Cancer of the larynx may be treated with radiation therapy, surgery, or chemotherapy. Some patients have a combination of therapies.

Radiation therapy (also called radiotherapy) uses high-energy x-rays to kill cancer cells. The rays are aimed at the tumor and the tissue around it. Radiation therapy is local therapy. It affects cells only in the treated area. Treatments are usually given 5 days a week for 5 to 8 weeks.

Laryngeal cancer may be treated with radiation therapy alone or in combination with surgery or chemotherapy:

• Radiation therapy alone: Radiation therapy is used alone for small tumors or for patients who cannot have surgery.

• Radiation therapy combined with surgery: Radiation therapy may be used to shrink a large tumor before surgery or to destroy cancer cells that may remain in the area after surgery. If a tumor grows back after surgery, it is often treated with radiation.

• Radiation therapy combined with chemotherapy: Radiation therapy may be used before, during, or after chemotherapy.

  After radiation therapy, some people need feeding tubes placed into the abdomen. The feeding tube is usually temporary.

Surgery is an operation in which a doctor removes the cancer using a scalpel or laser while the patient is asleep. When patients need surgery, the type of operation depends mainly on the size and exact location of the tumor.

There are several types of laryngectomy (surgery to remove part or all of the larynx):

• Total laryngectomy: The surgeon removes the entire larynx.

• Partial laryngectomy (hemilaryngectomy): The surgeon removes part of the larynx.

  • Supraglottic laryngectomy: The surgeon takes out the supraglottis, the top part of the larynx.

  • Cordectomy: The surgeon removes one or both vocal cords.

Sometimes the surgeon also removes the lymph nodes in the neck. This is called lymph node dissection. The surgeon also may remove the thyroid.

During surgery for cancer of the larynx, the surgeon may need to make a stoma. (This surgery is called a tracheostomy.) The stoma is a new airway through an opening in the front of the neck. Air enters and leaves the windpipe (trachea) and lungs through this opening. A tracheostomy tube, also called a trach (“trake”) tube, keeps the new airway open. For many patients, the stoma is temporary. It is needed only until the patient recovers from surgery. More information about stomas can be found in the “Living with a Stoma ¹” section.

After surgery, some people may need a temporary feeding tube.

Here are some questions to ask the doctor before having surgery: How will I feel after the operation? Will I need a tracheostomy? Will I need to learn how to take care of myself or my incision when I get home? Where will the scars be? What will they look like? Will surgery affect my ability to speak? If so, who will teach me how to speak in a new way? When can I get back to my normal activities?

Chemotherapy is the use of drugs to kill cancer cells. Your doctor may suggest one drug or a combination of drugs. The drugs for cancer of the larynx are usually given by injection into the bloodstream. The drugs enter the bloodstream and travel throughout the body.

Chemotherapy is used to treat laryngeal cancer in several ways:

• Before surgery or radiation therapy: In some cases, drugs are given to try to shrink a large tumor before surgery or radiation therapy.

• After surgery or radiation therapy: Chemotherapy may be used after surgery or radiation therapy to kill any cancer cells that may be left. It also may be used for cancers that have spread.

• Instead of surgery: Chemotherapy may be used with radiation therapy instead of surgery. The larynx is not removed and the voice is spared.

Chemotherapy may be given in an outpatient part of the hospital, at the doctor’s office, or at home. Rarely, a hospital stay may be needed.

Glossary Terms

Treatment with drugs that kill cancer cells.

An operation on the vocal cords or on the spinal cord.

An operation to remove one side of the larynx (voicebox).

An operation to remove all or part of the larynx (voice box).

A device that forms light into intense, narrow beams that may be used to cut or destroy tissue, such as cancer tissue. It may also be used to reduce lymphedema (swelling caused by a buildup of lymph fluid in tissue) after breast cancer surgery. Lasers are used in microsurgery, photodynamic therapy, and many other procedures to diagnose and treat disease.

Treatment that affects cells in the tumor and the area close to it.

A surgical procedure in which the lymph nodes are removed and examined to see whether they contain cancer. For a regional lymph node dissection, some of the lymph nodes in the tumor area are removed; for a radical lymph node dissection, most or all of the lymph nodes in the tumor area are removed. Also called lymphadenectomy.

An operation to remove part of the larynx (voice box).

The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.

A small, thin knife used for surgery.

A surgically created opening from an area inside the body to the outside.

An operation to remove the supraglottis, which is part of the larynx (voice box) above the vocal cords.

A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.

An operation to remove all of the larynx (voice box).

Surgery to create an opening (stoma) into the windpipe. The opening itself may also be called a tracheostomy.

A 2-inch- to 3-inch-long curved metal or plastic tube placed in a surgically created opening (tracheostomy) in the windpipe to keep it open. Also called trach tube.