The top pictures show cancer of the voice
or larynx. The picture on the left is a cancer of
or top of the
voice box (larynx). The middle picture is a cancer of the
true vocal cords.
picture on the far right is a cancer of the sub-glottis or below the vocal
the cancer requires removing the voice box in a procedure called a
In this procedure the food tube or
is separated from the airway
and the wind pipe is brought out through the neck. The patient on the
right had a
to treat a recurrent cancer
after radiation therapy
Smoking is by far the major risk factor for developing laryngeal
cancer. The use of alcohol and smoking further increases the risk of
cancer of the larynx, oral cavity, and esophagus.
Somerset is located in south central
Kentucky, in the hills of Appalachia. Since my practice started in
Somerset, I have evaluated 68 patients with invasive cancer (squamous cell
carcinoma) of the voice box (larynx). 65 patients smoked. 64
patients had a 20 pack year, or greater, history of smoking (smoking 1/2 pack per day
for 40 years). Two patients had severe GE Reflux and in one patient the
cause of the cancer was unknown.
The average age was 64 years. The
average length of smoking was 61 pack years. (A pack year is one pack per day
smoked in one year, or one-half pack per day smoked over two years.) 14
patients had quit smoking. Four patients had quit more than 25 years prior
to developing the cancer. Exposure to the carcinogens in tobacco can cause
permanent genetic damage in the cells and tumors can develop years later.
Fifteen of these patients were treated with a laryngectomy (had their
voice box removed).
pictures below show a patient's larynx pre and post biopsy for two T1 squamous cell carcinomas of the true vocal cords.
The patient was treated with vocal cord stripping and radiation therapy.
To the right is a picture showing the histopathology of the above patient's
are hoarse for more than four weeks, you definitely need to have your voice box
examined by a doctor. Cancers usually grow slowly, but can sometimes grow
fast. Below are five pictures of a patient who is five years status
post-radiation therapy for
cancer. The two pictures on the
left show an absence of a mass in the voice box. The three on the right were
taken one month later and show that a large tumor has developed, possibly
arising from his lower throat (hypopharynx
Video of a
biopsy of a larynx cancer in a patient who
Video of Mucosal Stripping on a
Vocal Cord with Leukoplakia
Facts About Smoking:
Tobacco use remains the leading preventable cause of death in the United States,
causing more than 400,000 deaths each year and resulting in an annual cost of more than
$50 billion in direct medical costs.
Each year, smoking kills more people than AIDS, alcohol, drug abuse, car crashes,
murders, suicides, and fires---combined!
Nationally, smoking results in more than 5 million years of potential life lost each year.
Approximately 80% of adult smokers started smoking before the age of 18. Every day,
nearly 3,000 young people under the age of 18 become regular smokers.
More than 5 million children living today will die prematurely because of a decision they
will make as adolescents---the decision to smoke cigarettes.
Smokers pay twice as much for life insurance and
will die an average of over 12 years sooner than non-smokers. Smokers have
more than one chance in 10 of developing lung cancer.
Studies also indicate that nonsmokers are adversely affected by environmental tobacco
smoke. Researchers have identified more than 4,000 chemical compounds in tobacco
smoke; of these, at least 43 cause cancer in humans and animals. Each year, because
of exposure to environmental tobacco smoke, an estimated 3,000 nonsmoking Americans
die of lung cancer, and 300,000 children suffer from lower respiratory tract infections.
Particularly alarming is the fact that more than 3 million young people under age 18
smoke half a billion cigarettes each year and that more than one-half of them consider
themselves dependent upon cigarettes. The decision to use tobacco is nearly always
made in the teen years, and about one-half of young people usually continue to use
tobacco products as adults.
Prevalence of Cigarette Smoking Among
Adults and Youths—United States, 1997
Kentucky: Adults: 30.8% Youth 47.0%
Kentucky has the highest rate of smoking in
the United States.
Sources: CDC, Behavioral Risk Factor Surveillance System (data on persons aged
18 years or older who reported having smoked 100 or more cigarettes and who reported currently smoking every day or some day), and CDC,Youth Risk Behavior
Surveillance System (data on young people in grades 9–12 who reported smoking cigarettes on one or more of the 30 days preceding the survey).
For more on tobacco facts and smoking:
Information on cigarette smoking as a cause of cancer: