Treatment for cancer of the larynx (voicebox), also known as laryngeal cancer
Treatment of laryngeal cancer will depend on where the cancer is in the larynx, the stage and grade of the cancer, your general health.
The main treatments for cancer of the larynx are radiotherapy and surgery. Chemotherapy and targeted therapies (or biological therapies) are also used.
These treatments are given alone or in combination. For most people, the aim is to remove or destroy the cancer and reduce the chances of it coming back.
Your doctor will plan your treatment to try to reduce long-term effects on your speech and swallowing, and on your appearance. Your doctor and specialist nurse will explain how the different treatment options may affect you.
The treatment you have will depend on:
where the cancer is in the larynx
the stage and grade of the cancer
your general health.
If the cancer is at an early stage, it can usually be cured by radiotherapy or by surgery through the mouth with an endoscope.
For other stages, you may need a combination of surgery, radiotherapy, chemotherapy or a targeted therapy.
If the tumour is large, you may need surgery to remove part or all of the larynx.
If an operation isn’t possible, some people are given a combination of chemotherapy and radiotherapy (chemoradiation).
Your doctor may advise you to have treatment after surgery to reduce the risk of the cancer coming back. Radiotherapy or chemoradiation can be given in this way after surgery.
Doctors sometimes give chemotherapy to reduce the size of the cancer before radiotherapy. You can also have chemotherapy if the cancer has spread outside the larynx or comes back after radiotherapy.
Some people have treatment with a targeted therapy drug along with radiotherapy.
If it isn’t possible to cure the cancer, your doctor will give you treatment to help control it and relieve symptoms. This is called palliative treatment.
How treatment is planned
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A team of specialists will meet to discuss and agree on the plan of treatment they feel is best for your situation.
This multidisciplinary team (MDT) will usually include:
a surgeon who specialises in cancer of the larynx (an ear, nose and throat specialist)
a clinical oncologist who specialises in radiotherapy, chemotherapy and targeted therapies
a radiologist who helps to interpret scans and x-rays
a pathologist who advises on the type and extent of the cancer
a clinical nurse specialist who gives information and support
a speech and language therapist who specialises in speech and swallowing problems
a dietitian who can advise you if you have problems with eating, drinking or weight loss.
The team may also include other healthcare professionals such as physiotherapists, dentists or oral surgeons, social workers, counsellors or psychologists.
Your specialist will consider a number of factors when advising you on your options. These will include your general health, the stage of the cancer and if it has spread to other parts of the body.
Your doctor and nurse will explain if there are different treatments that they can use in your situation.
Sometimes people find it hard to make a decision about treatment. If you’re asked to make a choice, make sure you have enough information. You’ll need to know the different options, what they involve and information about the possible side effects to decide what’s right for you.
We have more information about making treatment decisions, which you may find helpful.
The benefits and disadvantages of treatment
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Many people are frightened at the idea of having cancer treatments, particularly because of the side effects that can occur. However, these can usually be controlled with medicines. Treatment can be given for different reasons and the potential benefits will vary depending upon your individual situation.
Cancer of the larynx may be cured with surgery or radiotherapy, even when it is locally advanced. Sometimes you need other treatment as well.
If the cancer is advanced and has spread to other parts of the body, treatment may only be able to control it, which can improve symptoms and quality of life. However, for some people in this situation, the treatment will have no effect on the cancer and they will get the side effects without any of the benefit.
If you’ve been offered treatment that aims to cure the cancer, deciding whether to accept it may not be difficult. However, if a cure is not possible and the purpose of treatment is to control the cancer for a period of time, it may be more difficult to decide whether or not to go ahead.
Making decisions about treatment in these circumstances is always difficult, and you may need to discuss in detail with your doctor whether you wish to have treatment. If you choose not to have it, you can still be given supportive (palliative) care with medicines to control any symptoms.
Before you have any treatment, your doctor will explain its aims. They will ask you to sign a form saying that you give permission (consent) for the hospital staff to give you the treatment.
No medical treatment can be given without your consent, and before you are asked to sign the form, you should be given full information about:
the type and extent of the treatment
its advantages and disadvantages
any significant risks or side effects
any other treatments that may be available.
If you don’t understand what you’ve been told, let the staff know straight away so they can explain again. Some cancer treatments are complex, so it’s not unusual to need repeated explanations.
It’s a good idea to have a relative or friend with you when the treatment is explained, to help you remember the discussion.
You may also find it useful to write a list of questions before your appointment.
People sometimes feel that hospital staff are too busy to answer their questions, but it’s important for you to know how the treatment is likely to affect you. The staff should be willing to make time for your questions.
You can always ask for more time if you feel that you can’t make a decision when your treatment is first explained to you.
You are also free to choose not to have the treatment. The staff can explain what may happen if you don’t have it. It’s essential to tell a doctor or the nurse in charge, so they can record your decision in your medical notes. You don’t have to give a reason for not wanting treatment, but it can help to let the staff know your concerns so they can give you the best advice.
Your multidisciplinary team uses national treatment guidelines to decide the most suitable treatment for you. Even so, you may want another medical opinion. If you feel it will be helpful, you can ask either your specialist or GP to refer you to another specialist for a second opinion.
Getting a second opinion may delay the start of your treatment, so you and your doctor need to be confident that it will give you useful information. If you do go for a second opinion, it may be a good idea to take a relative or friend with you, and have a list of questions ready, so that you can make sure your concerns are covered during the discussion.