Management of Early Laryngeal Cancer: The Role of Individualized Medicine

Treatment options for early laryngeal cancer include radiation therapy or surgical resection. It is widely agreed upon that early laryngeal cancer should be managed with only one treatment modality. The debate on which treatment modality is best for early laryngeal cancer has essentially been going on for the last 65 years. Many new developments have impacted the treatment decision making process. These developments include the introduction of transoral endoscopic partial laryngeal surgery, such as transoral laser microsurgery (TLM) which is replacing external partial laryngectomy procedures; improvements in external beam radiation therapy (EBRT) delivery techniques and technology which result in enhanced accuracy and decreased extralaryngeal side effects and complications; and the introduction of quality of life measures and understanding their importance, in addition to survival rate, in defining successful outcome or failure. This review article concentrates on some of the important issues facing the patient, his/her family, and the treating physicians in the treatment decision making process.