Keeping on Top of Your Condition
The Larynx
The larynx, also called the voice box, is a 2-inch-long, tube-shaped
organ in the neck. We use the larynx when we breathe, talk, or
swallow.
The larynx is at the top of the windpipe (trachea).
Its walls are made of cartilage.
The large cartilage that forms the front of the larynx is sometimes called
the Adam's apple. The vocal
cords, two bands of muscle, form a "V" inside the larynx.
Each time we inhale (breathe in), air goes into our nose or mouth, then
through the larynx, down the trachea, and into our lungs. When we exhale
(breathe out), the air goes the other way. When we breathe, the vocal
cords are relaxed, and air moves through the space between them without
making any sound.
When we talk, the vocal cords tighten up and move closer together. Air
from the lungs is forced between them and makes them vibrate, producing
the sound of our voice. The tongue, lips, and teeth form this sound into
words.
The esophagus,
a tube that carries food from the mouth to the stomach, is just behind the
trachea and the larynx. The openings of the esophagus and the larynx are
very close together in the throat. When we swallow, a flap called the epiglottis
moves down over the larynx to keep food out of the windpipe.
What Is Cancer?
Cancer is a group of more than 100 different diseases. They all affect
the body's basic unit, the cell. Cancer occurs when cells become abnormal
and divide without control or order.
Like all other organs of the body, the larynx is made up of cells.
Normally, cells divide to produce more cells only when the body needs
them. This orderly process helps keep us healthy.
If cells keep dividing when new cells are not needed, a mass of extra
tissue
forms. This mass of tissue, called a growth or tumor,
can be benign
or malignant.
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Benign tumors are not cancer. They do not spread to other
parts of the body and are seldom a threat to life. Benign tumors can
usually be removed, but certain types may return.
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Malignant tumors are cancer. They can invade and destroy
nearby healthy tissues and organs. Cancer cells can also break away from
the tumor and enter the bloodstream and the lymphatic
system. That is how cancer spreads to other parts of the body.
This spread is called metastasis.
Cancer of the larynx is also called laryngeal
cancer. It can develop in any region of the larynx -- the glottis
(where the vocal cords are), the supraglottis
(the area above the cords), or the subglottis
(the area that connects the larynx to the trachea).
If the cancer spreads outside the larynx, it usually goes first to the
lymph
nodes (sometimes called lymph glands) in the neck. It can also
spread to the back of the tongue, other parts of the throat and neck, the
lungs, and sometimes other parts of the body.
Cancer that spreads is the same disease and has the same name as the
original (primary) cancer. When cancer of the larynx spreads, it is called
metastatic laryngeal cancer.
Symptoms of Larynx Cancer
The symptoms of larynx cancer depend mainly on the size and
location of the tumor. Most cancers of the larynx begin on the vocal
cords. These tumors are seldom painful, but they almost always cause
hoarseness or other changes in the voice. Tumors in the area above the
vocal cords may cause a lump on the neck, a sore throat, or an earache.
Tumors that begin in the area below the vocal cords are rare. They can
make it hard to breathe, and breathing may be noisy.
A cough that doesn't go away or the feeling of a lump in the throat may
also be warning signs of cancer of the larynx. As the tumor grows, it may
cause pain, weight loss, bad breath, and frequent choking on food. In some
cases, a tumor in the larynx can make it hard to swallow.
Any of these symptoms may be caused by cancer or by other, less serious
problems. Only a doctor can tell for sure. People with symptoms like these
usually see an ear, nose, and throat specialist (otolaryngologist).
Larynx Cancer Diagnosis
To find the cause of any of these symptoms, the doctor asks about the
patient's medical history and does a complete physical exam. In addition
to checking general signs of health, the doctor carefully feels the neck
to check for lumps, swelling, tenderness, or other changes. The doctor can
also look inside the larynx in two ways:
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Indirect laryngoscopy.
The doctor looks down the throat with a small, long-handled mirror to
check for abnormal areas and to see whether the vocal cords move as they
should. This test is painless, but a local anesthetic
may be sprayed in the throat to prevent gagging. This exam is done in
the doctor's office.
