing tube to assist breathing.</li>
</ul>
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<div>Dr. Uthai Prapamontol, a specialist in head, neck, trachea, and laryngeal surgery at the Ear, Nose, and Throat Center, Phyathai 3 Hospital, recommended the following post-laryngectomy care for laryngeal cancer patients:</div>
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<li>Patients will continue to receive fluids and electrolytes intravenously</li>
<li>Patients cannot eat by mouth during the first 2 weeks</li>
<li>Patients will receive liquid nutrition through a nasogastric tube inserted through the nose into the stomach</li>
<li>If there are no complications, after 10–14 days post-surgery, doctors will start oral feeding</li>
</ul>
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<h4><strong><span style="color: #00826a;">What are the complications after laryngectomy?<br />
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<p>Common complications after laryngectomy for cancer treatment include leakage of the repaired esophageal wall (fistula) after larynx removal. In such cases, patients need to stay longer in the hospital for wound care and cleaning and require prolonged tube feeding until the fistula heals completely.</p>
<div>These complications are not life-threatening but increase hospital stay and treatment costs.</div>
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<h4><span style="color: #00826a;">Can patients speak after laryngectomy?</span><strong><span style="color: #00826a;"><br />
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<p>As mentioned, laryngectomy varies depending on the severity and spread of the disease. However, if the patient does not undergo total laryngectomy, after surgery, they can receive speech therapy. Once symptoms improve, patients can learn to speak using three methods:</p>
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<li>Esophageal voice</li>
<li>Tracheoesophageal prosthesis</li>
<li>Electrolarynx (electronic speech aid)</li>
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<h4><span style="color: #00826a;">Radiation therapy for laryngeal cancer<strong><br />
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<p>Dr. Uthai Prapamontol explained that radiation therapy uses high-energy rays to kill cancer cells or shrink tumors. External beam radiation is the main treatment for laryngeal cancer and may be used instead of surgery for small tumors or for patients unsuitable for surgery. Radiation is often combined with chemotherapy. Treatment is usually given 5 days a week for 30-35 sessions.</p>
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<h4><span style="color: #00826a;">Side effects of radiation therapy</span></h4>
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<li>Dry mouth</li>
<li>Difficulty swallowing</li>
<li>Skin color changes in the radiation area</li>
<li>Mouth and throat pain causing difficulty eating and weight loss, starting about 2 weeks into radiation and improving about 2 weeks after completion</li>
<li>Difficulty breathing due to swelling of the larynx after radiation</li>
<li>Hoarseness</li>
<li>Reduced taste sensation</li>
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<h4><span style="color: #00826a;">Chemotherapy for laryngeal cancer</span><strong><span style="color: #00826a;"><br />
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<p>Chemotherapy is another treatment option depending on symptoms and physician assessment. Common side effects include:</p>
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<li>Nausea, vomiting, fatigue, easy tiredness, loss of appetite</li>
<li>Hair loss</li>
<li>Low white blood cell count, increasing infection risk</li>
<li>Easy bleeding or bruising due to low platelet count</li>
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<div style="text-align: right;"><span style="color: #00826a;"><strong>Dr. Uthai Prapamontol</strong></span></div>
<div style="text-align: right;">Specialist in Surgery</div>
<div style="text-align: right;">Head, Neck, Trachea, and Larynx</div>
<div style="text-align: right;">Ear, Nose, and Throat Center, Phyathai 3 Hospital</div>
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Because laryngeal cancer accounts for only 2% of all cancers, few people are aware of this disease... so it is often detected late. How about checking the symptoms a bit? Because if laryngeal cancer is detected early, surgery can cure it.

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