In this section: Laryngeal Cancer

larynGeal Cancer 



What do we mean by 'Laryngeal Cancer'? It is a type of Throat Cancer that is also known as voice box cancer. If it's not the cancer type you're looking for, please explore the information about other types of Throat Cancers or other types of Head and Neck Cancers.

All the information in this section is available in a PDF.
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1. Treatment options for Laryngeal Cancer

Following a diagnosis of Laryngeal Cancer, your cancer care team will discuss the treatment options including the possibility of participating in a clinical trial that is suitable for you. This is also a good time to consider if you would like a second opinion.

The most suitable treatment of Laryngeal Cancer depends on many things including:

  • size and location of the cancer

  • whether the cancer has spread

  • personal factors (e.g. age, general health and treatment history)

  • types of treatment available (and whether any clinical trials are available) 

  • ​your preferences for treatment

There are two broad categories of treatment for Laryngeal Cancers; surgery and radiation therapyChemotherapy is sometimes used at same time with radiation therapy (called concurrent chemotherapy).

2. Surgery for Laryngeal Cancer

Surgery is generally used for advanced stage Laryngeal Cancer. Your doctor may consider removing the cancer using a robot (Transoral Robotic Surgery, or TORS). TORS may be performed by a head and neck cancer surgeon, which is carried out through the mouth without any external cuts. 

How can I prepare for the surgery?

Your doctor will explain details of the surgery, general risks and side effects of surgery. Ask your doctor if you have questions. They may recommend:

  • stopping blood thinners (e.g. aspirin) before surgery to reduce the risk of bleeding

  • special stockings to reduce the risk of blood clots

  • early mobilisation (i.e. not staying in bed) to reduce the risk of blood clots and chest infection

  • antibiotics to lower the risk of wound infection.

If you smoke, it is important that you consider stopping smoking before starting treatment to help reduce the risk of infection and help you recover after your treatment.

The surgery options for early and advanced Laryngeal Cancers are:


Some advanced laryngeal cancers can be removed without any external cuts using a robotic system or by using laser surgery.

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A laryngectomy is the removal of all (total laryngectomy) or part of the larynx (partial laryngectomy).

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Partial laryngectomy is removal of part of your larynx. The larynx is the medical name for the voice box. 

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This is removal of part of the hypopharynx via an open neck approach. 

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This is the removal of all the larynx and pharynx. It is different to laryngectomy, where only the larynx (or part of it) is removed. 

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This involves removal of lymph nodes from the neck. This is important even when there is no sign of cancer in the lymph nodes on the scan, because there is a risk of microscopic cancer in the lymph glands of the neck.
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This may be considered if a large area of tissue is removed. This may involve taking tissue from another part of the body called a free flap repair. This operation is carried out by a surgeon who specialises in reconstructive surgery, your head and neck surgeon or another surgeon.
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A tracheostomy is used to create an opening in the trachea (windpipe) in the lower neck, where a tube is inserted to allow air to flow in and out, when you breathe. This is used as swelling after major head and neck surgery may affect your ability to breathe. The tracheostomy tube is usually removed within a week of surgery once normal breathing is possible.
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  • A gastrostomy tube (called a PEG tube) goes through the skin and the muscles of your abdominal wall into the stomach. Gastrostomy is recommended if feeding is needed for a medium to longer time (months or years).
  • A nasogastric tube goes through the nose down into the stomach. Nasogastric feeding is used for short time (days or weeks).
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Side effects of surgery

Treatment for laryngeal cancer may lead to a number of side effects . You may not experience all of the side effects. Speak with your doctor if you have any questions or concerns about treatment side effects.

3. Radiation Therapy for Laryngeal Cancer

The most common radiation therapy treatment for Laryngeal Cancer is called external beam radiation.  This type of radiation therapy applies radiation from outside the body.

Radiation therapy can be used in both the early and advanced stages of Laryngeal Cancer in the following ways:

Small field

This is frequently used in the definitive treatment (curative) of early (stage I or II) laryngeal cancer in an outpatient setting. This is when radiation therapy is targeted at the larynx alone. Treatments are usually given daily, for a period of 7 weeks.


