Cancer of the Larynx : Methods of Treatment, Side Effects

by National Cancer Institute

(Page 3 of 5)

Methods of Treatment

Cancer of the larynx may be treated with radiation therapy, surgery, or chemotherapy. Some patients have a combination of therapies.

Radiation therapy (also called radiotherapy) uses high-energy x-rays to kill cancer cells. The rays are aimed at the tumor and the tissue around it. Radiation therapy is local therapy. It affects cells only in the treated area. Treatments are usually given 5 days a week for 5 to 8 weeks.

Laryngeal cancer may be treated with radiation therapy alone or in combination with surgery or chemotherapy:

Radiation therapy alone: Radiation therapy is used alone for small tumors or for patients who cannot have surgery.

Radiation therapy combined with surgery: Radiation therapy may be used to shrink a large tumor before surgery or to destroy cancer cells that may remain in the area after surgery. If a tumor grows back after surgery, it is often treated with radiation.

Radiation therapy combined with chemotherapy: Radiation therapy may be used before, during, or after chemotherapy. After radiation therapy, some people need feeding tubes placed into the abdomen. The feeding tube is usually temporary.

These are questions you may want to ask your doctor before having radiation therapy:

• Why do I need this treatment?
• What are the risks and side effects of this treatment?
• Are there any long-term effects?
• Should I see my dentist before I start treatment?
• When will the treatments begin? When will they end?
• How will I feel during therapy?
• What can I do to take care of myself during therapy?
• Can I continue my normal activities?
• How will my neck look afterward?
• What is the chance that the tumor will come back?
• How often will I need checkups?

Surgery is an operation in which a doctor removes the cancer using a scalpel or laser while the patient is asleep. When patients need surgery, the type of operation depends mainly on the size and exact location of the tumor.

There are several types of laryngectomy (surgery to remove part or all of the larynx):

Total laryngectomy: The surgeon removes the entire larynx.

Partial laryngectomy (hemilaryngectomy): The surgeon removes part of the larynx.

Supraglottic laryngectomy: The surgeon takes out the supraglottis, the top part of the larynx.

Cordectomy: The surgeon removes one or both vocal cords.

Sometimes the surgeon also removes the lymph nodes in the neck. This is called lymph node dissection. The surgeon also may remove the thyroid.

During surgery for cancer of the larynx, the surgeon may need to make a stoma. (This surgery is called a tracheostomy.) The stoma is a new airway through an opening in the front of the neck. Air enters and leaves the windpipe (trachea) and lungs through this opening. A tracheostomy tube, also called a trach ("trake") tube, keeps the new airway open. For many patients, the stoma is temporary. It is needed only until the patient recovers from surgery.

After surgery, some people may need a temporary feeding tube.

Here are some questions to ask the doctor before having surgery:

• How will I feel after the operation?
• Will I need a tracheostomy?
• Will I need to learn how to take care of myself or my incision when I get home?
• Where will the scars be? What will they look like?
• Will surgery affect my ability to speak? If so, who will teach me how to speak in a new way?
• When can I get back to my normal activities?

Chemotherapy is the use of drugs to kill cancer cells. Your doctor may suggest one drug or a combination of drugs. The drugs for cancer of the larynx are usually given by injection into the bloodstream. The drugs enter the bloodstream and travel throughout the body.

Chemotherapy is used to treat laryngeal cancer in several ways:

Before surgery or radiation therapy: In some cases, drugs are given to try to shrink a large tumor before surgery or radiation therapy.

After surgery or radiation therapy: Chemotherapy may be used after surgery or radiation therapy to kill any cancer cells that may be left. It also may be used for cancers that have spread.

Instead of surgery: Chemotherapy may be used with radiation therapy instead of surgery. The larynx is not removed and the voice is spared.

Chemotherapy may be given in an outpatient part of the hospital, at the doctor's office, or at home. Rarely, a hospital stay may be needed.

These are questions you may want to ask your doctor before having chemotherapy:

• Why do I need this treatment?
• What will it do?
• Will I have side effects? What can I do about them?
• How long will I be on this treatment?
• How often will I need checkups?

Side Effects of Cancer Treatment

Cancer treatments are very powerful. Treatments that remove or destroy cancer cells are likely to damage healthy cells, too. That's why treatments often cause side effects. This section describes some of the side effects of each kind of treatment.

Side effects may not be the same for each person, and they may even change from one treatment session to the next. Before treatment starts, your health care team will explain possible side effects and how they can be managed. It may help to know that although some side effects may not go away completely, most of them become less troubling.

It may also help to talk with other patients. A social worker, nurse, or other member of the medical team can set up a visit with someone who has had the same treatment.

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