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    Ca Larynx 2

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    Kelvin Maikana
    Laryngeal carcinoma is cancer that develops in the larynx (voice box). It is usually squamous cell carcinoma. Most cases originate in the glottis and are more common in men ages 60-70 who smoke or drink alcohol. Symptoms include hoarseness, cough, throat pain, and difficulty swallowing. Diagnosis involves laryngoscopy and imaging tests. Treatment options include surgery to remove part or all of the larynx, chemotherapy, radiation therapy, and clinical trials. Nursing focuses on airway clearance, breathing, communication, pain management, and nutrition.

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    Ca Larynx 2

    Uploaded by

    Kelvin Maikana
    59 views34 pages
    Laryngeal carcinoma is cancer that develops in the larynx (voice box). It is usually squamous cell carcinoma. Most cases originate in the glottis and are more common in men ages 60-70 who smoke or drink alcohol. Symptoms include hoarseness, cough, throat pain, and difficulty swallowing. Diagnosis involves laryngoscopy and imaging tests. Treatment options include surgery to remove part or all of the larynx, chemotherapy, radiation therapy, and clinical trials. Nursing focuses on airway clearance, breathing, communication, pain management, and nutrition.

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    CA LARYNX 2

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    Laryngeal carcinoma is cancer that develops in the larynx (voice box). It is usually squamous cell carcinoma. Most cases originate in the glottis and are more common in men ages 60-70 who smoke or drink alcohol. Symptoms include hoarseness, cough, throat pain, and difficulty swallowing. Diagnosis involves laryngoscopy and imaging tests. Treatment options include surgery to remove part or all of the larynx, chemotherapy, radiation therapy, and clinical trials. Nursing focuses on airway clearance, breathing, communication, pain management, and nutrition.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    59 views34 pages

    Ca Larynx 2

    Uploaded by

    Kelvin Maikana
    Laryngeal carcinoma is cancer that develops in the larynx (voice box). It is usually squamous cell carcinoma. Most cases originate in the glottis and are more common in men ages 60-70 who smoke or drink alcohol. Symptoms include hoarseness, cough, throat pain, and difficulty swallowing. Diagnosis involves laryngoscopy and imaging tests. Treatment options include surgery to remove part or all of the larynx, chemotherapy, radiation therapy, and clinical trials. Nursing focuses on airway clearance, breathing, communication, pain management, and nutrition.

