BLANCIA COLLEGE FOUNDATION, INC
COLLEGE OF NURSING
CASE PRESENTATION
CANCER OF THE
LARYNX
ACLAO, HANNA MAE B.
BSN- 3
ANATOMY OF THE LARYNX
I. INTRODUCTION
● Cancer of the larynx is a malignant tumor in and around the larynx (voice
box). Squamous cell carcinoma is the most common form of cancer of the
larynx.
● Cancer of the larynx occurs more frequently in men than in women, and
it’s most common in people between the ages of 50 to 70 years of age
●Laryngeal cancer spread first beyond your larynx may invade your thyroid,
windpipe (trachea), esophagus, tongue, lungs, liver and bones.
● Laryngeal cancer is part of a group of head and neck cancers.
Types of laryngeal cancer:
●Squamous cell carcinoma
●Lymphoepithelioma
●Spindle cell carcinoma
●Verrucous cancer
II. OVERVIEW OF THE DISEASE
Laryngeal cancer, or larynx cancer can develop in any of the three major
parts of the larynx:
Supraglottis: the area above the vocal cords
Glottis: the middle portion that contains the vocal cords
Subglottis: the area below the vocal cords and above the trachea
(windpipe)
Causes of laryngeal cancer
Some forms of HPV (human papillomavirus), a sexually transmitted
infection (STI), can cause laryngeal cancer, family history of head and
neck cancer, and overuse of the voice.
You also have a much higher chance of developing it if you use tobacco,
or drink alcohol frequently, and GERD.
Laryngoscope- is a procedure healthcare providers use to examine your
larynx (voice box).
Treatment for laryngeal cancer
1. Chemotherapy: Medical oncologists use medications to kill or slow the
growth of cancer cells. People often get chemotherapy intravenously
(through a vein).
Side Effects:
●Nausea & Vomiting ●Hair loss
●Loss of Appetite ●Nail changes
●Mouth sores ●Skin changes
●Diarrhea ●Ringing in the ears
2. Radiation therapy: Radiation oncologists deliver high-energy
radiation beams to kill cancer cells. The radiation targets only the tumor to
minimize damage to surrounding healthy tissue.
●Sore and inflamed throat ●Voice changes
●Dry mouth ●Fatigue
●Excess mucus in the mouth and throat ●Nausea
●Trouble swallowing ●Lymphedema
●Buildup of fluid in the face and neck that causes swelling.
3. Surgery: For early laryngeal cancer, surgery can remove the tumor
while preserving your larynx (and your ability to speak and swallow).
Side effects
●Scarring
●Changes in how you eat and swallow
●Changes in your sense of smell and taste
●Changes in how you talk or not being able to talk the way you did before
●Changes in how you breath
●Changes in how you look
Laryngectomy- a kind of surgery that removes your entire larynx.
TYPES OF LARYNGECTOMY
1. Partial Laryngectomy- removes part of the larynx and is used for
smaller tumors. Though there are several kinds of partial laryngectomy
surgeries, the intended outcome is the same: to remove only a portion of the
larynx ( the entire cancerous part) so that as much of the larynx is left intact
as is feasible.
2. Supraglottic Laryngectomy- is an operation to remove the
epiglottis, false vocal cords, andsuperior half of the thyroid cartilage.
3. Hemilaryngectomy- is a surgery in which either the right or left half
(hemi) of your voice box is removed.
4. Total laryngectomy- involves the removal of all laryngeal structures
and a section of the upper trachea, which leads to disconnection of the
airway and a permanent breathing hole in the neck (tracheostoma).
The type of communication you have after a total laryngectomy:
● Electrolarynx, sometimes referred to as a "throat back", is a medical
device about the size of a small electric razor used to produce clearer speech
by those people who have lost their voice box, usually due to cancer of the
larynx.
●Voice Prosthesis- is a valve that allows you to make sounds by pushing air
from your lungs through the valve and up into your mouth.
Stages of laryngeal cancer include:
Early laryngeal cancer: In stages 0, 1 and 2, the tumor is small. Cancer
hasn’t spread beyond your larynx.
Advanced laryngeal cancer: In stages 3 and 4, the tumor has grown
larger. It’s affected your vocal cords or invaded your lymph nodes or other
areas of your body.
Signs & Symptoms
● A change in your voice, such as sounding hoarse.
● Pain when swallowing or difficulty swallowing.
● A lump or swelling in your neck.
● A long-lasting cough or breathlessness.
● A persistent sore throat or earache.
● A high-pitched wheezing noise when you breathe.
● In severe cases, difficulty breathing.
III- History of Patient
● Tobacco smoking and a high alcohol intake.
IV- History of Presenting Complaint
● Patient complaints of change in voice (hoarseness).
V. SYSTEM REVIEW
● Patient’s sensory changes like taste and smell.
● If not treated, the enlarging tumor can compress the trachea and cause
breathing problems.
● There may be diminished hearing
Extremities
● With squamous cell carcinoma of the larynx, painful paronychia is present.
VI. PAST MEDICAL HISTORY
●None
VII. PAST SURGICAL HISTORY
●None
VIII. DRUG HISTORY
●None
IX. FAMILY HISTORY
●Patient’s father had undergone chemoradiotherapy at the age of 44 for a
left glottic laryngeal carcinoma.
X. PERSONAL HISTORY
● The patient is a basketball coach. 25 cigarettes a day and alcohol drinking
XI. TRAVEL HISTORY
●None
XII. SOCIAL HISTORY
● Pt. drinks 3 to 4 drinks per day and currently smokes 25 cigarettes a day.
XIII. EXAMINATION
● Neck swelling
● Hearing loss
● Tenderness of the thyroid cartilage
●Presence of malignant cells form in the larynx
Absent:
●Pallor
●Cyanosis
●Clubbing
●Jaundice
XIV. PATHOPHYSIOLOGY
XV. Drug study
XV. NURSING CARE PLAN
Identified Problem: Laryngeal Cancer
Nursing Diagnoses: Impaired verbal communication related to partial
removal
of vocal cords.
XVII. IMMEDIATE GOALS/ LONG TERM GOALS
● To preserve the function of the larynx, whenever possible.
● To provide best possible oncologic control, while optimizing functional
outcomes.
● To remove the tumor.
● To restore the clients' functional speech ability, facilitate comfortable
swallowing, and, thus, improve the quality of life.
● To help the individual learn how to eat, drink, and talk with their new voice.
XVIII. PROGNOSIS
● The overall 5-year survival rate of patients with local recurrence who undergo
salvage surgery varies greatly from 22 to 66% (14–17). One previous study has
even shown the 5-year survival rate in this patient population to be as low as 2%
(4).
● Patients considered cured after being disease free for five years.
● Most laryngeal cancers reoccur in the first two years
● Despite advances in detection and treatment options the five year survival, has
not improved much over the last thirty years.