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Direct laryngoscopy. The doctor inserts a lighted tube (laryngoscope)
through the patient's nose or mouth. As the tube goes down the throat,
the doctor can look at areas that cannot be seen with a simple mirror. A
local anesthetic eases discomfort and prevents gagging. Patients may
also be given a mild sedative to help them relax. Sometimes the doctor
uses a general anesthetic to put the person to sleep. This exam may be
done in a doctor's office, an outpatient clinic, or a
hospital.
If the doctor sees abnormal areas, the patient will need to have a
biopsy.
A biopsy is the only sure way to know whether cancer is present. For a
biopsy, the patient is given a local or general anesthetic, and the doctor
removes tissue samples through a laryngoscope. A pathologist
then examines the tissue under a microscope to check for cancer cells. If
cancer is found, the pathologist can tell what type it is. Almost all
cancers of the larynx are squamous
cell carcinomas. This type of cancer begins in the flat,
scale-like cells that line the epiglottis, vocal cords, and other parts of
the larynx.
If the pathologist finds cancer, the patient's doctor needs to know the
stage (extent) of the disease to plan the best treatment. To find out the
size of the tumor and whether the cancer has spread, the doctor usually
orders more tests, such as x-rays,
a CT
(or CAT) scan, and/or an MRI.
During a CT scan, many x-rays are taken. A computer puts them together to
create detailed pictures of areas inside the body. An MRI scan produces
pictures using a huge magnet linked to a computer.
Larynx Cancer Treatment Options
Treatment for cancer of the larynx depends on a number of factors.
Among these are the exact location and size of the tumor and whether the
cancer has spread. To develop a treatment plan to fit each patient's
needs, the doctor also considers the person's age, general health, and
feelings about the possible treatments.
Many patients want to learn all they can about their disease and their
treatment choices so they can take an active part in decisions about their
medical care. When discussing treatment options, the patient may want to
talk with the doctor about taking part in a research study of new
treatment methods. Such studies, called clinical
trials, are discussed in the Treatment
Studies section.
The patient and the doctor should discuss the treatment choices very
carefully because treatments for this disease may change the way a person
looks and the way he or she breathes and talks. In many cases, the patient
meets with both the doctor and a speech
pathologist to talk about treatment options and possible changes
in voice and appearance.
People with larynx cancer have many important questions. The
doctor and other members of the health care team are the best ones to
answer them. Most patients want to know the extent of their cancer, how it
can be treated, how successful the treatment is expected to be, and how
much it is likely to cost. These are some questions patients may want to
ask the doctor:
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What are my treatment choices?
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Would a clinical trial be appropriate for me?
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What are the expected benefits of each kind of treatment?
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What are the risks and possible side effects of each treatment?
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How will I speak after treatment?
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How will I look?
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Will I need to change my normal activities? If so, for how long?
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When will I be able to return to work?
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How often will I need to have checkups?
When a person is diagnosed as having cancer, shock and stress are
natural reactions. These feelings may make it difficult for patients to
think of everything they want to ask the doctor. Often, it helps to make a
list of questions. To help remember what the doctor says, patients may
take notes or ask whether they may use a tape recorder. Some people also
want to have a family member or friend with them when they talk to the
doctor -- to take part in the discussion, to take notes, or just to
listen.
Getting a Second Opinion
Treatment decisions are complex. Before starting treatment, the patient
might want a second doctor to review the diagnosis and treatment plan. It
may take a week or two to arrange for a second opinion. A short delay will
not reduce the chance that treatment will be successful. Some insurance
companies require a second opinion; others cover a second opinion if the
patient requests it.
There are a number of ways to find a doctor who can give a second
opinion:
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The patient's doctor may be able to suggest a specialist to
consult.
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The Cancer Information Service, at 1-800-4-CANCER, can tell callers
about treatment facilities, including cancer centers and other programs
supported by the National Cancer Institute.
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Patients can get the names of doctors from their local medical
society, a nearby hospital, or a medical school.
