How Is it Treated?

The treatment for your cancer depends on your overall physical health, the type and stage of your cancer, the probability of recovery, and the impact of treatment on your ability to function. Some of the treatment options are:

Surgery

For cancer of the larynx, either part of or the entire larynx needs to be removed. The most frequent operations for this form of cancer are:

• Partial laryngectomy. Removal of the tumor and part of the larynx. The amount removed is the smallest possible to rid the area of cancer.

• Total laryngectomy. The entire larynx is removed, and a hole, called a stoma, is cut in the neck for breathing purposes. Without a voice box, speaking must be done in one of five ways:
  1. Swallowing air to create a belching speech.
  2. Inserting a valve to allow air into the mouth to produce sounds.
  3. Using a horn to produce a mechanical voice.
  4. An electronic larynx that is pressed against the neck and using the mouth and tongue to form words.
  5. Some patients may be candidates for an artificial larynx.

• Neck dissection. An additional procedure used when the tumor has spread beyond the larynx to lymph glands or tissues in the area.

In cases of oral cancers, other operations may be performed to remove the tumors from the lip, tongue, cheek, back of the nose or throat, or the jawbone itself. The nature of the surgery often involves some alterations in appearance, voice, swallowing or breathing capacity. These changes are usually temporary.

• Tumor resection. This procedure involves removing the whole tumor and some of the tissue surrounding it. Depending on the location and size of the tumor, this procedure is done through the mouth, through an incision in the neck, or by splitting the jawbone to provide access - a procedure known as mandibulotomy.

• Full or partial mandible resection. If your tumor cannot be easily removed or has grown into the jawbone, this operation involves removing part of or the entire jawbone.

• Maxillectomy. When cancer on the roof of the mouth has spread to the bone, the cancer and bone are removed. They are replaced with a prosthesis, an artificial device.

• Mohs' surgery. The procedure involves removing and examining small slices of tissue under a microscope, one at a time, until all the cancer has been removed.

• Neck dissection. If oral cancer spreads to the lymph nodes of the neck, they must be removed.

Since these operations are specifically designed to cure cancer, it is very important to discuss the type and nature of the surgery, and the recovery required with regard to eating, breathing, speech and appearance. There are very extensive resources available for your support and recovery after treatment for head and neck cancer.

Medical

Both radiation therapy (RT) and chemotherapy can be used either separately or together in the treatment of head and neck cancers.

• Radiation therapy uses high-energy particles to destroy or slow cancer cells. It is commonly used to treat small cancers, or as a follow-up to surgery to kill any remaining cancer cells that could not be removed. Radiation therapy for laryngeal cancer most often involves focusing a beam of radiation from outside the body, known as external beam radiation. There is also a form of internal RT, where small, radioactive seeds or pellets are placed in the area of the tumor or metastases to kill remaining cells. Usually, internal RT requires a short hospital stay to make sure radiation levels are low enough for discharge from the hospital.

• Chemotherapy. The drugs used for chemotherapy are either injected or taken by mouth, absorbed into your bloodstream and distributed all over your body. Cancer cells are most sensitive, but chemotherapy can also affect the rapidly growing or dividing normal cells of your body. Examples are the cells lining your gut and those in hair follicles. That is why digestive side effects are most common, along with hair loss. Chemotherapy may be a treatment option for you, either alone or in combination with radiation after surgery.

More on Cancers of Head and Neck

In the Encyclopedia:

This article was reviewed and updated June 2007.