For early stage laryngeal cancers (stages I-II), patients respond equally well to surgery or radiation treatment. For intermediate stage cancers (stages II-III), a combination of radiation and chemotherapy or radiation and surgery provide the best opportunity to preserve the larynx. Depending on the location and size of the tumor, some patients may undergo radiation or surgery alone.
Surgery may involve partial or total removal of the larynx (laryngectomy), portions of the subglottis or supraglottis or removal of just the vocal cords (cordectomy). In some patients, the thyroid gland may also be removed. Partial laryngectomy allows surgeons to preserve speech. At MD Anderson, two procedures are used to preserve normal function:
Transoral Laser Microsurgery (TLM) uses a flexible, hollow-core fiber to transmit CO2 laser energy, enabling surgeons to reach otherwise inaccessible areas and to perform a 360-degree resectionaround tumors in ways that were previously not possible.
Supracricoid Partial Laryngectomy: the supraglottis, vocal cords and thyroid cartilage are removed, while sparing other structures needed to swallow and produce speech.
While advanced techniques are helping preserve normal function, patients who have had their entire larynx or vocal cords removed will lose the ability to speak or breathe normally. There are several options to restore speech:
- A special valve implanted between the trachea and esophagus (food pipe), which eliminates the need for an electrolarynx
- Using a handheld vibrating device (electrolarynx) to produce sounds and words
- Intensive speech therapy to learn how to use the esophagus for speaking
Chemotherapy drugs can be used to shrink the tumor before surgery or to kill lingering cancer cells after surgery and/or radiation treatment. A combination of chemotherapy and radiation may be used as a primary treatment for patients with larger tumors or those who cannot tolerate surgery.
Laryngeal cancer patients are strongly urged not to smoke or drink alcohol both during and after cancer treatment. Drinking and smoking can make treatments less successful, as well as greatly increasing the chances for recurrence.
Regular follow-up and screening is vital due to the high risk of cancer returning to the larynx or other areas in the head and neck region. Patients may have to see their doctor every two months for the first two years after treatment, since 80-90% of new cancers occur within the first three years.