Radiotherapy for laryngeal (larynx) cancer

Radiotherapy uses high-energy rays to destroy the cancer cells, while doing as little harm as possible to normal cells.

How and when radiotherapy is used to treat laryngeal cancer depends on the stage of the cancer. 

We understand that having treatment can be a difficult time for people. We're here to support you. If you want to talk, you can:

• Call the Macmillan Support Line on 0808 808 00 00.
• Chat to our specialists online.
• Visit our laryngeal (larynx) cancer forum to talk with people who have been affected by laryngeal cancer, share your experience, and ask an expert your questions.

If the cancer is larger, or spreads to lymph nodes or tissues nearby it is called (locally advanced) In this case, radiotherapy may be combined with other treatments.

You may have radiotherapy:

• after surgery to destroy any remaining cancer cells, and reduce the risk of it coming back
• after surgery, combined with chemotherapy (chemoradiation)
• instead of surgery, combined with chemotherapy (chemoradiation)
• combined with a targeted therapy drug.

If you have surgery first, you usually start chemoradiation or radiotherapy 6 or 7 weeks later.

Radiotherapy is usually given from outside the body. This is called external beam radiotherapy.

High-energy x-rays are directed at the cancer from a radiotherapy machine. Radiotherapy is not painful, but you do have to lie still for a few minutes while the treatment is being given.

You usually have external beam radiotherapy as an outpatient in the hospital radiotherapy department. It is normally given as a number of short treatments. These are called treatment sessions or fractions.

You may have radiotherapy:

• Monday to Friday, with a rest at the weekend (this is the most common method)
• more than once a day (hyperfractionation).

Treatment may take 3 to 7 weeks. This is called a course of treatment. Your cancer doctor, specialist nurse or radiographer will discuss the treatment with you.

If you are having radiotherapy to help with symptoms, you may only need a short course or a single treatment session.

IMRT is the main type of external beam radiotherapy used to treat cancer of the larynx. It shapes the radiotherapy beams and allows the radiographer to give different doses of radiotherapy to different parts of the treatment area.

This means the healthy tissue surrounding the tumour has lower doses of radiotherapy. This can help reduce the risk of side effects and late effects. It may also allow the radiographer to give higher doses of radiotherapy to the tumour.

Research has shown that having IMRT may reduce some long-term side effects, including having a dry mouth. This is because radiotherapy given in this way avoids the salivary glands, where saliva (spit) is produced.

Some people may have regular scans during their treatment. This is to make sure the radiotherapy is targeting the treatment area. Sometimes the treatment may need adjusting, for example, if you lose weight during treatment.

Volumetric modulated arc therapy (VMAT)

VMAT is a type of IMRT that is used to treat many different cancers. It is sometimes used to treat larynx cancer. 

VMAT delivers a continuous dose of radiation as the machine rotates 360 degrees around the body. This treatment accurately shapes the radiation dose to the tumour while minimising the dose to the healthy tissue surrounding it. 

Giving the radiotherapy in this way makes it very accurate and shortens the treatment time.

Many types of external beam radiotherapy are conformal. This means the beams are specially shaped to fit the treatment area. It may be used to give lower doses of radiotherapy.

At the beginning of each session, the radiographers will make sure you are in the correct position. They will tell you how long your treatment will take. They then carefully fit you with your mask and make sure you are comfortable.

When everything is ready, they leave the room and the treatment starts. The treatment itself is not painful. It does not make you radioactive. You will not be a risk to anyone during your treatment.

The radiographers will watch you on cameras. If you need to talk to them during your treatment, you can use the intercom.

In some treatment rooms, you can listen to music to help you relax during treatment. Ask your radiographers if this is possible.

During treatment, the radiotherapy machine may stop and move into a new position. This is so you can have radiotherapy from different directions. Some radiotherapy machines make a small beeping noise to tell you when the treatment is starting and when it has finished.