Laryngeal Cancer: Treatment Choices

There are many different ways to treat laryngeal cancer. Which one may work best for you? It depends on a number of factors. These include the size and stage of your cancer and where it is. Factors also include your age, overall health, and the side effects you’ll find acceptable.

Learning about your treatment choices

You may have questions and concerns about your treatment choices. You may also want to know how you’ll feel, how you'll look, and how your body will work after treatment, and if you’ll have to change your normal activities.

Your healthcare provider is the best person to answer your questions. They can explain what the treatment choices are, how well they're expected to work, what the risks and side effects may be, and how much it's likely to cost.

Your healthcare provider may advise a specific treatment. Or you may be offered more than one choice and asked to decide which one you’d like to use. It can be hard to make this decision. It's important to take the time you need to make the best decision.

Deciding on the best plan may take some time. Talk with your healthcare provider about how much time you can take to explore your choices. You may want to get another opinion before deciding on your treatment plan. You may also want to involve your family and friends in this process.

Types of treatment for laryngeal cancer

Treatment for cancer is either local or systemic. You may have both.

Local treatments remove, destroy, or control cancer cells in a certain place in the body. Surgery and radiation are local treatments.

Systemic treatments destroy or control cancer cells throughout the body. Chemotherapy and targeted therapy are examples.

Goals of treatment for laryngeal cancer

Treatment may control or cure the cancer. It can also improve your quality of life by helping to control the symptoms of the disease. The goal of laryngeal cancer treatment is to do one or more of these things:

• Remove the primary or main cancer tumor or other tumors

• Kill the cancer cells or keep them from growing and spreading

• Prevent or delay the cancer's return

• Ease symptoms of the cancer, such as pain or pressure in nearby tissues

The main goal of laryngeal cancer treatment is to preserve the way the larynx works. Your treatment team will talk with you about this.

Treatments for laryngeal cancer

There are five main treatment methods for laryngeal cancer. Each has a different purpose:

Surgery

The goal of surgery is to remove the tumor from the larynx while leaving as much of the larynx intact as possible. People who have any part of the larynx removed will have voice changes after surgery. Depending on the extent of the surgery, some people may no longer be able to speak or breathe normally. Lymph nodes that contain cancer may also need to be removed. 

Surgery may also be used to put in ports for chemotherapy or create a tracheostomy. A tracheostomy is a hole through the front of the neck into the windpipe (trachea). A tube is put into this hole to allow you to breathe through it instead of your mouth or nose. A tracheostomy may be needed only during treatment. Then plastic or reconstructive surgery may be needed to help restore the way you look and breathe. If all the larynx is removed, you'll have a tracheostomy the rest of your life.

Radiation therapy

The goal of radiation is to kill cancer cells using powerful beams of energy. This treatment can be used to shrink a tumor before surgery. Or it can be used after surgery to kill any remaining cancer cells. Sometimes it's used as the main treatment instead of surgery. Radiation may also be used if the cancer comes back after treatment. Radiation only treats cancer cells in the area that's radiated.

Chemotherapy

This is when strong medicines are used to treat cancer. For laryngeal cancer, the goal of chemotherapy (chemo) is to reduce the chance that the cancer will spread to other parts of the body. Or if the cancer has already spread, chemo can treat the spread.

Your healthcare provider may prescribe chemotherapy before or after surgery. In some cases, chemo and radiation therapy are used together to kill all cancer cells. This is called radiosensitizing treatment or chemoradiation.

Targeted therapy

Targeted therapy uses medicines that attack specific parts of cancer cells. Some laryngeal cancer cells are controlled by a protein called epidermal growth factor receptor (EGFR), which helps them grow. The most commonly used medicine that targets these cells is called cetuximab. It blocks EGFR so the cancer cell growth slows or stops.

Targeted therapy might be used along with radiation therapy to help treat early-stage laryngeal cancer. Or it might be used along with or after chemo for cancers that have come back or spread to other parts of the body.

Immunotherapy

This treatment uses medicines that boost your immune system to better fight cancer. It may be used if laryngeal cancer comes back or spreads after getting chemo. Immunotherapy may also be used if chemo isn't working.

Clinical trials for new treatments

Researchers are always finding new ways to treat cancer. These new methods are tested in clinical trials. Before starting treatment, ask your healthcare provider if there are any clinical trials you should look into.