Treatment options can be considered include radiotherapy, surgery, and chemotherapy. The treatment advised for each case depends on various factors; the exact site of the primary tumour in the larynx, the stage of the cancer (how large the cancer is and whether it has spread), the grade of the cancerous cells, and your general health.
A patient should have a discussion with a specialist who knows about the patient’s health condition. The specialist will be able to give the pros and cons, likely success rate, possible side-effects, and other details about the possible treatment options for your type of cancer.
Some treatments are standard 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.
Some treatments are standard 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.
Generally, there are three types of treatment:
1. Surgery
- Tumours which are larger tend to require surgery which is aimed at curing the cancer by removing it all. Surgery normally is used to relieve symptoms if the cancer is at an advanced stage (palliative surgery). The operations are all done whilst you are asleep under a general anaesthetic.
- The type of surgery required depends on size of the tumour, the exact site of the tumour in the larynx, and whether the cancer has spread to nearby structures or lymph glands.
i. Laryngopharyngectomy: Surgery to remove the entire larynx (voice box) and part of the pharynx (throat). To be able to breathe after the operation, the top part of the trachea is attached to the front of the neck. Then the patient will have a permanent hole (stoma) in the front of the neck. The vocal cords will have been removed so the patient will not be able to speak normally again.ii. Partial laryngopharyngectomy: Surgery to remove part of the larynx and part of the pharynx. A partial laryngopharyngectomy prevents loss of the voice. A cut is made in the front of the neck to get at the larynx. If only part of the larynx is removed you should not need a permanent stoma ('hole in the neck') to breathe, and speech may be preserved. A temporary stoma may be requiredwhilst the wound is healing.iii. Endoscopic resection: Endoscopic are passed down the inside of the larynx which can cut out a tumour. Sometimes a laser is used to 'burn' out the tumour. This technique does not involve a cut from the outside. It is only suitable for tumours that are small and still confined to the inner lining of the larynx.
2. Chemotherapy
- 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
- 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 which are regional chemotherapy. The way the chemotherapy is given depends on the type and stage of the cancer being treated.
- Chemotherapy may be used to shrink the tumor before surgery or radiation therapy. This is called neoadjuvant chemotherapy.
3. Cetuximab
- A new treatment for laryngeal cancer.
- This is a type of monoclonal antibody. It can recognise and bind to specific proteins (receptors) that are found in the cancer cells. These proteins are epidermal growth factor receptors (EGFR) which stimulate the cancer cell to grow and divide.
- Cetuximab locks onto the EGFR and can prevent the cancer cells from growing and dividing.
- This treatment is usually given at the same time as radiotherapy in people who are unable to have chemotherapy.
- After hypopharyngeal cancer has been diagnosed, tests are done to find out whether the cancer cells have spread within the hypopharynx or to other parts of the body.
- Staging can be used to check if cancer has spread within the hypopharynx or to other parts of the body. The information accumulated from the staging process determines the stage of the disease which is important to be known as the stage of the disease will determine the type of treatment required. The results of some of the tests used to diagnose hypopharyngeal cancer are often also used to stage the disease.
Clinical test
- Some patients may take part in a clinical trial which may be the best treatment choice.
- Clinical trials are part of the cancer research process which is done to find out if new cancer treatments are safe and effective or better than the standard treatment.
- Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment and can help to 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.