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    LARYNGEAL CARCINOMA

    RATHEESH R L
    cancer of the larynx
    • Laryngeal cancer, also known as cancer of the
    larynx or laryngeal carcinoma, are
    mostly squamous cell carcinomas, reflecting
    their origin from the skin of the larynx.
    • Cancer can develop in any part of the larynx, but
    the cure rate is affected by the location of the
    tumor.
    • For the purposes of tumor staging, the larynx is
    divided into three anatomical regions:
    the glottis, supraglottis and the subglottis.
    • Most laryngeal cancers originate in the glottis.
    Supraglottic cancers are less common, and
    subglottic tumours are least frequent.
    • Cancer of larynx accounts for approximately
    half of all head and neck cancers.
    • Cancer of the larynx is most common in
    people between the ages of 60 and 70 yrs and
    it occurs 4 – 5 times frequently in men than in
    women.
    RISK FACTORS
    • CARCINOGENS:
    – Tobacco(smoke)
    – Combined effects of alcohol & tobacco
    – Asbetos
    – Second hand smoke
    – Paint fumes
    – Wood dust
    – Cement dust
    – Chemicals
    – Tar products
    – Mustard gas
    – Leather and metals
    OTHER FACTORS:
    – Straining the voice
    – Chronic laryngitis
    – Nutritional deficiencies
    – History of alcohol abuse
    – Familial predisposition
    – Age (higher incidence after 60 yrs of age)
    – Gender
    – Race(african americans)
    – Weakend immune system
    Clinical manifestations:
    • Hoarseness of more than 2 wks duration
    occurs in the patient with cancer in the glottic
    area because the tumor impedes the action of
    vocal cords during speech.
    • The voice may sound harsh,raspy and lower in
    pitch.
    • Patient may complain of a persistent cough or
    sore throat and pain and burning in the
    throat especially when consuming hot liquids
    or citrus juices.
    • A lump may be felt in the neck
    • Later symptoms include dysphagia
    ,dyspnea,unilateral nasal obstruction or
    discharge,persistent hoarseness,persistent
    ulceration& foul breath.
    • Cervical lymphadenopathy
    • Unintentional weight loss, a general
    debilitated state
    • Pain radiating to the ear may occur with
    metastasis.
    Diagnostic findings:
    • An initial assessment includes a complete
    history and physical examination of the head
    and neck
    • This identification of risk factors ,family history
    and underlying medical conditions.
    • An indirect laryngoscopy using a flexible
    endoscope,is initially performed in the
    otolaryngologists office to visually evaluate
    the pharynx,larynx and possible tumor.
    • Mobility of the vocal cords is assessed ,if
    normal movement is limited ,the growth may
    affect muscle,other tissue,and even the
    airway.
    • The neck and thyroid gland are palpated for
    enlarged lymphnodes & enlarged thyroid
    gland.
    • Diagnostic procedures that may be used
    include endoscopy,including virtuaaal
    endoscopy,optical imaging and CT.
    • If the tumor is suspected on an initial
    examination a direct laryngoscopic
    examination is performed under local or
    general anesathesia to evaluate all cases of
    the larynx.
    • In some cases intraoperative examination
    obtained by direct microscopic visualization
    and palpation of the vocal cords may yield a
    more accurate diagnosis.
    • CT and MRI are used to assess regional
    adenopathy of soft tissues & to stage &
    determine the extend of a tumor.
    • PET scanning may also be used to detect
    recurrence of a laryngeal tumor after
    treatment.
    TREATMENT
    • Surgery:
    There are many types of surgery for
    throat cancer to allow more normal function in
    swallowing and speech without a stoma (a
    surgically made opening in the neck that allows
    breathing).
    CORDECTOMY
    • Cordectomy is the surgical removal of a cord…
    SUPRAGLOTTIC LARYNGECTOMY
    • Supraglottic laryngectomy or horizontal
    partial laryngectomy is an operation to
    remove the epiglottis, false vocal cords, and
    superior half of the thyroid cartilage.
    HEMILARYNGECTOMY
    • Hemilaryngectomy is an operation to remove
    the anterior soft parts of the larynx in
    continuity with the underlying thyroid
    cartilage.
    PARTIAL LARYNGECTOMY
    • In this surgery the doctor removes part of the
    voice box -- one vocal cord, part of a cord, or
    the epiglottis
    TOTAL LARYNGECTOMY
    • A surgical procedure in which the whole voice
    box is removed, and the stoma opening into
    the larynx is permanent. The patient breathes
    through the stoma.
    • Chemotherapy:
    These are drugs used to shrink
    tumors and/or kill cancer cells after surgery
    and/or radiation treatment. Chemotherapy is
    often used in combination with other therapies.
    • Radiation therapy:
    it involves placement of
    radioactive substance to remove tumor.
    • Proton therapy:
    This radiation doses using pencil
    beam technology directed at the tumor while
    preserving nearby healthy tissue
    • Targeted therapies:
    These drugs are used to stop
    the growth of cancer cells by interfering with
    proteins and/or other receptors on cancer cells.
    • Cancer clinical trials:
    This involves the use of
    experimental drugs or other methods that may
    show promise in survival and/or reduction in
    clinical symptoms.
    NURSING MANAGEMENT
    • Assess respiratory status including rate, pattern,
    lung sounds, and cough effectiveness at least
    every 4 hours.
    • Monitor quantity, color, and odor of secretions.
    • Assess vital signs and pain at least every 4 hours.
    Administer analgesics as ordered.
    • Provide written information as requested.
    • Monitor intake, output, and daily weight.
    • Arrange dietary consultation to determine caloric
    requirements.
    • Maintain clear airways and lung sounds.
    • Maintain oxygen saturation level greater than
    92%.
    • Demonstrate interest in providing incision and
    stoma care.
    • Accept information about potential
    communication strategies.
    • Communicate effective pain management.
    • Maintain appropriate body weight, intake, and
    output
    NURSING DIAGNOSIS
    • Risk for ineffective airway clearance related to
    postoperative edema
    • Risk for ineffective breathing pattern related
    to pain and anxiety
    • Disturbed body image related to total
    laryngectomy and presence of tracheostomy
    stoma
    • Impaired verbal communication related to
    total laryngectomy
    • Pain related to surgical procedure
    • Risk for imbalanced nutrition: Less than body
    requirements related to difficulty eating after
    surgery

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