This is a curative treatment option for patients with advanced stage Laryngeal Cancer. The aim of the therapy is to preserve the larynx and its function. It is another option to removing the voice box (total laryngectomy). Radiation therapy comprehensively treats the cancer of the voice box, its surrounding region, and the lymph nodes at both sides of the neck. Radiation therapy is typically delivered daily (but not on weekends) for 7 weeks and can be given as:

  • definitive radiation therapy alone; or

  • definitive radiation therapy with concurrent chemotherapy (adding chemotherapy to radiation therapy (chemoradiation) to make it more effective).


This is given after the surgical removal of the voice box and the lymph nodes (on both or either sides of the neck). It is used as an additional treatment to kill cancer cells that may not have been removed during surgery. It usually starts about 4 weeks after surgery to allow recovery from surgery. Radiation therapy treatment usually lasts for about 6 weeks. Sometimes chemotherapy is added to the adjuvant radiation therapy (chemoradiation) to make it more effective.


In cases where a cure is not possible, radiation therapy is used to relieve symptoms of advanced laryngeal cancer. Symptoms that may require palliative radiation therapy include pain, bleeding, breathing and swallowing difficulties.

How do I prepare for radiation therapy? 

You will meet with many members of the cancer care team, who will help you learn how to look after yourself through radiation therapy, recovery and long term follow-up. They will also talk to you about side effects and how to manage them. It may be helpful to write down questions as they come up, so you can ask anyone in your cancer care team when you see them.

 Radiation therapy mask-making and simulation 

  • Radiation therapy is a precise treatment. In order to make sure, that the cancer is covered by the treatment, you will need to be very still during the treatment, usually for about five minutes. A radiation therapy mask that is made to fit perfectly to your shape, will be put on you during each treatment to help the machine target where the cancer is.
  • You will have a planning CT scan (and sometimes other scans) with the mask on. Your radiation oncologist and radiation therapists will use these scans with all your other clinical information to develop a radiation therapy plan just for you (a personalised plan). Your plan will be checked by the radiation therapy and radiation oncology physics team before it is ready to be used for your treatment. This whole process can take approximately 2-3 weeks.

Teeth and mouth care

If you are having radiation therapy for advanced stage laryngeal cancer, dental extraction may be needed to remove any broken or infected teeth before radiation therapy. It is important to take out any broken or infected teeth before radiation therapy. Taking out unhealthy teeth after radiation therapy can cause problems with the jaw bone. 

Diet, nutrition and the role of your dietitian

Your cancer and its treatment can make it hard to eat and drink. Your doctor will recommend you see a dietitian to maximise your nutrition during treatment as well as while you are recovering. Sometime feeding tubes may be recommended depending on the area being treated and the dose of radiation therapy.
There are two common types of feeding tubes: 

  • Gastrostomy tube (sometimes called a PEG tube): this type of tube is inserted through your abdominal wall into your stomach, with part of the tube staying outside the stomach.  A syringe can be attached to the tube to give you food this way if needed. The tube is inserted using a camera through the mouth into the stomach (gastroscopy) or using a CT scanner to guide insertion directly through the skin. If a PEG tube is needed, your doctor will organise this before starting your radiation therapy

  • Nasogastric tube: this type of tube goes through the nose down into the stomach and is usually used for short periods (days or weeks). A nasogastric tube can be inserted at any time (before, during or after treatment).

Speech, voice and swallowing

Your cancer and its treatment can make swallowing and speech difficult. Your doctor will recommend you see a speech pathologist, who can help you with ways to manage swallowing and communication difficulties, during and after treatment. Your speech pathologist will also help with your voice rehabilitation during and after treatment. 

 There are many other aspects of supportive care that are available, ask your doctor if you have any specific needs.

Side effects

The side-effects of radiation therapy start around two weeks into treatment and progress through treatment to peak in the last week or just after treatment ends. The side effects start to improve 2-3 weeks after the end of treatment.

Side effects associated with radiation therapy depend on:
  • the dose of radiation therapy

  • the area being treated

  • whether or not chemotherapy is added to the radiation.

Each person responds to radiation therapy differently. Some people may experience a few side effects while others may not experience any at all. The following are some common side effects of radiation therapy.
  • tiredness

  • hoarse voice

  • skin irritation in the treated area e.g. redness, dryness and itching, weeping skin, scaling or sometimes skin breakdown (sores)

  • pain on swallowing or difficulty with swallowing

  • irritation in the throat progressing to sore throat requiring pain killers

  • dry mouth and throat (with advanced stage laryngeal cancer treatment).

