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Laryngeal Cancer and Treatment

• Voice Box (Larynx) Cancer:

  • Better prognosis if detected early, localized to larynx.

  • Symptoms often associated with lifestyle: smoking, alcohol use, GERD (gastroesophageal reflux disease).

• Symptoms:

  • Persistent hoarseness can indicate laryngeal problems.

  • If laryngitis lasts more than two weeks, seek medical attention to rule out serious issues.

  • Other symptoms may include difficulty swallowing (due to pressure on esophagus), halitosis, and potential blood in sputum.

Diagnosis and Early Treatment

• Importance of Early Detection:

  • The smaller and localized the tumor, the higher the chance of successful treatment.

• Treatment Options:

  • Radiation Therapy: Effective if cancer is caught early, can include brachytherapy (placing radioactive seed directly at the tumor site).

  • Micro Laser Surgery: Non-invasive, allows for minimal trauma and quick recovery (3 days recovery).

  • Surgical Options:

    • Partial Laryngectomy: May lead to temporary tracheostomy due to swelling, but voice preservation is possible.

    • Total Laryngectomy: Leads to permanent loss of normal voice, may require extensive surgical removal of surrounding tissues, including the epiglottis.

Post-Operative Care

• Tracheostomy:

  • Definition & Purpose: New airway created for breathing; does not imply need for ventilation support.

  • Temporary Relieving Measures: Coughing ability may be affected, requiring suctioning to remove mucus.

• Training & Education:

  • Pre-operative education on tracheostomy care is crucial for better post-operative outcomes.

Other Indications for Tracheostomy

• Used in cases of:

  • Chronic lung disease where ventilation support is required.

  • Aspiration prevention in unconscious patients.

  • Severe airway obstruction (e.g., anaphylaxis).

Types of Tracheostomy Tubes

• Single Lumen: One tube, requires complete removal for cleaning; not ideal for all settings.

• Double Lumen:

  • Design: Outer cannula with an inner cannula that can be removed for cleaning without taking out the outer tube.

  • Fenestrated Tubes: Allow some airflow past the larynx, enabling speech capabilities.

Lung Cancer Overview

• Prevalence & Causes:

  • Leading cause of cancer deaths; 90% of cases linked to smoking.

  • Other risks include asbestos exposure and history of tuberculosis.

• Early Symptoms:

  • Persistent cough, wheezing, chest pain, blood-tinged sputum, leading to further complications as tumor grows.

Metastatic Lung Cancer

• Characteristics:

  • Tumors spread quickly; can metastasize to trachea, esophagus, liver, bones, or brain.

  • Symptoms escalate with advanced disease, including weight loss and severe fatigue.

• Diagnosis Method:

  • Biopsy is the definitive method for confirming lung cancer.

Surgical Treatments for Lung Cancer

• Resections:

  • Wedge Resection: Removal of a small lung segment.

  • Lobectomy: Removal of an entire lobe of the lung is common.

• Pre-Operative Care:

  • Focus on improving lung function, ensuring patient compliance with no smoking.

• Post-Operative Management:

  • Monitoring vital signs, ensuring pain management, and motivating for lung expansion exercises like coughing and using an incentive spirometer.

Patient Positioning and Recovery

• Positioning Post-Surgery:

  • Unaffected side lying for lobectomy to promote expansion of the operated lung.

  • Affected side lying for pneumothorax cases.

• Home Recovery:

  • Strict no smoking policy and avoidance of respiratory irritants; monitored physical activity to prevent complications.