Treatment

Types of treatment

Radiotherapy, surgery and chemotherapy may be used alone or in combination to treat cancer of the larynx.

Radiotherapy is the most common treatment and will cure most people with small tumours.

With larger tumours it is not so likely that radiotherapy will cure the cancer. For these tumours it may be necessary to remove part or all of the larynx (laryngectomy) with surgery.

Chemotherapy may be used before or during radiotherapy to try to shrink the tumour and make the radiotherapy more likely to cure the cancer. This treatment aims to avoid having to remove the larynx, to allow the person to keep their voice.

Chemotherapy may also be used if the cancer has spread beyond the larynx.

If you have any questions about your treatment, don’t be afraid to ask your doctor or the nurses looking after you. It often helps to make a list of questions you want to ask. It can also be supportive to take a close friend or relative with you to the discussion.

A team of doctors will look after you.  They will take into account you age, general health, and the type, stage and grade of your cancer to plan the best treatment for you.

Some people find it reassuring to have another medical opinion to help them decide about their treatment. Most doctors will be pleased to refer you to another specialist for a second opinion if you feel that this will be helpful.

If you have cancer of the larynx, your treatment is more likely to be successful if you do not smoke. Giving up smoking can be very difficult, especially at times of stress, but several organisations can help you. Your GP or cancer specialist can also give you advice.

Giving your consent

Before you have any treatment your doctor will explain the aims of the treatment to you. You will usually be asked to sign a form saying that you give your permission (consent) for the hospital staff to give you the treatment. No treatment can be given without your consent. Before you are asked to sign the form you should have been given full information about:

• the type and extent of the treatment you are advised to have
• the advantages and disadvantages of the treatment
• any possible alternative treatments that may be available
• any significant risks or side effects of the treatment.

If you don’t understand what you have been told, let the staff know straight away so that they can explain again. Some cancer treatments are very complex, so it is not unusual for people to need to have the information repeated.

People often feel that the hospital staff are too busy to answer their questions, but it is important that you know how the treatment is likely to affect you. The staff should be willing to make time for you to ask questions.

You can always ask for more time to decide about the treatment, if you feel that you can’t make a decision when it is first explained to you. You are also free to choose not to have the treatment, and the staff can explain what may happen if you do not have it. It is essential to tell a doctor, or the nurse in charge, immediately so that they can record your decision in your medical notes. You do not have to give a reason for not wanting to have treatment, but it is helpful to let the staff know your concerns so that they can give you the best advice.

The benefits and disadvantages of treatment

Many people are frightened at the idea of having cancer treatments, because of the side effects that can occur. Some people ask what would happen if they did not have any treatment.

Although cancer treatments can cause side effects, these can usually be controlled with medicines.

Treatment can be given for different reasons and the potential benefits will vary depending upon the individual situation. In people with early-stage laryngeal cancer, radiotherapy or surgery may be used with the aim of curing the cancer.

If the cancer is at a more advanced stage, or has come back after treatment, the treatment may only be able to control it. This can lead to an improvement in symptoms and a better quality of life. However, for some people in this situation the treatment will have no effect upon the cancer and they will get the side effects without any of the benefit.

If you have been offered treatment that aims to cure your cancer, deciding whether to accept the treatment may not be difficult. However, if a cure is not possible and the treatment is being given to control the cancer for a period of time, it may be more difficult to decide whether to go ahead.

Making decisions about treatment in these circumstances is always difficult. You may need to discuss in detail with your doctor whether you wish to have treatment. If you choose not to, you can still be given supportive (palliative) care, with medicines to control any symptoms.