Can You Treat Throat Cancer Without Losing Your Voice?

With some tumors, surgeons can offer laryngeal conservation surgery, says Eric Lamarre, MD, a head and neck surgical oncologist at Cleveland Clinic in Ohio. “That means you take out a portion of the voice box, yet maintain much of the function,” he explains.

“Modern surgical approaches have transformed how we treat throat cancer,” says Taha Mur, MD, a head and neck surgical oncologist and reconstructive surgeon at Rutgers Cancer Institute and RWJBarnabas Health in New Brunswick, New Jersey. These techniques allow surgeons to access and remove tumors through the mouth — without external incisions — which means surgeons can often preserve the larynx and its critical functions: breathing, swallowing, and voice, says Dr. Mur.

Organ-sparing doesn’t just mean protecting your vocal cords — your throat has all kinds of structures that help you speak, says Dr. Lamarre, like false vocal folds and the epiglottis. “And so, when we talk about surgery, particularly for laryngeal cancer, we have to factor in all of those [areas],” he says.

Transoral Robotic Surgery (TORS)

Your care team will assess your tumor and your overall health to decide if TORS is a good option for you. “The primary limitation is that it is not appropriate for all tumor sizes or locations,” says Mur, adding that not all surgical centers have access to robotic-trained surgical teams.

Laser Microsurgery

Partial Laryngectomy

“Those are open procedures, whereby we open the voice box, remove the affected cancer, and then typically reconstruct it with a whole variety of techniques,” Lamarre says.

Radiation and Chemotherapy

The best treatment for throat cancer depends on several factors.

“Advances in both surgery and radiation have meaningfully expanded what's possible, but the right choice always depends on the individual, the tumor's location and stage, overall health, and what matters most to the patient in terms of quality of life,” says Mur.

In his practice, Lamarre uses the National Comprehensive Cancer Network (NCCN) guidelines to pinpoint the best options for curing the cancer, then looks at which one may help preserve the voice and ability to swallow. “At the end of the day, you use those guidelines to inform your clinical decision-making when you're sitting in the office with the patient,” says Lamarre.

Throat cancer treatment options can get complicated, so it may help to go to your appointment prepared with a list of questions.

• What treatment will work best for my cancer?
• What is the goal of this treatment: cure, or controlling the cancer?
• Which option provides me with the best chance of cure?
• If chemotherapy and radiation are being considered, can you recommend a radiation oncologist and a medical oncologist I can also meet with?
• How will my treatment affect how I breathe, swallow, and speak?
• Which option provides me with the best chance of long-term function (swallowing and speech)?
• What are the short- and long-term side effects I should prepare for?
• Will I need a tracheostomy after surgery, and for how long?
• Is this treatment choice being decided by a multidisciplinary tumor board?
• Am I a candidate for a minimally invasive surgical approach?
• What does recovery look like, and what support will I have?

“An informed patient is an empowered patient,” says Mur. “There are rarely one-size-fits-all answers in throat cancer treatment, and your care team should welcome these conversations.”

• Throat cancer treatment can cause vocal changes, but for some earlier-stage tumors, you can choose treatments that preserve your voice and still cure the cancer.
• Organ-preserving treatment options include transoral robotic surgery, laser microsurgery, laryngectomy, and a combination of radiation and chemotherapy.
• Even when organ preservation is possible, your voice may or may not function the same again.
• Your cancer care team will help you choose the best throat cancer treatment option based on your tumor type, size, and spread, as well as other health conditions that may affect recovery.