Radiation Therapy for Laryngeal Cancer

Radiation therapy is sometimes combined with chemotherapy, the use of drugs to destroy cancer cells throughout the body. This approach is called chemoradiation. Chemotherapy can make cancer cells more sensitive to radiation therapy, destroying more of the tumor. Doctors prescribe chemoradiation to manage advanced laryngeal cancer and to help preserve the function of the vocal cords.

For some advanced cancers, doctors combine surgery and radiation therapy, with or without chemotherapy. Radiation therapy is given after surgery to help destroy any remaining cancer cells.

Radiation therapy may also be used to help relieve symptoms when a person has laryngeal cancer that cannot be cured.

Radiation oncologists use CT scans in conjunction with computer software to create personalized treatment plans.

Using information from the CT scans, the software creates three-dimensional images of the tumor within the voice box and the lymph nodes in the neck. The software also identifies nearby structures, such as the pharyngeal muscles, which enable you to swallow; the upper and lower jawbones; salivary glands, which produce saliva to help break down food; the spinal cord; nerves important for arm function; and the thyroid gland, which helps regulate metabolism.

These images guide doctors in delivering highly targeted radiation doses to the tumor while minimizing the dose to healthy tissue.

Doctors at NYU Langone usually use intensity modulated radiation therapy to manage laryngeal cancer. With this approach, a machine called a linear accelerator rotates around you as you lie on a treatment table. The machine delivers radiation beams from various directions. These beams are divided into many small, computer-controlled doses of different strengths.

Tailored to the size, shape, and location of the laryngeal tumor, these “minibeams” deliver high doses of radiation to the cancer and avoid nearby healthy structures. Treatment is delivered in fractions—typically once daily, five days a week, for six to seven weeks.

Daily use of a special scan, called a cone-beam CT, ensures that the radiation therapy is delivered as planned. During treatment, the tumor shrinks and you may lose weight, changing the shape of the body. As a result, a radiation oncologist may reposition you on the treatment table and adjust the radiation beams to match the precise location of the tumor.

The side effects of radiation therapy for laryngeal cancer may include a sore and inflamed throat, dry mouth, excess mucus in the mouth and throat, trouble swallowing, voice changes, fatigue, nausea, and lymphedema, a buildup of fluid in the face and neck that causes swelling. This treatment may also cause temporary tightening of your face and neck muscles.

To ease discomfort, NYU Langone doctors prescribe medication and can refer you to speech and swallowing therapists, nutritionists, pain specialists, social workers, and specialists in integrative health services.

Rehabilitation is also available to help you manage lymphedema and any muscle tightness you may be experiencing.