Appointment sheet
Laryngeal and hypopharyngeal cancer
Prepared with OnCo (onco.cc/prep/laryngeal-cancer/). Orientation, not medical advice; your team knows your case.
My details
Name
Date of appointment
Hospital and clinician
Who is coming with me
What I know, what is unclear, changes to discuss
Saved in this browserWhat I know so far
What is unclear to me
Changes since last time
My questions
18 on the sheetNewly diagnosed
- 1.What is my exact diagnosis, stage, and grade, and which tests established them?
- 2.Which biomarkers have been tested on my tumour (for example Stage and cartilage invasion on CT, Vocal cord mobility, Smoking and alcohol exposure, PD-L1), and what were the results?
- 3.Which subtype is my cancer, and does that change the recommended treatment?
- 4.Is germline (inherited) genetic testing recommended for me or my family?
Early glottic cancer
- 5.For my situation (early glottic cancer), which of the standard options do you recommend and why?
Locally advanced, larynx preservable
- 6.For my situation (locally advanced, larynx preservable), which of the standard options do you recommend and why?
- 7.Am I a candidate for Cisplatin, and what side effects should I expect?
- 8.How do the results of RTOG 91-11 apply to someone like me?
Extensive disease or non-functioning larynx
- 9.For my situation (extensive disease or non-functioning larynx), which of the standard options do you recommend and why?
Recurrent or metastatic
- 10.For my situation (recurrent or metastatic), which of the standard options do you recommend and why?
- 11.Am I a candidate for Pembrolizumab, Cetuximab, and what side effects should I expect?
- 12.How do the results of KEYNOTE-048 apply to someone like me?
Prevention
- 13.For my situation (prevention), which of the standard options do you recommend and why?
Any stage
- 14.Are there clinical trials I could join, for example of Pembrolizumab, Adaptive radiotherapy (online replanning)?
- 15.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
- 16.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
- 17.I read that “Hypopharyngeal cancer survival has barely improved”. How does that affect my plan?
- 18.I read that “Choosing between preservation and laryngectomy in T4 disease”. How does that affect my plan?
Tests and results to bring
Biomarker results to ask for: Stage and cartilage invasion on CT, Vocal cord mobility, Smoking and alcohol exposure, PD-L1 (recurrent disease).
Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.
The treatments I may be offered
- Prevention: Smoking cessation and alcohol reduction; no screening programme exists. (Smoking cessation in cancer patients, Alcohol reduction, pricing and cancer warning labels)
- Early glottic cancer: Transoral laser microsurgery or radiotherapy alone; both cure most patients and preserve the voice. (IMRT / IGRT (modern external beam), Hypofractionated radiotherapy)
- Locally advanced, larynx preservable: Concurrent cisplatin chemoradiation (RTOG 91-11); induction chemotherapy for selection in some centres. (Cisplatin, RTOG 91-11)
- Extensive disease or non-functioning larynx: Total laryngectomy with neck dissection and postoperative radiotherapy or chemoradiation; voice prosthesis rehabilitation. (IMRT / IGRT (modern external beam))
- Recurrent or metastatic: Salvage laryngectomy after radiotherapy failure; pembrolizumab-based therapy for metastatic disease (KEYNOTE-048). (Pembrolizumab, KEYNOTE-048, Cetuximab)
From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.
Answers and next steps
Saved in this browserWhat I was told
Agreed next steps, dates and who to call