Clinical Education Package: Laryngeal Cancer

This package provides a structured introduction to laryngeal cancer for clinical staff who may not encounter this patient group routinely. It is designed to complement local induction programmes and can be completed in individual sections.

Module 1: Anatomy and disease overview

The larynx is responsible for voice production, airway protection during swallowing, and breathing. Laryngeal cancer most commonly arises from squamous cell carcinoma and is strongly associated with smoking and alcohol use. It is classified by subsite — glottic, supraglottic, and subglottic — and staged using the TNM classification.

Module 2: Diagnosis and staging

Patients typically present with hoarseness, dysphagia, or a neck lump. Diagnosis is confirmed via direct laryngoscopy under general anaesthesia with biopsy. Cross-sectional imaging (CT/MRI/PET-CT) is used for staging and surgical planning.

Module 3: Treatment pathways

Treatment depends on disease stage and patient fitness:

• Early-stage disease: Radiotherapy or transoral laser microsurgery (TLM) can achieve cure while preserving voice function.
• Locally advanced disease: Total laryngectomy with or without adjuvant radiotherapy, or organ-preservation protocols using concurrent chemoradiotherapy, may be considered.
• Palliative intent: Systemic therapy or radiotherapy for symptom control in patients unfit for curative treatment.

Module 4: Post-treatment care priorities

After laryngectomy, patients require ongoing support from a multidisciplinary team including:

• Nursing staff: Stoma care, HME management, wound care
• Speech and language therapy: Voice rehabilitation, swallowing assessment
• Dietetics: Nutritional support, management of dysphagia
• Clinical psychology: Adjustment to altered body image and communication
• Oncology: Surveillance for recurrence

Module 5: Recognising complications

Early identification of complications reduces morbidity. Staff should be alert to:

• Pharyngocutaneous fistula (saliva leaking through the wound)
• Stoma stenosis or crusting
• TEP displacement or aspiration through the prosthesis
• Signs of hypothyroidism following radiotherapy

Assessment and sign-off

On completion of this package, staff are encouraged to discuss learning points with their line manager or clinical supervisor. This package should be reviewed in conjunction with local protocols and the treating MDT’s clinical guidelines.