Cancers arising in the larynx (voice box) are devastating malignancies that account for roughly 200,000 deaths annually worldwide. Although this only represents 2-5% of all malignancies, these cancers have special importance because of their significant effects on voice, swallowing and quality of life. In the United States, it is estimated that over 13,000 new cases are diagnosed each year. The rate of new cases of laryngeal cancer is falling by about 2% to 3% a year, most likely because fewer people are smoking.
Surgery for cancers of the larynx are big operations. All types of surgery are done under general anesthetic. So, you will be asleep for the whole operation. Usually, surgery for early stage larynx cancers is done through your mouth (endoscopic surgery). The size and position of your cancer affects how much of the voicebox your surgeon removes.
The first step in decision-making for patients with cancer of the larynx is accurate diagnosis and staging. This requires adequate tissue biopsy and histologic interpretation by a pathologist. After the diagnosis is obtained, the doctor may order imaging studies to get a more accurate impression of disease extent.
Our doctors may then recommend surgery as a viable treatment option. Your test results help your specialist decide if surgery is an option. Your doctor might not be able to tell you exactly what stage your cancer is until after surgery.
Goals of surgery:
The surgery you have depends on the size and exact location of your cancer. Some early-stage cancers may be amenable to partial resection of one of the vocal cords. Other, more-advanced, cancers may require partial or total laryngectomy.
The surgeon makes a cut in your neck. They remove part of your voice box (larynx). This is called an open partial laryngectomy. You keep at least part of one vocal cord. You are usually still able to speak afterwards. But your voice may be quite hoarse or weak.
During the operation the surgeon also makes a hole in your neck, which you breathe through. The hole is called a stoma (tracheostomy). The tracheostomy allows your voice box to heal after the surgery.
Most people who have a partial laryngectomy have a temporary tracheostomy. After a brief recovery time, your doctor removes your tracheostomy tube and your stoma gradually closes up. Once it has closed, you can start to speak naturally again. Some people need a permanent tracheostomy, but this is rare.
Surgery through your mouth (endoscopic surgery) is becoming a more common method to remove part of your voicebox (larynx).
Your surgeon might remove the whole of your voice box (larynx) to remove your cancer. This is called a total laryngectomy. Part of the pharynx might also be removed.
Your larynx is the connection between your mouth and your lungs. After it is removed, that connection is no longer there. So, your surgeon attaches the end of your windpipe to a hole in your neck, which you now breathe through. This is called a stoma. After a total laryngectomy, this stoma is permanent. You will now always breathe through your stoma.
Without your vocal cords and with a stoma, you are not able to speak in the normal way. This can be very difficult to cope with. But there are now several ways to help you make sounds and learn to speak again.