Patient Overview

Patient Overview

Laryngeal Cancer Treatment by Prof. Dr. Ashequr Rahman Bhuiyan

Patient Profile:

• Name: Mr. X (pseudonym)
• Age: 58
• Gender: Male
• Medical History: Long-term smoker (30 years) and heavy alcohol use. No significant family history of cancer.

Presentation:

• The patient presented with a persistent hoarseness of voice for the past 3 months.
• He also complained of difficulty swallowing (dysphagia) and a sensation of a lump in the throat.
• Over the past few weeks, he experienced painful swallowing and occasional coughing up of blood-streaked sputum.
• His symptoms worsened at night, and there was a noticeable weight loss and fatigue.

Clinical Examination & Diagnostics:

• Physical Examination:
  • Hoarseness of voice was evident upon examination.
  • Palpation of the neck revealed no enlarged lymph nodes, but there was tenderness on the left side of the larynx.
  • The patient did not exhibit signs of respiratory distress at the time of examination.
• Imaging & Biopsy:
  • Laryngoscopy showed an irregular mass in the glottic region of the larynx, extending towards the left vocal cord.
  • CT scan of the neck confirmed a locally invasive tumor in the larynx, with invasion into the left vocal cord.
  • A biopsy of the mass revealed Squamous Cell Carcinoma (SCC), confirming the diagnosis of laryngeal cancer.

Treatment Plan:

• Surgical Intervention:
  The patient was scheduled for total laryngectomy due to the extent of tumor invasion, with the goal of removing all cancerous tissue. This approach was chosen to prevent further spread of the disease and to improve the patient’s chances of survival.

  • Prof. Dr. Ashequr Rahman Bhuiyan performed the surgery with precision, ensuring the removal of the entire larynx, along with any affected tissues and surrounding lymph nodes.
  • The patient was fitted with a tracheostomy tube immediately following surgery to assist with breathing while awaiting recovery.

• Rehabilitation & Support:

  • After the surgery, the patient was placed on a recovery plan that included post-surgical care, pain management, and speech therapy to adapt to life without a larynx.
  • The patient was provided with swallowing rehabilitation to manage dysphagia, and speech therapy was started for alternative voice methods, including the use of an electrolarynx or esophageal speech.

• Adjuvant Treatment:

  • After surgery, the patient was referred for radiotherapy to reduce the risk of recurrence and to address any microscopic residual cancer cells.
  • The patient was closely monitored for potential post-operative complications like infection or wound dehiscence.

Outcome:

• The patient’s recovery was smooth after the laryngectomy, and he was able to adapt to the new methods of communication with the help of speech therapy.
• Follow-up imaging and clinical evaluations showed no evidence of recurrence at the 6-month post-operative mark.
• The patient was able to return to daily activities, although with changes in his speech and swallowing function.

Conclusion: This case exemplifies the importance of early detection and surgical intervention in laryngeal cancer. Prof. Dr. Ashequr Rahman Bhuiyan’s expertise in laryngectomy and cancer management ensured that the tumor was completely excised, improving the patient’s survival rate. Through a well-coordinated rehabilitation program, the patient was able to regain functional speech and maintain a good quality of life post-surgery. Prof. Dr. Bhuiyan’s approach to both surgical and supportive care contributed significantly to the positive outcome in this challenging case.