Treating Recurrent Laryngeal and Hypopharyngeal Cancers

Cancer is called recurrent when it come backs after treatment. Recurrence can be local (in or near the same place it started) or distant (spread to other parts of the body, like the lungs or bone). Treatment options for patients whose laryngeal or hypopharyngeal cancers come back after treatment depend mainly on what the first treatment was and where the cancer recurs.

Because these cancer recurrences are hard to treat, patients may want to think about taking part in clinical trials of newer treatments.

Local recurrence

Local recurrences in people who have already had limited surgery such as partial laryngectomy can often be treated with more extensive surgery (such as total laryngectomy). This may be followed by radiation therapy or chemoradiation (radiation and chemo are given at the same time).

Local recurrence may also be treated with chemotherapy. Chemo may be given along with cetuximab. Or, chemoradiation may be used. Immunotherapy might also be an option in some cases, either alone or with chemotherapy.

If cancer comes back locally after radiation therapy, the usual treatment is total laryngectomy, but more radiation therapy is sometimes used.

If surgery can't be done, chemo or chemoradiation can be used to help control the cancer and ease any problems it might be causing. (This is called palliative or supportive care.)

Distant recurrence

Distant recurrences that have not responded to radiation therapy and surgery are treated with chemotherapy and/or targeted therapy. Another option might be treatment with an immunotherapy drug, either alone or with chemotherapy. Chemoradiation may also be used, if a person can tolerate it. 

If there are only a few tumors, surgery may be done. Radiation or chemo are also options.

Chemo or chemoradiation can be used to help control the cancer and ease any problems it might be causing. (This is called palliative or supportive care.)