Resources We Trust Mayo Clinic: Throat Cancer: Diagnosis and TreatmentCleveland Clinic: How to Get Your Voice Back After Laryngeal Cancer SurgeryAmerican Cancer Society: Surgery for Laryngeal and Hypopharyngeal CancersNational Cancer Institute: Laryngeal Cancer Treatment (PDQ®)–Patient VersionAmerican Speech-Language-Hearing Association: Laryngeal Cancer
Treatment Options That May Save Your Voice Treatment Options For earlier stage cancers, a cure may be possible without the need to completely remove your larynx or voice box. When treating throat cancer with voice preservation in mind, you have several options, including robotic and laser surgeries, traditional open surgery, radiation, and chemotherapy .e60dc2a1-f33c-4a05-9b50-8e3e8e5976296276084a-3d9a-42bf-b9c1-e5ade9fb261a Transoral Robotic Surgery (TORS) To perform transoral robotic surgery (TORS), your surgeon removes the tumor through your mouth using specialized miniature tools that they control through a computer.e60dc2a1-f33c-4a05-9b50-8e3e8e5976294912905a-e98c-45c5-97f8-3a56fa546857 This allows them to see difficult-to-reach areas up close and remove cancer with precision, Mur says. After a TORS procedure, people typically experience a shorter hospital stay and faster recovery than with open surgery, Mur adds. Research shows this surgery also leads to better swallowing ability and fewer complications afterward.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c91facfc-a027-441d-a33e-4a538f145887 Your care team will assess your tumor and your overall health to decide if TORS is a good option for you. “The primary limitation is that it is not appropriate for all tumor sizes or locations,” says Mur, adding that not all surgical centers have access to robotic-trained surgical teams. Laser Microsurgery During laser microsurgery, a surgeon places a long, thin tube called an endoscope into your mouth until the end rests close to your tumor.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296276084a-3d9a-42bf-b9c1-e5ade9fb261a This tube contains a camera and light, so your doctor can see the tumor and remove it with a precise laser beam.e60dc2a1-f33c-4a05-9b50-8e3e8e597629dc8ca129-4cb0-4267-a7f7-b0cbfca49e7e Like TORS, laser microsurgery offers a faster recovery time than open surgery.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293019871a-cc64-478f-ba21-19c01ef275ed Research also shows this surgery can increase survival compared with other types of treatment, like partial surgery and radiotherapy.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299b18c4c8-e84e-41f2-83fa-a1d35be68ecf “However, like TORS, it is best suited for earlier-stage disease, and outcomes are highly dependent on surgeon expertise,” says Mur. Some tumors are harder to see with laser microsurgery, which may limit how much can be removed.e60dc2a1-f33c-4a05-9b50-8e3e8e5976299b18c4c8-e84e-41f2-83fa-a1d35be68ecf Partial Laryngectomy When robotic and laser surgeries aren’t an option, your surgeon can still preserve your voice with a partial laryngectomy, or removing part of your throat.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296276084a-3d9a-42bf-b9c1-e5ade9fb261a “Those are open procedures, whereby we open the voice box, remove the affected cancer, and then typically reconstruct it with a whole variety of techniques,” Lamarre says. Depending on your tumor location and type, your surgeon may remove part of your throat above your vocal cords, or just one cord (one side). These variations can help you keep the ability to speak after surgery.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296276084a-3d9a-42bf-b9c1-e5ade9fb261a With any surgery type, some people need a temporary tracheostomy — a tube that goes through the front of your neck into your windpipe. This tube helps you breathe while your throat heals.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293748f3bc-e7d1-4743-a572-eefe86228627 Radiation and Chemotherapy For some tumors, radiation alone or radiation plus chemotherapy can replace surgery by eradicating tumors, offering even better protection for your voice.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293748f3bc-e7d1-4743-a572-eefe86228627 “Radiation therapy can treat throat cancer while preserving anatomical structures, making it an excellent option for certain patients,” Mur says. For throat cancer, chemotherapy works best alongside radiation (a treatment called chemoradiation).e60dc2a1-f33c-4a05-9b50-8e3e8e5976298d97336b-f89e-4fa0-91b5-88aefc95e41e Chemotherapy serves two functions: It makes your tumor more sensitive to radiation, and it can help manage any cancer that has spread to other organs, says Lamarre. Chemotherapy and radiation can come with side effects like dry mouth, trouble swallowing, fatigue, nausea, and immune system depression.e60dc2a1-f33c-4a05-9b50-8e3e8e597629c83896fd-439a-4047-a418-81108afbebd1e60dc2a1-f33c-4a05-9b50-8e3e8e597629bb23c19e-2324-4e23-8d4e-4e49fcd4b1a8 But your care team will monitor these and provide options to ease discomfort. While chemoradiation may allow you to keep the voice box, the voice quality and swallowing function may or may not be the same.e60dc2a1-f33c-4a05-9b50-8e3e8e597629805cdc4a-4282-4633-9984-3a411962e444
The Takeaway Throat cancer treatment can cause vocal changes, but for some earlier-stage tumors, you can choose treatments that preserve your voice and still cure the cancer. Organ-preserving treatment options include transoral robotic surgery, laser microsurgery, laryngectomy, and a combination of radiation and chemotherapy. Even when organ preservation is possible, your voice may or may not function the same again. Your cancer care team will help you choose the best throat cancer treatment option based on your tumor type, size, and spread, as well as other health conditions that may affect recovery.
