Mr. Khau experienced persistent hoarseness. An endoscopy at Tam Anh General Hospital Ho Chi Minh City revealed a tumor-like lesion on the anterior commissure of his vocal cord, with reduced vocal cord vibration. A biopsy was taken, leading doctors to diagnose left vocal cord cancer, squamous cell carcinoma type, stage T2.

Six years prior, Mr. Khau underwent surgery for an acoustic neuroma, resulting in right facial paralysis. He also received treatment for pulmonary tuberculosis 5 years ago and weighed about 50 kg. "My father always said he was old and wouldn't seek treatment for any new illness," shared Ms. Lan, Mr. Khau's daughter, explaining her request to the doctors to "soften" the diagnosis after receiving her father's cancer results.

Professor Doctor Tran Phan Chung Thuy, Director of the Ear, Nose, and Throat Center, explained that a doctor's professional principle is not to withhold medical information from patients. However, delivering an cancer diagnosis is challenging, requiring doctors to be skillful and sensitive. Many patients collapse, give up, and refuse treatment upon hearing such news, especially when they are elderly and frail.

Early treatment is crucial for patients to not miss the "golden" window. At stages one and two, when the tumor is confined to the larynx, the 5-year survival rate is nearly 80%, and voice function can be preserved. "After careful consideration, we agreed to inform the patient that he had a small, benign tumor, despite it being untrue, to honor the family's wishes," said Professor Chung Thuy. The elderly man agreed to the "benign tumor" surgery.

Professor Chung Thuy recommended CO2 laser surgery for the patient. This minimally invasive microsurgical technique is suitable for early-stage cancer, boasts a low recurrence rate, and eliminates the need for post-operative radiation therapy. The transoral approach allows for complete removal of the cancerous tumor without open surgery, preserving laryngeal function. Recovery time is faster, reducing hospital stays compared to open procedures.

Professor Chung Thuy (left) performs CO2 laser surgery to remove Mr. Khau's cancerous tumor. Photo: Tam Anh General Hospital

The team performed a tracheotomy and laryngoscopy. Endoscopy revealed a tumor on the left vocal cord, extending partially to the ventricular band but not yet to the subglottis or the anterior commissure of the left vocal cord. Doctors used a CO2 laser to precisely target and completely remove the cancerous tissue, along with the surrounding margins, which were sent for pathological examination. The frozen section biopsy results, reported to the operating room, confirmed negative margins, indicating no remaining cancer cells.

The team concluded the surgery after over one hour by removing the laryngoscope. Post-operatively, Mr. Khau recovered well, discharged after 4 days, with the surgical site healing properly. Throughout this period, Mr. Khau remained unaware of his actual condition, diligently attending monthly follow-up appointments with his daughter. Three months after surgery, Mr. Khau could speak with a soft voice, and his laryngeal function was preserved.

Professor Chung Thuy stated that patients typically need to be fully informed about their health status. However, in practice, doctors often encounter two scenarios: either the family wishes to conceal the patient's true condition, or they want the doctor to explain and consult thoroughly with the patient. In such cases, doctors must be skillful, empathetic, and provide positive, easy-to-understand advice to encourage treatment. When patients are accurately and fully informed about their condition, they feel empowered to proactively choose suitable treatment options.

According to Professor Chung Thuy, current cancer treatment methods have advanced significantly and can be effective if detected early. Everyone should undergo annual health check-ups for proactive screening and early detection of diseases or abnormalities.

Uyen Trinh