Treatment by stage for laryngeal cancer
This page describes the treatment by stage of cancer of the larynx. Stage means how far the cancer has grown. This page has information about
- A quick guide to what's on this page
- Treatment for T stage 0 or Tis larynx cancer
- Treatment for early stage larynx cancer (T stage 1 – 2)
- Treatment for locally advanced larynx cancer (T stage 3)
- Treatment for T stage 4 larynx cancer
- Treatment for laryngeal cancer that has come back
- Palliative treatment
Treatment by T stage for laryngeal cancer
T stage 0 If the affected area is very small, your doctor may completely remove it when a biopsy is taken. Or you may have laser treatment to kill off the affected cells. If the abnormal cells come back, you will need to have more tissue removed.
T stage 1 or 2 You may have either endoscopic laryngeal surgery or radiotherapy for T stage 1 or 2 cancer of the larynx. If endoscopic surgery is not suitable for you, you may have a partial laryngectomy.
T stage 3 A partial laryngectomy may be possible for stage 3 laryngeal cancer. But the most common treatment these days is a combination of radiotherapy and chemotherapy. This is sometimes given with a biological therapy.
T stage 4 The main treatment for this stage is chemoradiation. In some situations you may need to have a laryngectomy to remove the cancer. The surrounding lymph nodes will be removed by surgery (neck dissection) or treated with radiotherapy.
If your cancer comes back – Your treatment depends on the treatment you had first time round. You may have surgery or radiotherapy, with or without chemotherapy or biological therapy.
You can view and print the quick guides for all the pages in the Treating laryngeal cancer section.
T stage 0 is really a pre cancerous stage where there are abnormal cells that may become cancerous. Or there are cancer cells which are all contained in the top layer of the skin like covering of the larynx (the mucosa). This stage is Tis or carcinoma in situ. It is unusual to have a larynx cancer diagnosed this early, as there are unlikely to be any symptoms at this stage.
If the affected area is very small, your doctor may completely remove it when a biopsy is taken. Or you may have laser treatment given via the mouth through an endoscope.
If the cancer cells come back again after this treatment, your doctor may suggest further laser surgery or a course of radiotherapy.
You may have either endoscopic laryngeal surgery or radiotherapy to treat T stage 1 and 2 cancer of the larynx. If laser surgery is not suitable for you, you may have a partial laryngectomy.
If the cancer is in the area above your vocal cords (supraglottis), your surgeon will do everything possible to leave the vocal cords unharmed. If your doctors think there is any risk of the cancer coming back, they may suggest radiotherapy after your surgery.
Doctors usually treat Tstage 3 laryngeal cancer using radiotherapy with chemotherapy (chemoradiation). If you are not well enough to have these 2 treatments together, you may have biological therapy alongside radiotherapy.
Instead of chemoradiation, it may be possible for you to have an endoscopic resection or a partial laryngectomy. You are likely to have either surgery to remove lymph nodes (neck dissection) or radiotherapy to these lymph nodes.
If the cancer is in the area below the vocal cords (subglottis), then you may have a total laryngectomy with radiotherapy afterwards. The radiotherapy lowers the risk of the cancer coming back. Or your doctor may treat you with radiotherapy alone.
We have detailed information about these surgical procedures.
T stage 4 means the cancer has spread into the surrounding tissues. You may be able to have radiotherapy with chemotherapy or biological therapy. This treatment aims to preserve your larynx. But you may need to have a total laryngectomy to remove the cancer and surrounding lymph nodes, followed by radiotherapy.
You may have radiotherapy and chemotherapy to shrink the cancer before you have surgery. Some people do not need surgery after this, so it can be kept in reserve in case the cancer comes back.
Your treatment depends on the treatment you had first time round. If the cancer comes back after radiotherapy, you will probably be asked to have a total laryngectomy.
If you had surgery the first time round, then you are most likely to have radiotherapy. You may have chemotherapy or biological therapy alongside radiotherapy.
You may have a fine needle aspiration (FNA) biopsy before you have treatment. 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.
This means treatment to control symptoms caused by a disease. Palliative treatment won't cure your cancer, but it may slow it down a bit. If your cancer has spread too far to be cured, or has come back after it was first treated, your doctor may suggest radiotherapy, chemotherapy, biological therapy or some combination of these. The aim of this treatment is to shrink the cancer and help to control the symptoms it causes.
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