Laryngeal Cancer: Therapy

General measures

  • Nicotine restriction (refraining from tobacco use) including passive smoking.
  • Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day).
  • Preservation of normal weight strive!Determination of BMI (Body Mass Index, body mass index) or body composition using electrical impedance analysis.
    • Falling below the BMI lower limit (from the age of 45: 22; from the age of 55: 23; from the age of 65: 24) → Participation in a medically supervised program for the underweight.
  • Avoidance of environmental stress:
    • Occupational exposure to asbestos or tar/bitumen.

Vaccinations

The following vaccinations are advised:

  • Flu vaccination
  • Pneumococcal vaccination

Regular checkups

  • Regular follow-up examinations for early detection of recurrence (recurrence of the disease), i.e.
    • 1st and 2nd year every three months
    • 3rd to 5th year every six months
    • After the 5th year, individual decision whether further follow-up is necessary.

Nutritional medicine

  • Note: PEG (percutaneous endoscopic gastrostomy: endoscopically created artificial access from the outside through the abdominal wall into the stomach) placement should only be performed if tube feeding is expected to be required for an extended period of time.
  • Nutritional counseling based on a nutritional analysis.
  • Nutritional recommendations according to a mixed diet, taking into account the general knowledge of nutrition in a tumor disease. This means:
    • Consume only limited energy-rich foods.
    • Moderate total fat intake
    • Little red meat (pork, beef, lamb, veal) and sausages.
    • Once or twice a week fresh sea fish, ie fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
    • High-fiber diet (whole grains, vegetables).
    • Daily total of 5 servings of fresh vegetables and fruits (≥ 400 g; 3 servings of vegetables and 2 servings of fruit).
    • Reduce consumption of smoked and cured foods, because they contain nitrate or nitrite as a component of curing salt. Their preparation produces compounds (nitrosamines), which are risk factors for various tumor diseases.
    • Refrain from polluted foods such as offal and wild mushrooms.
    • Do not eat moldy food
  • Observe the following special dietary recommendations:
  • Selection of appropriate food based on the nutritional analysis
  • See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
  • Detailed information on nutritional medicine you will receive from us.

Sports Medicine

  • Endurance training (cardio training) and strength training (muscle training).
    • In general, endurance training on a bicycle ergometer can be recommended, which is performed according to the principle of interval training. This means that load phases lasting 1 to 3 minutes alternate with rest phases also lasting 1 to 3 minutes. The training should be performed at about 80% of the maximum heart rate for a total of 30 minutes.
  • Preparation of a fitness or training plan with suitable sports disciplines based on a medical check (health check or athlete check).
  • Detailed information on sports medicine you will receive from us.

Psychotherapy

Training

  • Rehabilitation and psychosocial care (according to S3 guideline):
    • Voice rehabilitation: “Patients should be informed about the different rehabilitation options with the involvement of speech therapists and patient support groups.”
    • Psychosocial rehabilitation: “Patients and relatives should be informed about possible psychosocial consequences and, if necessary, assistance already in the course of primary therapy“.
  • After a laryngectomy (laryngectomy) can be trained via swallowing technique the esophageal replacement voice (ructus speech).Note: In almost all cases, patients are now provided with voice prostheses.