Treatment of Laryngeal Cancer

Each case of laryngeal cancer is unique and treatment cannot be considered standardized. Many factors influence the types of treatments proposed for someone diagnosed with laryngeal cancer. There also are many situations in which different treatment options are available. The patient and the physician must together decide which option is best.

A very small laryngeal cancer (what would be called a T1 tumor on the staging system) can be treated either with radiation therapy or with surgery. Radiation therapy is a daily procedure which lasts about 15-30 minutes each day, five days a week for about six weeks. Surgery is done most often through the mouth and involves removing the portion of the larynx that contains the tumor.

A larger tumor involving more than one portion of the larynx can also be treated with radiation therapy or with surgery. Since the tumor is larger, the treatments will likely be more extensive. The radiation therapy is done in a similar fashion, but a larger part of the larynx is treated. If surgery is chosen, it involves removing a larger portion of the larynx. This operation is called a "partial laryngectomy" and is almost always done through an incision in the neck. Post operatively a temporary tracheotomy (breathing hole in the neck) is often used.

If a large portion of the larynx is involved with cancer, an even more aggressive treatment must be used. The more aggressive surgical treatment is removal of the entire larynx, a procedure called a total laryngectomy. In order to complete this operation the windpipe must be brought out to the neck to form a permanent opening called a stoma. Since the vocal cords are removed in this operation, the patient will learn a new manner of speaking.

In some cases, a combination of chemotherapy and radiation therapy can be used instead of surgery. The patient is carefully examined after two treatments of chemotherapy. If the tumor has decreased in size, additional chemotherapy and radiation therapy will continue. If the tumor has not become smaller, a total laryngectomy must be done.

Laryngeal cancer has a tendency to spread to lymph nodes in the neck, so the neck must also be treated with either radiation or surgery, called a neck dissection.

Close follow-up is extremely important after any treatment for head and neck cancer because there is a risk that the tumor can recur. This risk is greater if the patient continues to smoke, so smoking cessation is extremely important. Typically the otolaryngologist will want to do exams in the office about once a month for a year and then gradually decrease the frequency of the visits.

It is important to remember that these descriptions are meant to provide only basic information. Please contact your doctor to discuss your individual condition and possible treatment plans.