Treatments for carcinoma of the glottis

The following are treatment options for the stages of carcinoma of the glottis. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Radiation therapy and surgery are the treatments used for stages 1 and 2 carcinoma of the glottis.

Radiation therapy is a common treatment for stages 1 and 2 carcinoma of the glottis.

Surgery that may be used for stage 1 carcinoma of the glottis includes:

• endoscopic laser surgery
• cordectomy (removal of part or all of the vocal cords)
• partial laryngectomy (removal of part of the larynx)

Surgery that may be used for stage 2 includes:

• endoscopic laser surgery
• partial or total laryngectomy depending on the location of the tumour

Treatment for stages 3 and 4 carcinoma of the glottis is often a combination of surgery, radiation and chemotherapy.

Radiation therapy may be used:

• as the main treatment with chemotherapy given during the same time period to avoid a total laryngectomy
• alone in people who cannot cope with chemoradiation and surgery
• alone or with chemotherapy after surgery if the tumour is hard to remove, can’t be completely removed or has spread to nearby tissue or lymph nodes

Chemotherapy may be used:

• with radiation therapy given during the same time period (chemoradiation) as the main treatment or following surgery if the tumour is difficult to remove, can’t be completely removed or has spread to nearby tissue or lymph nodes
• as the first treatment (induction chemotherapy) before treatment with chemoradiation or surgery

Surgery may be used for people who don’t respond well to radiation therapy or chemoradiation or those with persistent disease (it doesn’t go away) after radiation therapy or chemoradiation. A total laryngectomy with or without a neck dissection is done. Surgery may be followed with radiation therapy or chemoradiation.

In some cases laser surgery may be the first treatment given for stage 3 glottic cancer. A total laryngectomy may be the first treatment given for large cancers, especially stage 4.

Targeted therapy may be used with radiation therapy instead of chemotherapy if you can’t cope well with chemoradiation.

Immunotherapy may be used to treat metastatic carcinoma of the glottis. Pembrolizumab (Keytruda) may be used as a first-line therapy with or without chemotherapy. Nivolumab (Opdivo) may be used to treat metastatic carcinoma of the glottis that has stopped responding to chemotherapy with platinum drugs such as cisplatin or carboplatin.

Recurrent carcinoma of the glottis means that the cancer has come back after it has been treated. Treatments for recurrences include:

• further surgery with or without radiation therapy after surgery
• further radiation therapy for small recurrences for people who cannot have or don’t want to have a laryngectomy
• chemotherapy
• immunotherapy

You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.

Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.

Some clinical trials in Canada are open to people with laryngeal cancer. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.