Laryngeal cancer survivor Jack Klugman speaks about oral cancer
Jack Klugman is the actor who played “Quincy”, the medical examiner who solved crimes on the TV show “Quincy, M.E.” that ran during the 70’s and 80’s. This show was basically the original “CSI” and the first to make forensic science and pathologists cool!!! He was also famous for playing the messy roommate on the “Odd Couple” during the 1970’s.
He was a heavy smoker and was originally diagnosed with laryngeal cancer in 1974 after developing hoarseness which is a common early sign. After the surgery, he continued to smoke. In 1989, he was found to have cancer again, requiring surgery that removed one his vocal cords. After a long recovery, he continues to perform as an actor but was left with a soft, raspy voice that you will hear in this public service announcement for oral cancer.
How many of these questions can you answer?
What is the most common histologic type of laryngeal cancer?
Do you remember the typical progression of mucosal lesions on the path towards cancer?
What are the risk factors?
What are the presenting signs of carcinoma of the larynx?
How do we make the diagnosis and what treatment modalities are used?
Why is vigilant follow-up important?
Laryngeal cancer
What is the most common histologic type of laryngeal cancer?
The most common tumor is squamous cell carcinoma.
Do you remember the typical progression of mucosal lesions on the path towards cancer?
Hyperplasia => atypical hyperplasia => dysplasia => carcinoma in-situ => invasive squamous cell carcinoma.
What are the risk factors?
Oncogenic types of HPV are now the most important risk factor. Alcohol and smoking are thought to have a synergistic effect. Other risk factors include asbestos and radiation.
What are the presenting signs of carcinoma of the larynx?
Persistent hoarseness is the most common initial symptom. Other symptoms are pain, sore throat, dysphagia, hemoptysis, and persistent cough.
SCC of the larynx is most commonly located in which of the following sites? A) supraglottis, B) glottis, or C) subglottis?
Most commonly arise in the glottis on the true vocal cords.
Supra glottis = false vocal cords, arytenoids, and epiglottis
Glottis = true vocal cords, anterior and posterior commissures.
Subglottis = area below the glottis and before the trachea.
How do we make the diagnosis and what treatment modalities are used?
The diagnosis is made by visualization of the larynx by indirect laryngoscopy or nasal endoscopy and biopsy of the tumor.
Treatment consists of various combinations of surgery, radiation, and chemotherapy depending on stage.
Why is vigilant follow-up important?
There is a high risk of a second malignancy especially if the patient continues to smoke and drink. The high incidence of second malignancy is thought to be due to a “field effect” since the entire mucosa was chronically exposed to the same carcinogens and irritants.
Copyright 2010 John Barone MD. All rights reserved.