18 | Chapter 1 treatment. In the case of early stage oropharyngeal tumors, this means that in case of a small, well accessible primary without or with minimal neck disease, surgery is a very good alternative for radiotherapy without risking the long term toxicity of radiotherapy23. The choice between radiation and surgery—or the combination thereof—is influenced by several factors, including tumor size, location, neck disease, HPV status, and patient preference. The impact of these treatments on patients varies. TORS, while less invasive than traditional surgery, may still lead to post-operative pain, temporary changes in swallowing, or speech difficulties, though these are generally less severe and resolve more quickly than with open surgical approaches15. Radiation therapy, while non-invasive, can cause acute side effects like mucositis, which typically resolve after treatment completion, but it may also lead to long-term changes in saliva production and taste sensation, swallowing problems and long tern fibrosis and atherosclerosis15. Choosing the appropriate treatment for early-stage oropharyngeal cancer involves careful consideration of the tumor’s size, location, N stage and the HPV status, as well as the patient’s overall health and personal preferences. Both TORS and radiation therapy offer the potential for cure with a focus on organ preservation and functional outcomes. Decisions regarding the optimal approach should be made in collaboration with a multidisciplinary team of specialists, ensuring that treatment plans are tailored to achieve the best possible balance between effective cancer control and preservation of quality of life. Laryngeal cancer Laryngeal cancer develops in the tissues of the larynx, which is commonly referred to as the voice box. The larynx plays a crucial role in breathing, swallowing, and speaking. Laryngeal cancer can manifest in various parts of the organ, including the vocal cords, supraglottis, glottis and subglottis. Risk factors for laryngeal cancer include tobacco use, particularly smoking, and excessive alcohol consumption. Chronic exposure to irritants such as industrial chemicals and asbestos, as well as gastroesophageal reflux disease (GERD), may also increase the risk of developing laryngeal cancer. Symptoms of laryngeal cancer can vary depending on the location and extent of the tumor but often include persistent hoarseness or changes in voice quality, difficulty swallowing (dysphagia), throat pain, ear pain, a lump or mass in the neck, and persistent coughing or coughing up blood24.
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