Cancer is a dreaded disease and even its treatment is horrifying for the pt. Nearly 1million new cancer cases are detected every year and about half of it die every year in our country(ICMR). Of these, nearly one-third are head-neck cancers in northWestern India. Major treatment arms are Surgery, Radiotherpy or Chemotherapy with long term side effects associated with each of armament.
After years of research and better understanding of molecular biology – genetics, cancer has become amenable to cure particularly if detected early and managed by an expert.
Due to newer innovative diagnostic and therapeutic methods as well as increase awareness about the disease in society, It has now become possible to not only think of cancer cure but even to reduce the major morbidity of the treatment. Larynx is an important organ of communication and it is the third most common cancer of Head and Neck region. Change in voice of more than four to six week, not responding to oral drugs particularly in a smoker is early sign of laryngeal cancer. However, commonest causes of change in voice are cold,infection, benign polyp,etc.
Cancer of larynx is diagnosed in early stage due to change in voice noticed by pt. (photo1). Transoral Laser Microsurgery (TOLM) is an endoscopic microsurgery with the help of Co2 LASER and is ASCO approved treatment modality for early laryngeal cancers.
NCCN guideline suggest use of TOLM for cT1, T2 lesions of glottis and supraglottis with results comparable to open partial laryngectomy or Curative external beam Radiotherapy and relatively less treatment related morbidity.(photo of Laser machine and microscope)
It is popularized by Professor Steiner et al from Germany for last two decades and put study of more than 150 cases in 1991.It is safe, less morbid and highly cost effective modality. It can be reused any number of time . Long term complication of radiotherapy like mucositis, cartilage necrosis, cicatrization and chance of RT induced second cancer can be avoided.( op.Procedure).