What Is Organ-Sparing Therapy? Organ-Sparing Therapy Decades ago, treatment for most laryngeal cancers involved removing part or all of that section of the throat.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e2a3ce85-9c29-4912-a149-d470a9dc4eb4 But this approach often left people with trouble swallowing and speaking afterward.e60dc2a1-f33c-4a05-9b50-8e3e8e597629404dcf3e-487f-4435-965a-8c89ef73f838 Over the past decades, organ-sparing therapy has been developed, still providing a cure without the need for a radical surgery. Organ sparing therapy consists of treatment with less-invasive surgery or radiation with or without chemotherapy. While the primary focus is still complete elimination of cancer, current techniques provide organ-sparing therapy — treatment that leaves some or all of your voice intact.e60dc2a1-f33c-4a05-9b50-8e3e8e597629404dcf3e-487f-4435-965a-8c89ef73f838 “Modern surgical approaches have transformed how we treat throat cancer,” says Taha Mur, MD , a head and neck surgical oncologist and reconstructive surgeon at Rutgers Cancer Institute and RWJBarnabas Health in New Brunswick, New Jersey. These techniques allow surgeons to access and remove tumors through the mouth — without external incisions — which means surgeons can often preserve the larynx and its critical functions: breathing, swallowing, and voice, says Dr. Mur. Organ-sparing doesn’t just mean protecting your vocal cords — your throat has all kinds of structures that help you speak, says Dr. Lamarre, like false vocal folds and the epiglottis. “And so, when we talk about surgery, particularly for laryngeal cancer, we have to factor in all of those [areas],” he says.
Surgery to remove laryngeal (throat) cancers carries a risk of voice changes, but for many tumors, organ-preserving treatments can protect your ability to speak. To decide on the best treatment path for both getting rid of the tumor and protecting your vocal cords, your cancer care team will look at the type, size, and stage of your cancer, plus other health conditions you have.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a95dffd9-35cc-42c9-b349-0141e93236d6 With some tumors, surgeons can offer laryngeal conservation surgery, says Eric Lamarre, MD , a head and neck surgical oncologist at Cleveland Clinic in Ohio. “That means you take out a portion of the voice box, yet maintain much of the function,” he explains. Even if you can’t speak or your voice is different after surgery, you have options. Surgeons can reconstruct the area that creates sound, and speech therapists can help you learn how to use your new voice.e60dc2a1-f33c-4a05-9b50-8e3e8e59762938b57656-5ade-4240-9517-3eb5f136a013
Which Throat Cancer Treatment Is Best? Which Is Best The best treatment for throat cancer depends on several factors. “Advances in both surgery and radiation have meaningfully expanded what’s possible, but the right choice always depends on the individual, the tumor’s location and stage, overall health, and what matters most to the patient in terms of quality of life,” says Mur. In his practice, Lamarre uses the National Comprehensive Cancer Network (NCCN) guidelines to pinpoint the best options for curing the cancer, then looks at which one may help preserve the voice and ability to swallow. “At the end of the day, you use those guidelines to inform your clinical decision-making when you’re sitting in the office with the patient,” says Lamarre.
Questions to Ask Your Doctor Questions to Ask Your Doctor Throat cancer treatment options can get complicated, so it may help to go to your appointment prepared with a list of questions. Consider asking your doctor the following questions.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a859b7d6-3618-4d8d-b5c3-a87108116cd9 What treatment will work best for my cancer? What is the goal of this treatment: cure, or controlling the cancer? Which option provides me with the best chance of cure? If chemotherapy and radiation are being considered, can you recommend a radiation oncologist and a medical oncologist I can also meet with? How will my treatment affect how I breathe, swallow, and speak? Which option provides me with the best chance of long-term function (swallowing and speech)? What are the short- and long-term side effects I should prepare for? Will I need a tracheostomy after surgery, and for how long? Is this treatment choice being decided by a multidisciplinary tumor board? Am I a candidate for a minimally invasive surgical approach? What does recovery look like, and what support will I have? “An informed patient is an empowered patient,” says Mur. “There are rarely one-size-fits-all answers in throat cancer treatment, and your care team should welcome these conversations.”