Throat Cancer Treatment, Voice Box Cancer Treatment

When detected early, these types of cancer are highly curable -- often with either surgery or radiation therapy alone. More advanced cancers are generally treated with various combinations of treatment options.

Radiation Therapy
MRI and CT imaging technology pinpoints the precise location of the tumor, and then beams of high-energy X-rays destroy the cancer cells. This targeted radiation treatment, used before and/or after surgery, minimizes damage to surrounding healthy tissue.

Surgery
Removes the tumor and surrounding tissues. Nearby lymph nodes may also need to be removed. Every surgery is different depending on the location and size of the tumor and whether it has spread. Our surgeons use a wide range of surgical approaches, including laser surgery, which can reduce damage to surrounding structures. Our doctors also employ robotic tools, which increase precision and allow them to remove hard-to-reach tumors.

Laryngectomy Surgery
In some cases, the entire voice box, including the vocal cords, may need to be removed. This is called a total laryngectomy. 

Before surgery, your doctor will discuss the nature of your surgery, including how long your hospital stay should be, and whether you need any additional treatments besides surgery. A speech-language pathologist will educate you about what changes to expect with breathing and swallowing. They will also review communication options in detail, which may include:

• Speaking with a handheld artificial (electronic) larynx.
• Learning to speak with esophageal speech.
• Using tracheo-esophageal speech via a tracheo-esophageal puncture (TEP) procedure. This is the gold-standard of post-laryngectomy communication. Your ENT surgeon may perform TEP surgery at the same time as your laryngectomy, or it can be done later. The TEP surgery or “puncture” creates a small opening in the wall between your trachea and esophagus. Then a small voice prosthesis device is placed, which allows air to flow from your lungs into your esophagus. This air allows the esophagus to vibrate and make sound. You’ll only need to undergo surgery once, but the voice prosthesis must be changed every few months.

After surgery, your doctor will meet with you periodically to evaluate your healing and determine when it is safe for you to eat and drink.

Chemotherapy
Medicines that kill cancer cells or stop them from growing are used to treat throat and voice box cancers, both before and after surgery. Our medical oncologists consider your specific type of tumor and assess the risks versus benefits before recommending chemotherapy as part of your personalized treatment plan. We routinely combine the newest chemotherapy drugs with standard drug regimens to achieve a better response, fewer side effects, and improved quality of life.

Immunotherapy
A relatively new treatment option, immunotherapy takes advantage of a person's own immune system to help kill cancer cells. There are several FDA-approved options that can be delivered via oral medications or IV infusion. Depending on each person's cancer type and stage, treatment history, and overall health, immunotherapy may be prescribed alone or in combination with another type of therapy, such as chemotherapy.

Targeted Therapy
Another newer form of treatment, targeted therapy can help stop or slow the growth or spread of cancer by targeting specific aspects of your tumor's biology. Targeted therapies may be delivered in pill form or through onsite IV infusion and are often used in combination with another treatment like chemotherapy or radiation.

Because throat and voice box cancers can cause problems with speaking, breathing, and swallowing, we partner with speech, physical, and occupational therapists who can help you improve those functions. 

Advanced cancers may require more extensive surgeries. Some patients may require an additional graft or flap reconstructive surgery to repair the area where tissue was removed. Our expert team of sub-specialized head and neck reconstructive surgeons will coordinate this complex care with your surgical team, often at the same time as your cancer surgery.

Nationally Ranked Cancer Program
As a National Cancer Institute-designated Comprehensive Cancer Center, we are recognized for exploring new treatment opportunities through ongoing clinical trials. We offer you the latest research discoveries before they are available elsewhere. In addition, since 1973, Duke has been a member of the National Comprehensive Cancer Network (NCCN), which sets industry standards for safety and quality.

Techniques to Preserve Function
Our physicians are specially trained in surgical and medical techniques that preserve the structure of your voice box as well as your ability to speak.

A Comprehensive Team
Our specialists -- otolaryngologists who are experts in head and neck surgery; medical, surgical, and radiation oncologists; radiologists; dentists; reconstructive surgeons; and oral surgeons -- work together to ensure you receive the best possible care. Specially trained nurses, occupational therapists, voice therapists, and speech pathologists help you maintain or regain your ability to talk, eat, swallow, and perform other daily functions. Social workers, psychologists, and palliative care experts help you cope with the emotional and psychological effects often associated with cancer. Physical therapists and cancer nutritionists help you maintain your strength and stamina through exercise and good eating habits.

Surgical Expertise
Our surgical specialists are expertly equipped to remove tumors in the head and neck, and use a variety of tools, including laser surgery and robotic surgery. These advanced techniques and tools increase surgical precision and remove hard-to-reach tumors in the throat and voice box. They also require smaller incisions, which shortens patient recovery time.