Cancer on the Vocal Cord

[LittleMi]

My Dad was just diagnosed with cancer on his vocal cord.  He was told there is a small spot on his vocal cord and it would be removed.  When the surgery happened the Dr said he did a biopsy and did not take it out due to spot being in a hard to get to area.  I have lots of questions but the main ones are if this is a small spot why did he not remove it? How do you know what the best treatment is?

[Fernando Roque, MD]

Hi.  During radiation treatment, the mouth and throat would produce less saliva, and would tend to be dry and develop ulcerations.  Eating and swallowing might become difficult as the treatment progresses. So you need to ask your doctor about this possible complication beforehand, and if there is a need to do PEG (percutaneous endoscopic gastrostomy) tube insertion while your dad is undergoing treatment to enable him to eat adequately.

[LittleMi]

Thank you.  Mom and Dad met with the Dr and the cancer is S-1 Squamous tumor.  He stated the reason surgery to remove it was not done is due to radiation treatment being so successful on this cancer and he would have to go from the outside to get to the spot to remove it.  So, it is just as you thought.  Can you give me any ideas on what to watch for and questions for the radiation Dr when they meet next week?

[Fernando Roque, MD]

Hi.  The reason why that small spot was not removed could be either of two things:

1) The spot is located in an inaccessible area and the doctor could not remove it without resorting to more extensive surgery.  It may be that your dad has early stage laryngeal cancer and the surgeon wants to preserve the larynx and wants to avoid extensive surgery. If this is the case (early stage cancer), radiation therapy can be done as an alternative to surgery.

2) It is possible to surgically remove the spot, but requires a more skilled surgeon.  If this is the case, it may be wise to seek a second opinion.