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Treatment decisions

See how your doctor decides which treatment you need for cancer of the larynx, the types of treatment you might have and treatment by stage.

Deciding which treatment you need

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
  • doctors who specialise in radiotherapy and drug treatments for cancer (clinical oncologists)
  • specialist head and neck cancer nurse
  • speech and language therapist
  • dietician
  • social worker
  • dentist

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 because it is clear which treatment will work best. 

But you may be given a choice, especially if you have a small, early tumour. For example, you might be able to choose between 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 who specialise in different aspects of treatment.

Treatment overview

You might have one or more of the following treatments:

  • surgery
  • radiotherapy
  • chemotherapy
  • biological therapy

Treatment by stage

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.

T 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) the surgeon will do everything possible to leave the vocal cords unharmed.

If your doctor thinks there is any risk of the cancer coming back, they might offer you radiotherapy after surgery.

T 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).  If this is the case, you may have biological therapy instead, or radiotherapy alone.

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.

T stage 4

You might be able to have radiotherapy with chemotherapy or biological therapy. This means you avoid surgery to remove your larynx.

But you might need surgery to remove your whole larynx (laryngectomy) and surrounding lymph nodes, followed by radiotherapy. 

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 frst 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 biological therapy.

Information and help

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About Cancer generously supported by Dangoor Education since 2010.