Glottic, Laryngeal Cancer-Preservation of the Larynx Improves QOL

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“A retrospective review of patients with laryngeal cancer using SEER-Medicare data demonstrated that chemoradiation was 4-fold more likely to be used in patients with advanced laryngeal cancer; however, survival was significantly better in patients treated with surgery and postoperative radiation”

Learn more about identifying and treating the triggers of vocal cord dysfunction.

It sounds simple enough- “first do no harm.” Or as little harm as you can do and still treat the cancer of the larynx patient. Oncology often overlooks the importance of quality of life. The articles linked and excerpted below illustrate a truism of oncology that all cancer patients must understand.

And that is that oncology treats aggressively to kill your cancer. This means that it is up to you to try to weigh the costs and benefits of your therapy. If your cancer surgeon tells you that “we got is all!” but you can’t speak or swallow, what will your quality of life be going forward?

Conventional oncology offers important information about your therapies going forward. I am simply saying that adding asking questions about long-term side effets and adding a complementary therapy or two (or three) might make a real difference in your quality of life going forward.

I am both a cancer survivor and cancer coach. I work with cancer patients to identify the risks and benefits of all therapies- both conventional (FDA approved) and evidence-based non-conventional.

Have you been diagnosed with head and neck cancer? What type, what stage? Please scroll down the page, post a question or comment and I will reply to you ASAP.

Thank you,

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

Contemporary management of advanced laryngeal cancer

“A retrospective review of patients with laryngeal cancer using SEER-Medicare data demonstrated that chemoradiation was 4-fold more likely to be used in patients with advanced laryngeal cancer; however, survival was significantly better in patients treated with surgery and postoperative radiation.[17] In this same cohort, pretreatment dysphagia, treatment with chemoradiation, and salvage surgery were significant predictors of an increased risk of long-term dysphagia, weight loss, gastrostomy, and tracheostomy dependence.[18] Initial treatment with surgery and postoperative radiation were associated with a lower odds of late pneumonia. These late toxicities were associate with poorer survival, with the greatest risk of death at 5 years associated with pneumonia…”

Functional organ preservation in laryngeal and hypopharyngeal cancer

“The principles of open versus laser microsurgical approaches for partial resections of the larynx are described, oncologic as well as functional results discussed and corresponding outcomes following primary radiotherapy are opposed. Over the last decade, the endoscopic partial resection of the larynx has developed to an accepted approach in the treatment of early glottic and supraglottic carcinomas thus leading to a remarkable decline in the use of open surgery

Conclusion-The comparison of treatment results of laser microsurgery and open vertical partial laryngectomy in early glottic cancer shows that local control and disease-specific survival do not differ. Transoral laser microsurgery has widely replaced open surgery due to less morbidity, better voice quality and lower cost. Accordingly, no articles on open surgery for early glottic cancer could be found in the English literature in the last 10 years…”

Preservation of laryngeal function improves outcomes of patients with hypopharyngeal carcinoma

“This study compares clinical characteristics and survival between patients with and without laryngeal function (LF) preservation during surgical treatment for hypopharyngeal carcinoma. We retrospectively reviewed 485 cases of hypopharyngeal carcinoma treated at a single institution for analysis.

There were 337 cases with and 148 cases without LF preservation after surgery. Preservation of LF was complete in 237 patients and partial in 100 patients. There were significant statistical differences between the preservation group and the group without preservation in T-stage, overall staging, and tumor sites except the N-stage. The patients with LF preservation had significantly better overall survival  and a lower risk of death than those without LF preservation, after multivariable adjustment.

Treatment with surgery in combination with radiotherapy is still the favorable choice for patients with hypopharyngeal carcinoma. The maximal restoration of pharyngoesophageal continuity and function improves survival for patients whose tumors are excised completely for the preservation of LF and laryngeal and pharyngeal reconstruction.

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