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10 slides generated from the cancer page, with a quiz from the open benchmark and speaker notes that cite the sources. Arrow keys move between slides; Print gives one slide per page.
Cancer of the voice box, a head and neck cancer, announces itself with hoarseness and is highly curable when caught early, by laser surgery or radiotherapy that preserve the voice. Advanced disease is treated with chemoradiation to keep the larynx where possible, with total laryngectomy for the most extensive tumours or when other treatment fails.
Laryngeal squamous cell carcinoma arises in the glottis (vocal cords), supraglottis or subglottis; hypopharyngeal cancer arises just behind and below and is grouped with it. Persistent hoarseness leads to early diagnosis of glottic tumours, which are treated with transoral laser microsurgery or radiotherapy alone with excellent cure rates. Locally advanced disease is treated with concurrent cisplatin chemoradiation, established by RTOG 91-11 as the best way to keep the larynx, while tumours that have destroyed cartilage or the larynx's function are best treated with total laryngectomy and postoperative radiotherapy, followed by voice rehabilitation with a voice prosthesis. Hypopharyngeal cancer presents late, with swallowing difficulty and neck nodes, and often needs laryngopharyngectomy. Smoking cessation is the most important single intervention.
| Setting | Approach | Guideline |
|---|---|---|
| Early glottic cancer | Transoral laser microsurgery or radiotherapy alone; both cure most patients and preserve the voice. | not mapped |
| Locally advanced, larynx preservable | Concurrent cisplatin chemoradiation (RTOG 91-11); induction chemotherapy for selection in some centres. | not mapped |
| Extensive disease or non-functioning larynx | Total laryngectomy with neck dissection and postoperative radiotherapy or chemoradiation; voice prosthesis rehabilitation. | not mapped |
| Recurrent or metastatic | Salvage laryngectomy after radiotherapy failure; pembrolizumab-based therapy for metastatic disease (KEYNOTE-048). | not mapped |
| Prevention | Smoking cessation and alcohol reduction; no screening programme exists. | not mapped |