Laryngeal Cancer

Why Choose Sylvester Comprehensive Cancer Center?

More board-certified head and neck surgical specialists than any other South Florida provider. We have experts who work together to treat every aspect of your head and neck care. In the majority of cases requiring reconstruction, you have just one operation for cancer removal and any reconstructive surgery. Sylvester is one of the best places in the country for simultaneous head and neck cancer surgery and microvascular reconstruction.

Clinical trials that focus on robotic surgery, chemotherapy, reducing radiation toxicity and immunotherapy are often available for head and neck cancer patients. You can get new treatments that aren’t available elsewhere. Your access to trials that match your specific cancer gives you the best chance for the best treatment outcomes.

Advanced radiation oncology tools. Our leading-edge technology offers crystal-clear tumor targeting, improved results, and less potential damage to nearby healthy tissue. These tools include RapidArc^® intensity modulated radiation therapy (IMRT), ViewRay MRI-guided radiation therapy (one of only five in the country), and a Siemens 4D-CT scanner.

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Treatments

At Sylvester Comprehensive Cancer Center, each cancer has a wide range of treatments that can be used alone or in combination to give the best outcome for your specific cancer, including standard therapies and novel therapies only available in clinical trials. That’s why careful diagnosis is so important.

Radiation and surgery are treatments for these cancers. Vocal cord stripping is one surgical approach. Laser surgery is an other approach. Smokers should not continue to smoke — it increases the chance that a cured laryngeal cancer will grow again and return.

Surgery

Your surgeon will remove the cancerous tumor. The surgeon also will check for cancer in any nearby lymph nodes. If found, the lymph nodes will be taken out. Some early vocal cord cancers may be treated by removing the cancerous vocal cord, or by laser surgery.

If a cancerous tumor is too big to remove, or if it has grown into other body areas, radiation therapy can be recommended. Chemotherapy is sometimes also part of your treatment. Cetuximab is a targeted therapy . It may be offered to such patients following radiation therapy.
- Laryngectomy: The surgeon removes the tumor from the larynx and as much of the larynx is left intact as possible. Any neck lymph nodes with cancer are removed. Radiation with chemotherapy afterward can decrease any chance of cancer cells coming back.
- Reconstructive Surgery: Sometimes, head and neck surgeries can cause substantial cosmetic changes. Your Sylvester head and neck experts will plan before any treatment starts for both the cancer removal and any bone or tissue reconstruction.
Radiation Therapy

Radiation therapy can be the primary treatment option for small tumors. The cancer is assessed again after the treatment is complete. Surgery can remove any remaining cancer.

Sylvester has one of the largest, most experienced and most sophisticated head/neck cancer radiation teams in the nation. Radiation therapy uses highly targeted radiation beams to kill cancer cells and shrink tumors. This is sometimes the only type of treatment needed for some head and neck cancer. More often it is used together with chemotherapy or targeted therapy. Our techniques include:
- Oral health evaluation: A thorough oral evaluation before radiation treatment begins is important to the success of the regimen. With a pretreatment oral evaluation, the dental team can identify and treat problems such as infection, fractured teeth or restorations, or periodontal disease. These issues could contribute to complications if left unaddressed.
- IMRT (intensity modulated radiation therapy): Patients benefit from Sylvester's experience as a world leader in treating head and neck cancers with IMRT, an advanced form of external beam radiation therapy. This therapy allows radiation specialists to shape radiation doses to the exact 3D shape of your tumor. The precise control and flexibility of IMRT minimizes the amount of radiation going to surrounding healthy tissue.
- Radiosensitizing treatment: In some cases, such as in cancers of the larynx (voice box) and oropharynx (middle of the throat), we may use chemotherapy and radiation therapy together to kill all the cancer cells. This can help reduce the need for surgery and preserve your voice box and/or throat structures.
Chemotherapy (Systemic Medical Therapy)

The high level of experience of Sylvester’s medical oncology team allows our physicians to choose and deliver the most advanced chemotherapy approaches, often before they become available or are commonly used in the community. Your doctor may prescribe chemotherapy before or after surgery. Your doctor might combine chemotherapy with radiation therapy to try and avoid surgery altogether. Most chemotherapy drugs used for head and neck patients don't cause hair loss.

If you need intravenous (infusion) chemotherapy, you can have it at the Comprehensive Treatment Unit (CTU) at Sylvester’s main location in Miami, a 12,000-square-foot unit that includes 33 recliners and 11 private rooms. If you prefer, you may have your infusion treatments at the Deerfield Beach, Plantation, Hollywood, Coral Springs, Coral Gables, and Kendall locations.
Targeted Therapy

This treatment uses medicines that target specific parts of cancer cells. For example, a protein called EGFR may accelerate the growth of head and neck cancer cells. The most commonly used medicine that targets these cells is called cetuximab. It blocks EGFR so the cancer cell growth often slows or stops.

Tests

Procedures for diagnosing head and neck cancers may include the following tests, after a medical history review and physical exam.

Endoscopic Ultrasound

This exam uses a long, thin, flexible tube called an endoscope with a light at the end. It is put in through the nose so the doctor can get a close look at the inside of your nasal cavity, the back of your nose, and your throat and voice box. A special tool on the endoscope may be used to remove samples of suspicious tissue.

Modified Barium Swallow

This is a series of X-rays taken while you swallow a safe, chalky substance called barium. A radiologist and a speech and swallowing therapist will co-lead this test. The barium coats the inside of your throat so any swallowing changes or obstructions are seen on the X-rays.

CT Scan (Computed Tomography, or CAT Scan)

Pictures of inside your body are taken using a computer and X-rays. Three-dimensional images offer us detailed pictures to see where cancer may be growing. CT scans can check the head and neck, chest and other areas of the body.

MRI (Magnetic Resonance Imaging)

This exam relies on magnets and radio waves to create very detailed pictures of the inside of your body.

Biopsy

A biopsy (a sample of the suspicious tissue) is the only sure way to know if you have cancer. The sample is checked by a pathologist (a cellular expert) who looks at the tissue under a microscope to check for cancer cells. The biopsy is removed from the primary tumor site in the head/neck area. If the suspicious area is a lump or lymph node on your neck, a very thin needle is used to determine if any cancer is in your lymph nodes. This is called a fine-needle aspiration.

Chest X-ray or Chest CT Scan

A specialist uses an X-ray to determine if cancerous cells have spread to your lungs.

PET (Positron Emission Tomography) Scan

A safe amount of radioactive material is injected into your blood through a vein. A PET scanner machine takes pictures of your entire body. The images will show the areas where your cells are using more of the radioactive substance. Those cells are more active than others and could be cancer cells.

Staging Head and Neck Cancers

Staging is the word used to describe how early or advanced a cancer is, and how fast it is growing. Stages range from I (low) to IV (advanced). Staging helps us to decide what treatment might be best for your cancer.

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