A Simple Guide of Laryngeal Cancer

A Simple Guide to Laryngeal Cancer
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What is Laryngeal Cancer ?
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Laryngeal cancer occurs when the cells lining the larynx(the vocal box) become abnormal and proliferates giving rise to cancer cells.

It affects more men than women.


What are the causes of Laryngeal Cancer?
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Various causes may be involved:

1.Genes. -males over the age of 55 years are at four times higher
risk than females.

2.Smoking. People who smokes have a higher risk than non smokers

3.Drinking alcohol can increase the risk of laryngeal cancer.

4.Occupation. There is evidence that workers exposed to sulfuric acid and asbestos have a higher risk of developing laryngeal cancer.


What are the signs and symptoms of Laryngeal Cancer?
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The following are symptoms of  Laryngeal cancer:

1.Hoarseness or other changes in the voice

2.A painless lump in the neck-usually a lymph node
infiltrated by cancer cells

3.Cough that does not go away

4.Persistent sore throat or a feeling that there is something
stuck in the throat

5.Difficulty in breathing or speaking

6.Ear pain

7.Weight loss


How can Laryngeal Cancer be diagnosed?
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Examination of the throat, vocal cords and neck for abnormal lumps

An endoscope is inserted into the throat to look at the vocal cords and their movement. 
The ENT specialist may extract issue (biopsy) which can be sent for testing, to confirm if there is a cancerous growth.

If a tumour is found, magnetic resonance imaging (MRI) can be
used to assess its size.

How can Laryngeal Cancer be treated?
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Treatment depends on the diagnosis of the laryngeal cancer and its spread outside of the vocal box.
Usually most laryngeal cancer are slow spreading.

Radiotherapy.

This is the most common treatment for small cancer of the larynx. This involves the use of radiation to attack cancer cells, stopping them from growing or multiplying.

Chemotherapy.

This involves the use of anti-cancer medication to treat
the cancer.

For both methods, the patient may experience side-effects such as tiredness and nausea.

Radiotherapy are often used together with chemotherapy.

Surgery

Surgery is used only when the cancer can not be treated by
radiotherapy or chemotherapy because the removal of the vocal
cords or the entire larynx can cause the loss of voice.
The lymph node in the neck may also be removed at the same time.

If surgery is done , usually a tracheostomy or hole in the
windpipe is done to allow air to enter or escape from the tubes in the lungs.

Some patient may also require a feeding tube after surgery because swallowing of food is affected by the surgery.
Most people will learn to swallow again so the feeding tube is
temporary.

Early treatment is recommended as it increases the patient's chances of survival.
Delayed action could result in the cancer spreading to other parts of the body, making it more difficult to treat.

Living with a Tracheostomy.
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The tracheostomy in the windpipe is necessary for air to enter and leave the lungs.
However the tracheostomy must be kept clean at all time and free of infection. Suction of mucus stuck in the windpipe may be necessary.
It is also dangerous for water to enter the windpipe and the lungs through the tracheostomy opening.
The tracheostomy opening should always be protected with a a
plastic stoma shield or scarf to prevent dust, water or smoke to
enter the windpipe.

After the surgery there may be loss of voice. 
A speech therapist is usually needed to teach the patient to learn to speak again.
He can teach the patient to use the oesophagus to force air
through the throat to produce new gutterial sounds. 
In the meantime, communication can be done with writing pads or computer.
New electronic and mechanical devices can also produce new
sounds

How can Laryngeal Cancer be prevented?
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No one can be fully protected from laryngeal cancer.
However, you can modify your lifestyle practices to reduce your
chances of contracting laryngeal cancer.

Don't smoke. Smoking increases the risk of laryngeal cancer by two to four times. Those who smoke, can still lower their risk by cutting down on the number of cigarettes smoked a day. Better still, quit smoking.

A Simple guide to Diphtheria

A Simple guide to Diphtheria
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What is Diphtheria?
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Diphtheria is an acute, infectious childhood disease of the respiratory tract caused by the bacillus Corynebacterium diphtheriae, a Gram positive, non-sporulating aerobic micro-organism.

How is Diphtheria transmitted?
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Diphtheria is transmitted by droplets from the throat of infected patients or clothes soiled by discharges from the patients.
It is highly infectious.
Incubation period is 2-4 days.

The organism multiplies in the upper respiratory tract, secreting toxins which produce necrosis and fibrinous exudate.
This fibrinous exudate can form a leathery membrane which extends through the throat, tonsils, nasopharynx, larynx and trachea.
Through the blood, the toxin can spreadto the heart, nervous system and kidneys. Infections may also be localised in wounds in the skin,conjunctiva and rarely the vagina.
The infections occur in persons of all ages.

What are the Signs and Symptoms of Diphtheria?
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The incubation peroid is usually 2-4 days after contact with an infected patient.

Symptoms start off with:
1. sudden onset of malaise

2. mild fever

3. sore throat

4. Thick white or grayish tonsillar exudate

5. Membrane may spread to nasopharynx

5. cervical lymphadenopathy

6. difficult breathing

7. respiratory stridor,

8. hoarseness of voice

9. brassy cough

10.dilirium and coma

What are the complications of Diphtheria?
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The worst affected are children below the 1 year old.

Some serious complications are:
1.myocarditis

2.cranial nerve paralysis, especially the soft palate and oculomotor nerves

3.peripheral neuritis

4.laryngeal obstruction

5.death can occur if there is obstruction to breathing.

Serious complications are less with older children or adults.

Adults rarely get Diphtheria because their immunity from vaccination usually last 10 years after the last dose.
When adults get Diphtheria, there is only slight inflammation with little or no exudates.

What are the investigations necessary to diagnose Diphtheria?
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Pharyngeal and nasal swabs for culture in Loeffler medium
Methylene blue stain of membrane

What is the Treatment of Diphtheria?
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Isolation in hospital is necessary.

1.Antibiotics (erythromycin or Penicillin) are used in the treatment of Diphtheria.

2.Antitoxin can be given by intramuscular or intravenous injection

3.Intravenous fluids given for dehydration

4.Tracheostomy if breathing obstruction is bad

5.Oxygen therapy in cases of breathing difficulty

6.Cardiac failure should be treated


Besides antibiotics, the following will help:
Steam inhalation
cough mixtures
avoid smokes, dust, dry air,sudden temperature change

What is the Prevention for Diphtheria?
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Vaccination against Diphtheria is the best prevention .
Since vaccination began, the worldwide incidence of Diphtheria has declined.

Vaccination against diphtheria, pertussis (whooping cough), tetanus (DPT) is usually given to a baby at 3 months of age and repeated at 4 and 5 months of age.

There is also a booster vaccination at 18 months.

What is the prognosis in Diphtheria?
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Death occurs in 10% of cases.

Mortality is highest in children under 10 and adults over 50.

One attack usually confers immunity.