Treatment of Laryngeal Cancer

The treatment of laryngeal cancer (cancer of the voice box) is planned for you personally, according to the site and stage of the tumour and your general health. The main methods used are surgery, radiation treatment (radiotherapy) and drug treatment (chemotherapy); these may be used alone or in combination. The aim is to remove the disease while preserving breathing, swallowing and speech as far as possible.

How is the treatment plan drawn up?

Treating laryngeal cancer is the work of a team, not of a single doctor. The head and neck surgeon, radiation oncologist, medical oncologist, pathologist, radiologist and speech therapist decide on the most suitable path for you in joint meetings known as the “tumour board”. In planning, your age, other illnesses, occupation and preferences are taken into account as much as the stage of the tumour.

Surgical treatment

Surgery is one of the main ways of treating laryngeal cancer. The methods used, depending on the size of the tumour, are:

• Endoscopic laser surgery: in early-stage tumours, removal of the tumour through the mouth, without an incision, with the help of a microscope and a laser.
• Partial removal of the larynx (partial laryngectomy): removal of only the diseased part of the larynx, preserving the healthy parts.
• Complete removal of the larynx (total laryngectomy): removal of the whole larynx in advanced-stage tumours; in this case breathing takes place through a permanent opening in the neck (stoma).
• Neck dissection: removal of the lymph nodes in the neck when there is spread, or when the risk of spread is high.

The surgical methods are described in more detail on a separate page.

Radiotherapy

Radiotherapy is a treatment that targets cancer cells with high-energy rays. In early-stage tumours it can be used alone as an alternative to surgery and has the advantage of preserving the natural quality of the voice. In advanced stages it is given after surgery to destroy any remaining cells, or together with chemotherapy in order to preserve the larynx. The treatment is given in short sessions on weekdays over a period of a few weeks. Side effects such as redness of the skin, a sore throat, difficulty swallowing, a dry mouth and altered taste may occur; most of them subside over time once treatment has ended.

Chemotherapy

Chemotherapy is treatment with drugs that act on cancer cells. In laryngeal cancer it is usually not used alone, but at the same time as radiotherapy to enhance its effect, or before surgery to shrink the tumour. In some patients, newer drugs that support the immune system or target the tumour cells may also be added to treatment. Side effects such as tiredness, nausea, mouth sores and susceptibility to infection are closely monitored by the treatment team.

Approaches that preserve the larynx

In suitable patients, “organ-preserving” treatments, in which radiotherapy and chemotherapy are given together, may be preferred instead of complete removal of the larynx. With this approach, the aim is to bring the disease under control while preserving the natural voice and airway. If the disease persists or returns after treatment, the option of surgery remains open.

Follow-up after treatment

Once treatment is complete, regular check-ups begin. These check-ups, more frequent in the first years and less frequent thereafter, include an endoscopic examination, imaging when needed, and an assessment of thyroid function. Giving up smoking and alcohol is an inseparable part of treatment, both for its success and for preventing the development of a new tumour.