There are many kinds of surgery used to treat these cancers. Some may remove the cancer. Others help restore the look and function of the head and neck.
For cancer of the larynx
Vocal cord stripping: To do this, the doctor uses a long tool to strip away the cancer in the top layers of tissue of the vocal cords. Very early (stage 0 or CIS) cancers are sometimes treated this way. Most people can speak normally again after this operation.
Laser surgery: Lasers can be used to treat some early cancers. An endoscope is passed down the throat to find the tumor, which is then burned or cut out with a laser. If the laser is used to remove part of a vocal cord, it may result in hoarse speech.
Cordectomy: This surgery involves taking out all or part of the vocal cords. Taking out part of a vocal cord may result in hoarseness. Normal speech is no longer possible if both vocal cords are removed.
Partial laryngectomy: Laryngectomy refers to taking out part or all of the larynx (voice box). Smaller cancers of the larynx can often be removed without taking out the entire voice box. The goal is to leave as much of the voice box as possible while removing the cancer. For small cancers of the vocal cords, the surgeon may be able to remove the cancer by taking out only one vocal cord and leaving the other behind. This allows for some speech to remain.
Total laryngectomy: This surgery involves taking out the whole voice box. The windpipe must be brought up to the front of the neck as a hole (stoma). The person then breathes through this stoma. (See the picture below.) Once the larynx is removed, normal speech is no longer possible. But people can learn other forms of speaking (see "Moving on after treatment"). The connection between the throat and the esophagus is usually not affected, so after recovering from surgery, food and liquids can be swallowed just as they were before the operation.
Illustrations by permission of the Mayo Foundation. From "Looking Forward...A Guidebook for the Laryngectomee" by R.L. Keith, et al, New York, Thieme-Stratton, Inc. and copyrighted by the Mayo Foundation, 1984.
For cancer of the hypopharynx
Total or partial pharyngectomy: In these surgeries all or part of the pharynx (throat) is removed. If part of the pharynx is removed it is called a partial pharyngectomy. If the entire pharynx is removed, it is called a total pharyngectomy. The larynx is often removed, too. Surgery may be needed to rebuild the throat. This will help the patient to swallow after the operation.
Reconstructive surgery: These surgeries are used to rebuild the throat after the cancer has been removed. Sometimes a muscle and area of skin may be moved from a place close to your throat, such as the chest, to rebuild the throat after surgery. Tissues from other parts of the body such as a piece of intestine or a piece of arm muscle may also be used to replace parts of your throat.
Surgery to remove lymph nodes
Because these cancers often spread to the lymph nodes in the neck, these lymph nodes may need to be removed. This is called a neck dissection. It is done at the same time as the surgery to remove the main tumor. The amount of tissue to be removed depends on the size of the cancer and how much it has spread.
Other surgeries that may be needed
Tracheotomy/tracheostomy: After some types of surgery, you may have a small tube placed into your windpipe through a hole in the front of your neck to help you breathe. The hole is left in place to protect the airway while you heal.
If you have a total laryngectomy or if a laryngeal or hypopharyngeal cancer is blocking the windpipe and is too large to be removed completely, an opening may be made to connect the lower part of the windpipe to a hole (stoma) in the front of your neck to allow you to breathe more comfortably.
Gastrostomy tube (G-tube or feeding tube): Sometimes the cancer (or its treatment) can interfere with swallowing. To help you get enough food, a feeding tube can be placed through the skin in the belly (abdomen) directly into the stomach. Then liquid nutrition can be placed directly into the stomach. The tube can be removed if you can swallow and eat well after treatment.
Possible risks and side effects of surgery
Any surgery can lead to problems like bleeding, blood clots, and infection. Laryngectomy and pharyngectomy often lead to the loss of normal speech, while smaller operations can also sometimes affect speech.
Surgery can also cause problems with swallowing and narrowing of the throat or larynx. The swallowing problem can be severe enough so that you have to use a feeding tube. In some cases the narrowing may affect breathing, so a tracheostomy may be needed.
Laryngectomy and pharyngectomy can also lead to the development of a fistula (an abnormal opening between 2 areas that are not normally connected).
Rarely, these operations can lead to problems with the thyroid and/or parathyroid glands. Damage to the thyroid gland can cause you to feel very tired and sluggish. Damage to the parathyroid glands can lead to low calcium levels. These problems are easy to treat once they are found.
A very rare but serious complication of neck surgery is rupture of the carotid artery (the large artery in the neck).
To find out more about surgery as a treatment for cancer, see Understanding Cancer Surgery: A Guide for Patients and Families.
Last Revised: 02/17/2016