Question: What are the treatments for Laryngeal Cancer ?
Answer: Key Points - There are different types of treatment for patients with laryngeal cancer. - Three types of standard treatment are used: - Radiation therapy - Surgery - Chemotherapy - New types of treatment are being tested in clinical trials. - Chemoprevention - Radiosensitizers - Patients may want to think about taking part in a clinical trial. - Patients can enter clinical trials before, during, or after starting their cancer treatment. - Follow-up tests may be needed. There are different types of treatment for patients with laryngeal cancer. Different types of treatment are available for patients with laryngeal cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment. Three types of standard treatment are used: Radiation therapy Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated. Radiation therapy may work better in patients who have stopped smoking before beginning treatment. External radiation therapy to the thyroid or the pituitary gland may change the way the thyroid gland works. The doctor may test the thyroid gland before and after therapy to make sure it is working properly. Hyperfractionated radiation therapy and new types of radiation therapy are being studied in the treatment of laryngeal cancer. Surgery Surgery (removing the cancer in an operation) is a common treatment for all stages of laryngeal cancer. The following surgical procedures may be used: - Cordectomy: Surgery to remove the vocal cords only. - Supraglottic laryngectomy: Surgery to remove the supraglottis only. - Hemilaryngectomy: Surgery to remove half of the larynx (voice box). A hemilaryngectomy saves the voice. - Partial laryngectomy: Surgery to remove part of the larynx (voice box). A partial laryngectomy helps keep the patient's ability to talk. - Total laryngectomy: Surgery to remove the whole larynx. During this operation, a hole is made in the front of the neck to allow the patient to breathe. This is called a tracheostomy. - Thyroidectomy: The removal of all or part of the thyroid gland. - Laser surgery: A surgical procedure that uses a laser beam (a narrow beam of intense light) as a knife to make bloodless cuts in tissue or to remove a surface lesion such as a tumor Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated. See Drugs Approved for Head and Neck Cancer for more information. (Laryngeal cancer is a type of head and neck cancer.) New types of treatment are being tested in clinical trials. This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI Web site. Chemoprevention Chemoprevention is the use of drugs, vitamins, or other substances to reduce the risk of developing cancer or to reduce the risk cancer will recur (come back). The drug isotretinoin is being studied to prevent the development of a second cancer in patients who have had cancer of the head or neck. Radiosensitizers Radiosensitizers are drugs that make tumor cells more sensitive to radiation therapy. Combining radiation therapy with radiosensitizers may kill more tumor cells. Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials. Follow-up tests may be needed. Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups. Treatment Options by Stage Stage I Laryngeal Cancer Treatment of stage I laryngeal cancer depends on where cancer is found in the larynx. If cancer is in the supraglottis, treatment may include the following: - Radiation therapy. - Supraglottic laryngectomy. If cancer is in the glottis, treatment may include the following: - Radiation therapy. - Cordectomy. - Partial laryngectomy, hemilaryngectomy, or total laryngectomy. - Laser surgery. If cancer is in the subglottis, treatment may include the following: - Radiation therapy with or without surgery. - Surgery alone. Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage I laryngeal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Stage II Laryngeal Cancer Treatment of stage II laryngeal cancer depends on where cancer is found in the larynx. If cancer is in the supraglottis, treatment may include the following: - Radiation therapy - Supraglottic laryngectomy or total laryngectomy with or without radiation therapy. - A clinical trial of radiation therapy. - A clinical trial of chemoprevention. If cancer is in the glottis, treatment may include the following: - Radiation therapy. - Partial laryngectomy, hemilaryngectomy, or total laryngectomy. - Laser surgery. - A clinical trial of radiation therapy. - A clinical trial of chemoprevention. If cancer is in the subglottis, treatment may include the following: - Radiation therapy with or without surgery. - Surgery alone. - A clinical trial of radiation therapy. - A clinical trial of chemoprevention. Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage II laryngeal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Stage III Laryngeal Cancer Treatment of stage III laryngeal cancer depends on where cancer is found in the larynx. If cancer is in the supraglottis or glottis, treatment may include the following: - Chemotherapy and radiation therapy given together. - Chemotherapy followed by chemotherapy and radiation therapy given together. Laryngectomy may be done if cancer remains. - Radiation therapy for patients who cannot be treated with chemotherapy and surgery.For tumors that do not respond to radiation, total laryngectomy may be done. - Surgery, which may be followed by radiation therapy. - A clinical trial of radiation therapy. - A clinical trial of chemotherapy, radiosensitizers, or radiation therapy. - A clinical trial of chemoprevention. If cancer is in the subglottis, treatment may include the following: - Laryngectomy plus total thyroidectomy and removal of lymph nodes in the throat, usually followed by radiation therapy. - Radiation therapy with or without surgery. - A clinical trial of chemotherapy, radiosensitizers, or radiation therapy. - A clinical trial of chemoprevention. Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage III laryngeal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Stage IV Laryngeal Cancer Treatment of stage IV laryngeal cancer depends on where cancer is found in the larynx. If cancer is in the supraglottis or glottis, treatment may include the following: - Chemotherapy and radiation therapy given together. - Chemotherapy followed by chemotherapy and radiation therapy given together. Laryngectomy may be done if cancer remains. - Radiation therapy for patients who cannot be treated with chemotherapy and surgery. For tumors that do not respond to radiation, total laryngectomy may be done. - Surgery followed by radiation therapy. Chemotherapy may be given with the radiation therapy. - A clinical trial of radiation therapy. - A clinical trial of chemotherapy, radiosensitizers, or radiation therapy. - A clinical trial of chemoprevention. If cancer is in the subglottis, treatment may include the following: - Laryngectomy plus total thyroidectomy and removal of lymph nodes in the throat, usually with radiation therapy. - Radiation therapy. - A clinical trial of radiation therapy. - A clinical trial of chemotherapy, radiosensitizers, or radiation therapy. - A clinical trial of chemoprevention. Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage IV laryngeal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website.