Laser surgery zaps throat cancer

Julia Sidorova did what anyone with a hoarse voice would do – she ignored it, figuring it would go away eventually. “It wasn’t painful,” she said, and she didn’t worry about it for almost two years.

But when she consulted her primary care provider and an otolaryngologist (ear, nose and throat specialist) about another problem altogether, her doctors discovered she had cancer, carcinoma in situ, on her vocal cords.

Sidorova had four surgeries to remove the lesions, but a month after each, her cancer returned. Her voice quality had deteriorated to a mere whisper and Sidorova was forced to communicate mostly with her hands. She could barely talk with a high-pitched, squeaky voice. Sidorova found the condition very fatiguing.

Sidorova came to UW Medical Center’s Otolaryngology - Head and Neck Surgery Center for help. An examination and biopsy of Sidrova’s vocal cords revealed ongoing masses that indicated a high probability of more cancer.

Doctors there talked to Sidorova about the pulsed dye laser (PDL) — a surgical tool shown to give good results for relief of lesions and voice preservation. The PDL laser is excellent for superficial growths, including benign growths like papillomas (warty masses of the vocal cords) or granulomas, precancerous growths, and even early vocal cord cancers.

Unlike radiation therapy, laser treatments can be repeated, keeping many patients out of the operating room, making it helpful to patients who are too sick to undergo general anesthesia or for patients who can be scheduled without the need to miss work or school as one would for a planned surgery.

The outpatient office procedure is very simple. After applying numbing medication, the surgeon directs a flexible telescope down the patient’s nose into the throat. The laser beam is delivered by a small flexible fiber that is passed through the telescope. Using the scope, the doctor sees everything inside the throat, vocal cords and all, and is able to pinpoint the cancerous lesions and zap them with the laser.

The laser uses a specific wave length of light to stop the growth of lesions by effectively cutting off their blood supply. The laser has the added benefit of being a very superficial treatment, which is effective on sensitive structures like the vocal cords because it does not cause deep or permanent damage.

“I lost my voice for one day after the procedure,” Sidorova says. “But I had a dramatically shorter recovery compared to the surgeries.”

As a research scientist for the UW Department of Pathology, Sidorova’s job often requires her to give presentations before a room full of people. Laser surgery has allowed her to get back to this part of her job, one she missed.