Researchers around the world are looking at better ways to treat laryngeal cancer and manage treatment side effects.
Go to Cancer Research UK’s clinical trials database if you are looking for a trial for laryngeal cancer in the UK. You need to talk to your specialist if there are any trials that you think you might be able to take part in.
Research and clinical trials
All cancer treatments have to be fully researched before they can be used for everyone. This is so we can be sure that:
- they work
- they work better than the treatments already available
- they are known to be safe
Doctors are looking at how they give radiotherapy to people with laryngeal cancers. You usually have radiotherapy once a day, Monday to Friday, for several weeks. They are comparing different ways of giving radiotherapy to see which way is better at stopping cancer from coming back.
Intensity modulated radiotherapy (IMRT) is a specialised type of radiotherapy which shapes the radiotherapy beam to fit the shape of the tumour very accurately. Researchers are comparing standard doses of IMRT with higher doses.
Doctors know that radiotherapy works best on cells that have a good supply of oxygen. Cancer cells don’t always have high levels of oxygen, especially the cells in the centre of a tumour. Researchers want to increase the oxygen levels in cancer cells so that radiotherapy can kill more of them. They are looking at a drug called nimorazole that mimics the effect of oxygen in tumour cells. It's called a radiosensitising drug.
Targeted cancer drugs change the way cells work. They can boost the body's immune system to fight off or kill cancer cells, or they can block signals that tell cells to grow.
Doctors have looked at different types of targeted cancer drugs for laryngeal cancer including:
- monoclonal antibodies such as zalutumumab, MEDI4736 and tremelimumab
- cancer growth blockers, such as buparlisib
Doctors are waiting for results from a trial to see if adding buparlisib to chemotherapy improves how well the treatment works. Another trial was looking at how zalutumumab works in the body for people with head and neck cancer.
Immunotherapy works by helping the immune system recognise and attack cancer cells. Doctors are looking at different types for head and neck cancer, including:
- AMG 319
Researchers are looking at a type of light treatment with chemotherapy for head and neck cancer that's come back after treatment. It's called PC A11.
You have a drug called Amphinex which makes body tissue sensitive to light and the chemotherapy drug bleomycin. After having these drugs, the doctor directs a laser light onto the surface of the cancer, or through fibres put directly into the cancer. The light activates the Amphinex, which in turn helps the bleomycin to get into the cancer cells and kill them.
Tests during and after treatment
Doctors are keen to find a more accurate way of seeing whether there are any cancer cells left after treatment. They hope that using a type of MRI scan called diffusion weighted MRI (DW-MRI) might be useful. DW-MRI scans measure the water movement between cells.
Researchers want to find out whether DW-MRI scans are helpful for seeing how well treatment for head and neck cancer has worked. Doctors hope the scans will help them decide who needs more treatment.
Side effects of treatment
Treatment for laryngeal cancer causes side effects that can be difficult to live with. Researchers are looking into different drugs and treatments to help with these side effects.
Preventing or treating bone damage
Rarely, radiotherapy to the head and neck area can damage the jaw bone. This is called osteoradionecrosis (ORN). Doctors think that a high pressure oxygen therapy called hyperbaric oxygen (HBO) may be able to prevent or treat this side effect. The idea is that HBO works by increasing the supply of blood to the jaw.
Researchers are looking at HBO therapy to prevent jaw bone problems in people having dental or jaw surgery after radiotherapy. They are also looking at whether HBO can help the jaw bone heal after surgery to remove a damaged jaw bone.
Some medications such as vitamin E and pentoxyphylline are thought to help prevent and help treat ORN. Some researchers are testing to see whether they help.
Helping to relieve a sore mouth
Radiotherapy for head and neck cancers can cause painful sores and ulcers in the mouth. This is called oral mucositis.
Doctors are looking at a new treatment for oral mucositis called low level laser therapy. They shine a weak laser light on the lining of the mouth to see if it:
- reduces pain during and after radiotherapy
- helps heal the mouth after treatment.
A number of drugs are also being developed to reduce oral mucositis with radiotherapy, or reduce the discomfort of oral mucositis.
Helping with taste changes
Your sense of taste can change after treatment for head and neck cancer. Researchers think that hypnosis might be able to help you manage these changes in taste.
Hypnosis puts you in a state where your body is deeply relaxed and your mind is active. It can change your thoughts, feeling and behaviours by making suggestions that focus on a particular image or idea.
Head and neck cancer services
Services for people with head and neck cancers including cancer of the larynx are now offered at fewer larger centres. The Head and Neck 5000 study aims to ask 5000 people how well these services work for them. This study has now closed and we’re waiting the results.
Living with laryngeal cancer
Doctors want to find out how they can improve support for people with head and neck cancers. To do this, researchers are asking patients to fill in a questionnaire to identify things that concern them. This is called a holistic needs assessment.
You then discuss your concerns with a doctor who can provide appropriate guidance and information. Although you don't have any direct benefit from taking part in the study, doctors hope it will help them support patients and improve care in the future.