Radiotherapy treatment for laryngeal cancer

You might have radiotherapy on its own as your main treatment, or combined with other treatments such as surgery, chemotherapy or targeted cancer drugs. Or you might have it to control symptoms of advanced cancer. 

What is radiotherapy?

Radiotherapy uses high energy rays to kill cancer cells. You can't feel radiotherapy at all when you have it. It's like having an x-ray.

Radiotherapy works because cancer cells are more likely to be killed by radiation than normal cells. But some normal cells are also damaged. This is what causes side effects.

You can have different types of radiotherapy. For laryngeal cancer, you have external beam radiotherapy. This is usually as conventional radiotherapy.

You might also have a type of external beam radiotherapy called intensity modulated radiotherapy (IMRT). This is usually to treat locally advanced cancer of the larynx. 

When do you have radiotherapy for laryngeal cancer?

You might have radiotherapy: 

• on its own
• after surgery
• with chemotherapy or targeted cancer drugs
• to relieve symptoms

On its own

Radiotherapy is often the first choice of treatment for laryngeal cancer. Most people who have early stage laryngeal cancer are cured with this treatment.

Your doctors might suggest radiotherapy or endoscopic surgery. Both treatments work well and help you to keep your voice. Whether radiotherapy is suitable for you depends on:

• the size of your cancer
• how far it has grown
• where it is

With early laryngeal cancer, you usually have radiotherapy as an outpatient daily from Monday to Friday for about 3 to 7 weeks.

Your doctor calculates the total dose of radiotherapy you need and then divides it up into a number of smaller doses (or fractions). You have fractions as a series of treatment sessions. This helps to reduce the side effects.

Sometimes you might have chemotherapy before radiotherapy. This is called neo adjuvant chemotherapy. It can shrink the tumour and make the radiotherapy work better.

With chemotherapy or targeted cancer drugs

For locally advanced (stage T3 or T4) laryngeal cancer, you might have chemotherapy or targeted cancer drugs added to your radiotherapy treatment. These treatments sometimes work better when you have them together. The chemotherapy or targeted cancer drugs can help to shrink or control the cancer.

Having radiotherapy and chemotherapy at the same time is called chemoradiotherapy.

After surgery

Radiotherapy after surgery is called adjuvant therapy. It helps to stop your cancer from coming back. Doctors use radiotherapy after surgery for a number of different reasons. You may have it if your doctor thinks the cancer is likely to come back because:

• the cancer was difficult to remove
• there may be cancer cells left behind
• the cancer had grown through the larynx wall
• cancer cells were found in your lymph nodes or breaking through the outer wall of the lymph nodes

You usually have treatment daily, from Monday to Friday for about 4 to 6 weeks. This is about 20 to 30 separate treatments (fractions).

You might also have chemotherapy added in some of the above situations, depending on where the cancer is. Your doctor will tell you if you need this.

To relieve symptoms

Radiotherapy can relieve symptoms in advanced cancer of the larynx. This is called palliative radiotherapy.

Advanced laryngeal cancer can cause you to have difficulty in swallowing. Or it can press on your windpipe and make it difficult for you to breathe. 

Radiotherapy can shrink the cancer for a time and relieve your symptoms and pain. To control symptoms, you are most likely to have a short course of radiotherapy, over a few days.