Laryngeal Treatment Options
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. The way the radiation therapy is given depends on the type of tumor and where it is in the body. 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.
Surgery 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 tracheotomy.
- Thyroidectomy - The removal of all or part of the thyroid gland.
- Laser Surgery - A surgical procedure that uses a laser beam 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 is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them 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. Follow-up care after treatment is important. Even when the cancer seems to be gone, it can return if cancer cells remain in the body after treatment. The doctor monitors the recovery of the person treated and checks for recurrence through lab tests, x-rays, CT scans, and other tests.
It helps to learn more about the side effects from your treatment(s) before you begin, so you will know what to expect. When you know more, you can work with your health care team to manage your quality of life during and after treatment.
There are effective and readily available medications to address traditional side effects from cancer treatment (such as nausea, diarrhea, constipation and mouth sores.) Also, as newer 'targeted therapies' become available, they tend to leave people with fewer traditional side effects.
Keep in mind that everyone reacts differently to treatment and experiences side effects differently. There are coping mechanisms and strategies that can help.
Laryngeal Treatment Side Effects
A Laryngectomy can lead to the development of a fistula (an abnormal opening between two areas that are not normally connected) or narrowing of the throat (a pharyngeal stricture). If there is damage to the thyroid gland, it can lead to hypothyroidism (a patient feels very tired and sluggish.) If there is damage to the parathyroid gland, it can lead to issues of low calcium levels, which can cause muscle spasms and irregular heart beat. A very rare, but serious complication of neck surgery is rupture of the carotid artery (the large artery in the neck).
A partial laryngectomy can lead to paralysis of the remaining vocal cord, dysphagia (issues swallowing) and the narrowing of the larynx (laryngeal stenosis).
A possible side effect of radiation is that healthy brain tissue may also be damaged. A patient may lose function if large areas of the brain receive radiation. Effects can include memory loss, personality changes, and trouble concentrating. Some patients may become irritable and fatigued during the course of radiation therapy. Nausea, vomiting, and headaches are also possible but are uncommon.
Chemotherapy has different side effects depending on the type and dose of drugs given and the length of time they are taken. These side effects can include hair loss, mouth sores, loss of appetite, nausea and vomiting, diarrhea, increased chance of infections (due to low white blood cell counts), easy bruising or bleeding (due to low blood platelet counts) and fatigue (due to low red blood cell counts.)