What are the main treatments for laryngeal cancer?

  Laryngeal cancer is a malignant tumor occurring in the larynx, and squamous cell carcinoma is the most common. Common triggers include smoking, alcohol consumption, air pollution, gastroesophageal reflux and so on. Among them, smoking is the main cause. 95% of laryngeal cancer patients I have experienced are long-term smokers, and most of them have obvious symptoms during the age of 50-65. Therefore, the best way to prevent laryngeal cancer is to quit smoking.  Laryngeal cancer is not an incurable disease. Common treatment methods include surgery, radiotherapy, chemotherapy, biotherapy and combination therapy. In order to achieve the best results, different methods should be used according to the patient’s specific conditions.  Surgery: The most commonly used method, which can be conventional surgery or laser surgery.  Advantages: all cancerous tissues and suspicious tissues are removed, high 5-year survival rate, good treatment effect, applicable to all types of laryngeal cancer. Relatively low cost.  Disadvantages: surgery, intraoperative and postoperative risks, partial loss of speech function or speech function significantly affected, surgical scars on the neck.  Radiation therapy: Radiotherapy for short Advantages: No need for surgery, relatively less risk, preserves speaking function, no scar on the neck. Effective for lymph nodes with subclinical metastases in the neck.  Disadvantages: It is suitable for low to medium differentiated laryngeal cancer, and poor for highly differentiated laryngeal cancer (highly differentiated laryngeal cancer is common). Good results for early stage and small tumors. Larger tumors with solid diameter over 1 cm, due to central hypoxia, cancer cells are in dormant state and insensitive to radiotherapy, which often leads to rapid recurrence. Although there are few complications in the near future, there are many long-term complications, such as: dry mouth, caries, cerebrospinal cord atrophy, neck stiffness, difficulty in opening mouth, etc. The relative cost is high.  Chemotherapy: Chemotherapy for short Advantages: effective for distant metastases.  Disadvantages: many systemic side effects, painful chemotherapy process, many complications. For example: severe vomiting, hair loss, vertigo, loss of appetite, etc. As with radiotherapy, for larger tumors due to central hypoxia, cancer cells are in a dormant state and also insensitive to chemotherapy.  Biological therapy: It is still at the stage of scientific research.  Combination therapy: Since various treatments have their advantages and disadvantages, it is necessary to adopt combination therapy according to different conditions of patients.  Early stage of medium to low differentiated squamous carcinoma can be treated by radiotherapy alone. In order to enhance the efficacy of radiotherapy, induction chemotherapy can be given before radiotherapy to enhance the sensitivity of cancer cells to radiotherapy. The function of the larynx can be preserved.  Early stage highly differentiated squamous carcinoma can be treated with laser surgery or conventional surgery. It is also possible to preserve all or part of the function of the larynx. Postoperative radiotherapy is determined by pathology and is usually not required.  Intermediate stage laryngeal cancer with larger solids is most suitable for surgical treatment. Depending on the situation, preoperative lymph node metastasis in the neck is found intraoperatively, the lymph nodes in the neck can be cleared. If preoperative examination does not reveal lymph node metastasis in the neck or only early metastasis, postoperative prophylactic radiotherapy can be done according to the situation. Or, if the neck lymph nodes are found to be enlarged after surgery, radical radiotherapy to the neck lymph nodes will be performed. Similarly, induction chemotherapy can be given before radiotherapy. If recurrence of the primary focus occurs after surgery, radiotherapy may also be performed.  Advanced tumors with very large solids, or tumors with distant metastases, the results of any method are not satisfactory. If surgery is still possible, surgery is still the mainstay. If the patient has poor physical condition and is estimated to be difficult to tolerate surgery, or the tumor is really too extensive to be repaired after resection, palliative radiotherapy or chemotherapy can be used. The purpose of treatment at this time is mainly to relieve the patient’s pain rather than to prolong the patient’s life.  Usually, chemotherapy is not used alone, but usually in combination with radiotherapy. Radiation therapy can be used alone or as a complement to surgery. Surgery is the most widely indicated and can be used alone or in combination with radiotherapy.  It should be noted that radiotherapy followed by surgery is not easy to heal the wound and is prone to serious complications. Therefore, when applying surgery + radiotherapy in combination, it is usually surgery followed by radiotherapy, rather than radiotherapy followed by surgery.