The American Society of Clinical Oncology recently published guidelines about larynx preservation in patients with laryngeal cancer. The guidelines note the importance of balancing successful cancer treatment with patient function and quality of life.
Head and neck cancers originate in the throat, larynx (voice box), pharynx, salivary glands, or oral cavity (lip, mouth, tongue). Most head and neck cancers involve squamous cells, which are cells that line the mouth, throat, or other structures.
For patients facing the treatment of laryngeal cancer, an important consideration is whether the larynx can be preserved. Because the larynx is involved in speech and communication, complete removal of the larynx can have a dramatic and adverse effect on a patient’s life.
Treatment approaches that preserve the larynx include radiation therapy alone, chemotherapy plus radiation therapy, and surgery that preserves the function of the larynx. Certain patients, however, may not be candidates for these approaches, and may require more extensive treatment.
To guide the use of larynx-preservation approaches, the American Society of Clinical Oncology summarized the available evidence and released recommendations. Final decisions about treatment, however, will still require consideration of each patient’s individual circumstances.
- For patients with limited laryngeal cancer (T1 or T2), the recommendations note that patients should initially be treated with the intent to preserve the larynx. In these patients, radiation therapy alone or larynx-preservation surgery each appear to produce similar survival outcomes. The recommendations include the qualification that “Limited-stage laryngeal cancer constitutes a wide spectrum of disease. The clinician must exercise judgment when recommending treatment in this category.”
- For patients with advanced stage (T3 or T4) laryngeal cancer, patients should be evaluated for their suitability for larynx preservation. If the cancer has not spread through the cartilage into soft tissue, larynx preservation (commonly involving treatment with chemotherapy plus radiation therapy) is often an appropriate treatment approach.
Patients who are going to undergo treatment for laryngeal cancer may wish to talk with their doctor about whether they are candidates for larynx preservation, and about the risks and benefits of different approaches to larynx preservation.
Reference: Pfister DG, Laurie SA, Weinstein GS et al. American Society of Clinical Oncology Clinical Practice Guideline for the Use of Larynx-Preservation Strategies in the Treatment of Laryngeal Cancer. Journal of Clinical Oncology. Early Online Publication July 10, 2006.
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