Talking is part of nearly everything we do, so it’s natural to be scared if your voice box must be removed. Losing the ability to talk - even for a short time - is hard. Patients and their families and friends need understanding and support during this time.

Within a week or so after a partial laryngectomy, you will be able to talk in the usual way. After a total laryngectomy, however, you must learn to speak in a new way. A speech pathologist usually meets with you before surgery to explain the methods that can be used. In many cases, speech lessons start before you leave the hospital.

Until you begin to talk again, it is important to have other ways to communicate. Here are some ideas that you may find helpful:

Keep pads of paper and pens or pencils in your pocket or purse.

Use a typewriter, computer, or other electronic device. Your words can be printed on paper, displayed on a screen, or produced in a male or female voice.

Carry a small dictionary or a picture book and point to the words you need.

Write notes on a “magic slate” (a toy with a plastic sheet that covers black wax; lifting the plastic erases the sheet).

The health care team can help patients learn new ways to speak. It takes practice and patience to learn techniques such as esophageal speech or tracheoesophageal puncture speech, and not everyone is successful. How quickly a person learns, how understandable the speech is, and how natural the new voice sounds depend on the extent of the surgery on the larynx.

Esophageal Speech

A speech pathologist can teach you how to force air into the top of your esophagus and then push it out again. The puff of air is like a burp. It vibrates the walls of the throat, making sound for the new voice. The tongue, lips, and teeth form words as the sound passes through the mouth.

This type of speech sounds low pitched and gruff, but it usually sounds more like a natural voice than speech made by a mechanical larynx. There is also no device to carry around, so your hands are free.

Tracheoesophageal Puncture

For tracheoesophageal puncture (TEP), the surgeon makes an opening between the trachea and the esophagus. The opening is made at the time of initial surgery or later. A small plastic or silicone valve fits into this opening. The valve keeps food out of the trachea. After TEP, patients can cover their stoma with a finger and force air into the esophagus through the valve. The air produces sound by making the walls of the throat vibrate. The sound is a lot like natural speech.

Mechanical Speech

You may choose to use a mechanical larynx while you learn esophageal or TEP speech or if you are unable to use these methods. The device may be powered by batteries (electrolarynx) or by air (pneumatic larynx).

Many different mechanical devices are available. The speech pathologist will help you choose the best device for your needs and abilities and will train you to use it.

One kind of electrolarynx looks like a small flashlight. It makes a humming sound. You hold the device against your neck, and the sound travels through your neck to your mouth. Another type of electrolarynx has a flexible plastic tube that carries sound into your mouth from a hand-held device. There are also devices that are built into a denture or retainer and can be worn inside your mouth and operated by a hand-held remote control.

A pneumatic larynx is held over the stoma and uses air from the lungs instead of batteries to make it vibrate. The sound it makes travels to the mouth through a plastic tube.

Followup Care

Followup care is important after treatment for cancer of the larynx. Regular checkups ensure that any changes in health are noted. Problems can be found and treated as soon as possible. The doctor will check closely to be sure that the cancer has not returned. Checkups include exams of the stoma, neck, and throat. From time to time, the doctor may do a complete physical exam and take x-rays. If you had radiation therapy or a partial laryngectomy, the doctor will also examine you with a laryngoscope.

Treatments for laryngeal cancer can affect the thyroid. A blood test can tell if the thyroid is making enough thyroid hormone. If the level is low, you may need to take thyroid hormone pills.

People who have laryngeal cancer have a chance of developing a new cancer in the mouth, throat, or other areas of the head and neck. This is especially true for those who are smokers or drink alcohol heavily. Most doctors strongly urge their patients to stop smoking and drinking to cut down the risk of a new cancer and other health problems.

The NCI has prepared a booklet for people who have completed their treatment to help answer questions about followup care and other concerns. Facing Forward Series: Life After Cancer Treatment 11 provides tips for getting the most out of medical visits. It describes the kinds of help people may need. Support for People with Cancer of the Larynx

Living with a serious disease such as cancer is not easy. Some people find they need help coping with the emotional and practical aspects of their disease. Support groups can help. In these groups, people living with cancer get together to share what they have learned about coping with the disease and the effects of treatment. People interested in finding a support group may want to talk with their health care provider for suggestions.

People living with cancer may worry about caring for their families, keeping their jobs, or continuing daily activities. Concerns about tests, treatments, hospital stays, and medical bills are also common. Doctors, nurses, and other members of the health care team can answer questions about treatment, working, or other activities. Meeting with a social worker, counselor, or member of the clergy can be helpful for those who want to talk about their feelings or discuss their concerns. Often, a social worker can suggest resources for help with rehabilitation, emotional support, financial aid, transportation, or home care.

The Cancer Information Service (1-800-4-CANCER) can provide printed materials on coping, as well as information to help patients and their families locate programs and services.

The Promise of Cancer Research

Doctors all over the country are conducting many types of clinical trials. These are research studies in which people take part voluntarily. Studies include new ways to treat cancer of the larynx. Research already has led to advances, and researchers continue to search for more effective approaches.

People who join these studies have the first chance to benefit from treatments that have shown promise in earlier research. They also make an important contribution to medical science by helping doctors learn more about the disease. Although clinical trials may pose some risks, researchers take very careful steps to protect their patients.

People with laryngeal cancer are participating in several types of treatment studies:

Radiation therapy. Researchers are studying a new approach to radiation therapy. Patients receive radiation three times a day, 5 days a week, for just over 2 weeks, instead of once a day for 5 to 7 weeks.

Drugs that reduce side effects. Researchers are testing therapies that reduce the side effects of radiation therapy. They are testing drugs that may help patients maintain their weight or help lessen damage to the skin during radiation therapy.

Chemotherapy. Scientists are studying drugs that kill cancer cells. These drugs are used alone or in combination with radiation therapy to spare the larynx from surgery.

Biological therapy. Scientists are studying monoclonal antibodies that slow or stop the growth of cancer.

If you are interested in learning more about joining a clinical trial, you may want to talk with your doctor.

Share This