Laser Surgery

Laser surgery

• Minimally invasive laser surgery may be used to treat some throat cancers and is a lower risk procedure than conventional surgery
• Laser surgery offers people a better quality of life afterward, including improved preservation of voice function and the ability to swallow
  • a sore in the throat that doesn’t heal
  • a white patch in the mouth
  • or a lump that persists in the neck
  • difficulty chewing, problems eating and drinking or moving the tongue often comes later
  • cancer of the larynx usually causes a voice change like persistent hoarseness
  • sometimes throat cancer causes a sore throat that doesn’t go away, pain with eating and drinking, pain in the ear or a lump in the neck

Types of cancers treatable with the laser

• Many types of head and neck cancer can be treated using laser techniques including:
  • Most types of cancer of the larynx
  • Some hypopharynx (the swallowing passage just above the larynx) cancers
  • Oropharynx (the tonsil area that connects the mouth to the hypophrarynx) cancers
  • Cancer of the mouth, especially the sides of the tongue and floor of the mouth
• The decision to use the new laser surgery depends on the stage of the cancer – minimally invasive laser surgery has long been used for small, localized (stage I) cancer
• For some patients with advanced tumours laser excision may also be a treatment option – the laser is an excisional tool —it’s used to cut out (excise) cancer
• People whose cancer hasn’t been treated with radiation therapy are usually the best candidates for laser excision
• About 75% of people with new larynx cancers and 50% of those with new mouth or pharynx cancers may be eligible for laser surgery

Laser surgery technique

• The surgeon uses natural passageways, such as the mouth to reach the tumour – no incisions are used
• Special fibreoptic videoscopes and microsurgical instruments allow the surgeon to guide the laser beam around the edges of the tumour with pinpoint accuracy
• Magnification allows the surgeon to distinguish visually between cancerous and healthy tissue
• The laser beam is then used as a cutting and sealing tool, to precisely remove the tumour with a safety margin

Mouth and throat cancers are common among tobacco users

• Cancers of the head and neck, including the larynx, pharynx and mouth, make up about 5% of all new cancer diagnoses
• Risk factors include cigarette, cigar and pipe smoking
• Use of smokeless tobacco and excessive use of alcohol also are significant risk factors
• Because men tend to have these habits in greater numbers than women, they make up the majority of mouth and throat cancer patients
• However, as more women become smokers, their share of these cancers is rising

Multimodality therapy

• Radiation therapy and chemotherapy are often used in combination with surgery to treat mouth and throat cancers
• The multidisciplinary cancer team includes:
  • ENT, Head and Neck Surgeons
  • Plastic Surgeons
  • Radiation Oncology Specialists
  • Medical Oncology Specialists
  • Nurses
  • Dieticians
  • Physiotherapists
  • Speech Pathologists
  • Occupational Therapists
  • Social Workers

Benefits of laser surgery

• Where suitable laser surgery offers less early post-operative pain, less scarring and fewer wound problems including infection – this means a shorter hospital stay
• Laser surgery avoids invasive, disfiguring surgery so often required in the past to treat cancer of the larynx or pharynx
• The major improvement laser surgery offers is in quality of life
• Problems such as trouble eating and tasting, progressive difficulty swallowing, loss of voice or speech, neck and shoulder disfigurement, and/or a permanent, surgically-constructed, external opening to the windpipe (stoma) usually can be avoided