Most side effects are short lived and may go away within 4–6 weeks of finishing radiation therapy. Some side effects may last for months after you finish radiation therapy and some may be permanent.

Uncommon side effects of radiation therapy for laryngeal cancer include aspiration (coughing and infection due to food/fluids trickling into your windpipe) and swelling in the airway causing obstruction and difficulty breathing. This can be relieved by the insertion of a temporary tracheostomy.  

Once your radiation therapy ends, you will continue to have follow-up appointments so that your doctor can check your recovery and monitor any side effects that you may have. If you've had advanced stage laryngeal cancer, your doctor may arrange for a PET scan about 12 weeks after finishing radiation therapy to make sure the cancer has completely gone. If the cancer doesn't go away after radiation therapy, or comes back again in the future, you may still be able to have salvage surgery (Total laryngectomy) to try to cure the cancer. 

Your doctor may recommend that you receive specific supportive care to help during your treatment and recovery.

To learn more about Radiation Therapy and to watch
a video of an Immobilisation Maks being made click here


4. Chemotherapy for Laryngeal Cancer

Chemotherapy works by destroying or damaging cancer cells. For laryngeal cancer, it is usually given into a vein through a needle with a cannula (tube) attached.

There are a number of ways that chemotherapy may be used to treat laryngeal cancer including: 


Sometimes chemotherapy is added to definitive radiation therapy (chemoradiation). It is usually used for advanced stage laryngeal cancers. This may be given once every 3 weeks or once a week throughout the duration of radiation therapy. The addition of chemotherapy makes the radiation more effective at killing cancer cells but also leads to increased side effects in most patients.


This is when chemotherapy is given after surgery in combination with radiation therapy (chemoradiation). This may be given once every 3 weeks or once a week throughout the duration of radiation therapy. The addition of chemotherapy makes the radiation more effective at killing cancer cells but also leads to increased side effects in most patients.


This is when chemotherapy is given before surgery or radiation therapy to help shrink large cancers and make them easier to remove or target with radiation therapy. This is not commonly used for laryngeal cancer.


This is used when the cancer is incurable. The cancer may be too large or has spread too much to be removed by surgery. Palliative chemotherapy helps to slow the growth of cancer and reduce symptoms. It is important to remember that palliative chemotherapy is not as intense as other types and is much less likely to have significant side effects.

Before you start treatment, your medical oncologist will choose one or more chemotherapy medications that will be best to treat the type of cancer you have. 

The chemotherapy medications your doctor chooses may depend on: 

  • whether the treatment is curative or palliative

  • when it is used

  • your medical history

    Side effects 

    The side effects of chemotherapy depend on the medication used and and how much you are given by your doctor (the dose). The most common medications used are called cisplatin, carboplatin and cetuximab. 

    Each person responds to chemotherapy differently. Some people may experience a few side effects while others may not experience any at all. The following are common side effects of chemotherapy: 
  • a feeling of wanting to vomit (nausea) or vomiting

  • more side effects of radiation, if you have chemotherapy at the same time as radiation

  • loss of feeling in the fingers and toes

  • kidney damage (caused by some medications)

  • hearing loss/thinning

  • ringing in the ears

  • rash

  • higher risk of infection (if the chemotherapy reduces the number of white cells in the blood)

Most of these side effects are short lived and may go away once you finish chemotherapy. Some side effects can take months or years to improve or may be permanent.

Once your treatments end, you will have regular follow-up appointments so that your doctor can check your recovery, make sure the cancer has not returned and monitor and treat any side effects that you may have.

Your doctor may recommend that you receive some specific supportive care to help during your recovery. 

All the information in this section is available in a PDF.
Download it here.
  • What is Laryngeal cancer?
  • What is the larynx
  • What does the larynx do?
  • What causes Laryngeal cancer?
  • Signs and Symptoms of Laryngeal cancer
  • Tests for Laryngeal cancer
  • Treatment options for Laryngeal cancer
  • Surgery 
  • Radiation Therapy
  • Chemotherapy
  1. Head and Neck Cancer Australia Resources 
  2. External Links to other Head and Neck Cancer Resources