Standard treatments for larynx cancer are radiation therapy, chemotherapy, and/or surgery, often in combination. At Mount Sinai, our goal is to preserve the larynx whenever possible.

Surgical options include:

• Cordectomy. Surgery to remove the vocal cords only.
• Partial laryngectomy: Surgery to remove part of the larynx (voice box). A partial laryngectomy helps retain the patient's ability to speak.
• 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.
• Laser surgery. A surgical procedure that uses a laser beam (a narrow beam of intense light) as a knife to make bloodless cuts in tissue or to remove a surface lesion, such as a tumor.

Even if your doctor removes all the cancer that could be seen at the time of surgery, you might be given chemotherapy or radiation therapy after surgery to kill any cancer cells that remain.

Reconstruction

Reconstructive surgery may be necessary in certain cases of advanced cancer when a large portion or all of the pharynx (lining of the throat) has been removed. To re-line the area and provide for a functional swallowing passageway, a number of reconstructive options exist, possibly using tissue from the chest wall, thigh, or forearm. Please visit our Department of Plastic and Reconstructive Surgery for more information.

Rehabilitation

After nonsurgical treatment, a great deal of effort is usually necessary to regain normal swallowing, due to the side effects of radiation and chemotherapy. A speech language pathologist will play a critical role in helping you resume normal swallowing function and helping you with any speech problems.

If you have had a total laryngectomy, you will not be able to speak like you did before. But there are ways you can talk.. Learning to talk will take time and effort. You will need to see a speech therapist — a person trained to help individuals who have lost their vocal cords.

One way to speak is through a tracheoesophageal puncture (TEP). TEP can be performed either during your first surgery or later on. TEP creates a connection between your windpipe and your food pipe through a small, artificially created hole (stoma) in your throat. A valve placed in this hole enables you to force air from your lungs into your mouth. You cover the stoma with your finger to force air out of your mouth.

If you cannot have TEP for some reason, or while you are learning to use your TEP voice, you might use an electrical device to produce speech. These use batteries and are placed in the corner of your mouth or against your neck. When you press a button, the device makes a vibrating sound. By moving your mouth and tongue, you can form words out of this sound.

Follow-up

Because cancers of the larynx can come back or a new cancer can develop, you will need to be followed closely after treatment. Because the cancer is most likely to come back within the first two years, you will likely have head and neck exams, including a scope exam, about every other month during the first year after treatment, and about four times a year during your second year. Follow-up may then be spread out to three, six, and 12 months if there is no sign of cancer. Your doctor will use X-rays, CT scans, or PET-CT scans to follow your progress.

Report any new symptoms to your doctor right away, as they may indicate the return of your cancer. The earlier your cancer is found, the better your chances of successful treatment.

Our larynx cancer specialists function as part of The Tisch Cancer Institute — a multi-disciplinary research and clinical care institution whose membership encompasses all Mount Sinai physicians and researchers whose work involves cancer. Call us today to make an appointment. We care, and we can make a difference.