Treatment options for laryngeal cancer
A team of doctors and other professionals discuss the best treatment and care for you. They are called a multidisciplinary team (MDT). The team can include:
- specialist head and neck surgeons
- specialist head and neck medical oncologists (doctors who specialise in drug treatments for cancer)
- specialist head and neck clinical oncologists (doctors who specialise in radiotherapy and drug treatments for cancer)
- radiologists (doctors who specialise in taking and reading x-rays and scans)
- specialist head and neck cancer nurses
- speech and language therapists
- dietitians
- social worker
- dentists
- histopathologists (doctors who study organs, tissues, cells and genetics to help provide a diagnosis)
The treatment you have depends on:
- your type of laryngeal cancer
- where the cancer is in your larynx
- how far it has grown or spread (the stage)
- how abnormal the cells look under a microscope (the grade)
- your general health and level of fitness
Your doctor will discuss your treatment, its benefits and the possible side effects with you.
Making decisions
In some situations, you might not have a choice of treatment. This is because it is clear which treatment will work best.
But your doctor may give you a choice, especially if you have a small, early tumour. For example, they may suggest trans-oral laser surgery (endoscopic resection) or radiotherapy. The outcomes of this type of surgery and radiotherapy are very similar.
Your doctor will discuss the risks and benefits of the different options with you.
You might have a combination of treatments. And you might need to see various people from the multidisciplinary team. They all specialise in different aspects of your treatment.
Ask your doctor or nurse to introduce you to someone who had treatment if you think this would be helpful to you.
Treatment overview
You might have one or more of the following treatments:
- surgery
- radiotherapy
- chemotherapy
- chemotherapy with radiotherapy (chemoradiotherapy)
- targeted cancer drug
Treatment by number stage
Stage 0 (Tis - tumour in situ)
The surgeon might completely remove the abnormal area when you have the biopsy. Or you might have laser treatment.
If the cancer cells come back again you might have further laser surgery or radiotherapy.
Stage 1 and 2
Treatment might include:
- surgery using a laser to remove the cancer through your mouth (trans-oral laser surgery)
- surgery to remove part of your voice box (a partial laryngectomy)
- radiotherapy
If your cancer is above your vocal cords (supraglottis), your surgeon will try their best to protect the vocal cords.
If your doctor thinks there is any risk of the cancer coming back, they might offer you radiotherapy after surgery.
Stage 3
You might have chemotherapy with radiotherapy (chemoradiotherapy). There may be reasons why you can't have chemotherapy. For example, due to other medical conditions, you might have. If this is the case, you may have a targeted cancer drug instead. Or you might have radiotherapy on its own.
Instead of chemoradiotherapy, you might have surgery. The surgeon may use a laser to remove the cancer through your mouth (trans-oral laser surgery.) Or you might have surgery to remove part of your voice box (partial laryngectomy). The surgeon is also likely to remove your lymph nodes. Or you have radiotherapy to these lymph nodes.
If your cancer is in the area below your vocal cords (subglottis), you might have surgery to remove all of your voice box (total laryngectomy). You have radiotherapy afterwards to lower the risk of the cancer coming back. Or you may have radiotherapy alone.
Stage 4
You might be able to have radiotherapy with chemotherapy or a targeted cancer drug. This means you avoid surgery to remove your larynx.
But you might need surgery to remove your whole voice box. This is also called a laryngectomy. You will also have the surrounding lymph nodes removed. You have radiotherapy after this. You might also have chemotherapy.
You might have radiotherapy and chemotherapy to shrink your cancer before surgery. Some people may not need surgery after this, so it can be kept in reserve in case the cancer comes back.
Laryngeal cancer that comes back
Your treatment depends on what treatment you had first time round.
Before treatment, your doctor might take another sample of tissue (biopsy). This is because it can sometimes be difficult to tell if a new lump in the treatment area is scar tissue or a cancer that has come back.
If your cancer comes back after radiotherapy your doctor will probably suggest surgery to remove your voicebox (total laryngectomy).
If your cancer comes back after surgery, you are most likely to have radiotherapy. You might have this alongside chemotherapy or a targeted cancer drug.
