It is important to be aware of the fact that laryngeal cancer is unique and treatment cannot be considered standardized. Treatment options have evolved so much in the last half century that the physicians and patients now have multiple choices available to them. Many factors influence the type of treatment options available to an individual and they must be recognized before any type of treatment is considered. These factors include age, quality-of-life issues, and voice results to name a few.

Treatment options for laryngeal cancer involve radiation, chemotherapy, surgery or a combination of the three. The following descriptions are deliberately brief and are meant only to present basic information.

A small tumor (what would be called aT1 in the staging system) can be treated with radiation therapy or with surgery. The most conservative treatment is radiation only. Radiation is a daily procedure, which lasts about 20 minutes each day, 5 days a week, for roughly a month and a half. Surgery on the other hand is done most often through the mouth and involves removing a portion of the larynx that contains the tumor.

Surgery is a treatment for laryngeal cancer varies considerably according to the size and extent of the tumor (again based on the staging system). For T4 lesions many surgeons resort to a total laryngectomy, which is the most aggressive surgical treatment and involves removal of the entire larynx.

For smaller tumors (T1, T2, and T3) there are surgical procedures that do not involves removal of the entire larynx, rather only a portion in the involved larynx. Some of the procedures categorized as partial laryngectomies are listed below:

Partial Cordectomy

This procedure encompasses excision of only the involved portion of the actual vocal cord.

Total Cordectomy

This procedure involves the excision of both vocal cords with the exception of any surrounding cartilaginous (bony) structure.

Hemilaryngectomy

This procedure involves the removal of half of the larynx and is done vertically to include both the vocal cord itself as well as the cartilaginous structures on the involved side.

Surgical options for reconstruction of the larynx after one of the above treatments are an option. There are also several options for speech after a total laryngectomy and can be found in the literature.

Chemotherapy and Radiation Therapy

In some cases a combination of chemotherapy and radiation therapy can be administered first instead of surgery. In this case the patient is carefully examined after two treatments of chemotherapy and if the treatment is working and the tumor has shrunk, then additional chemotherapy can continue. If after two treatments the tumor remains the same size, then surgery must be considered the primary option to ensure the cancer does not metastasize (spread) to other parts of the body.

In addition to the larynx the neck regions must also be treated with radiation or surgery as this type of cancer may spread to other areas, specifically the lymph nodes.

Close follow-up is extremely important after treatment for laryngeal cancer, as there is always a chance of recurrence. The risk is greater is the patient continues to abuse tobacco. The physician will typically require examinations once a month for a year and then gradually decrease the frequency of the visits.

It is important to note that these descriptions are a brief overview. There are many other implications to successful treatment that can only be discussed with your physician.