Laryngeal cancer medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Faizan Sheraz, M.D. [2]

Overview

The optimal therapy for laryngeal cancer depends on the stage at the time of diagnosis.

Medical Therapy

The optimal therapy for laryngeal cancer depends on the stage at the time of diagnosis. Treatment according to stages is as follows:

Stage	Treatment
Stage 1	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
Stage 2	If cancer is in the Supraglottis, treatment may include the following: Radiation therapy Supraglottic laryngectomy or total laryngectomy with or without radiation therapy 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
Stage 3	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
Stage 4	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

Supportive Treatment

Many patients also need swallowing rehabilitation after treatment to help them adjust to the changes in the structure of the throat.

Radiation therapy

There are two types of radiation therapy

• External beam radiation therapy
• Internal radiation therapy
• Radiation therapy may be helpful in patients who have stopped smoking before beginning treatment
• External radiation therapy to the thyroid or the pituitary gland may alter thyroid gland functioning
• Hyperfractionated radiation therapy and new types of radiation therapy are being studied in the treatment of laryngeal cancer

References

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