Treatment Methods for Larynx Cancer
Cancer of the larynx is usually treated with radiation
therapy (also called radiotherapy) or surgery.
These are types of local
therapy; this means they affect cancer cells only in the treated
area. Some patients may receive chemotherapy,
which is called systemic
therapy, meaning that drugs travel through the bloodstream. They
can reach cancer cells all over the body. The doctor may use just one
method or combine them, depending on the patient's needs.
In some cases, the patient is referred to doctors who specialize in
different kinds of cancer treatment. Often several specialists work
together as a team. The medical team may include a surgeon; ear, nose, and
throat specialist; cancer specialist (oncologist);
radiation
oncologist; speech pathologist; nurse; and dietitian. A dentist
may also be an important member of the team, especially for patients who
will have radiation therapy.
Radiation therapy uses high-energy rays to damage cancer cells
and stop them from growing. The rays are aimed at the tumor and the area
close to it. Whenever possible, doctors suggest this type of treatment
because it can destroy the tumor and the patient does not lose his or her
voice. Radiation therapy may be combined with surgery; it can be used to
shrink a large tumor before surgery or to destroy cancer cells that may
remain in the area after surgery. Also, radiation therapy may be used for
tumors that cannot be removed with surgery or for patients who cannot have
surgery for other reasons. If a tumor grows back after surgery, it is
generally treated with radiation.
Radiation therapy is usually given 5 days a week for 5 to 6 weeks. At
the end of that time, the tumor site very often gets an extra "boost" of
radiation.
Surgery or surgery combined with radiation is suggested for some
newly diagnosed patients. Also, surgery is the usual treatment if a tumor
does not respond to radiation therapy or grows back after radiation
therapy. When patients need surgery, the type of operation depends mainly
on the size and exact location of the tumor.
If a tumor on the vocal cord is very small, the surgeon may use a laser,
a powerful beam of light. The beam can remove the tumor in much the same
way that a scalpel does.
Surgery to remove part or all of the larynx is a partial or total laryngectomy.
In either operation, the surgeon performs a tracheostomy,
creating an opening called a stoma
in the front of the neck. (The stoma may be temporary or permanent.) Air
enters and leaves the trachea and lungs through this opening. A tracheostomy
tube, also called a trach ("trake") tube, keeps the new airway
open.
A partial laryngectomy preserves the voice. The surgeon removes only
part of the voice box -- just one vocal cord, part of a cord, or just the
epiglottis -- and the stoma is temporary. After a brief recovery period,
the trach tube is removed, and the stoma closes up. The patient can then
breathe and talk in the usual way. In some cases, however, the voice may
be hoarse or weak.
In a total laryngectomy, the whole voice box is removed, and the stoma
is permanent. The patient, called a laryngectomee,
breathes through the stoma. A laryngectomee must learn to talk in a new
way.
If the doctor thinks that the cancer may have started to spread, the
lymph nodes in the neck and some of the tissue around them are removed.
These nodes are often the first place to which laryngeal cancer
spreads.
Chemotherapy is the use of drugs to kill cancer cells. The
doctor may suggest one drug or a combination of drugs. In some cases,
anticancer drugs are given to shrink a large tumor before the patient has
radiation therapy or surgery. Also, chemotherapy may be used for cancers
that have spread.
Anticancer drugs for larynx cancer are usually given by
injection into the bloodstream. Often the drugs are given in cycles -- a
treatment period followed by a rest period, then another treatment and
rest period, and so on. Some patients have their chemotherapy in the
outpatient part of the hospital, at the doctor's office, or at home.
However, depending on the drugs, the treatment plan, and the patient's
general health, a hospital stay may be needed.
Larynx Cancer Treatment Studies
Researchers are looking for treatment methods that are more effective
against cancer of the larynx and have fewer side effects. When laboratory
research shows that a new method has promise, it is used to treat cancer
patients in clinical
trials
. These trials are designed to find
out whether the new approach is both safe and effective and to answer
scientific questions. Patients who take part in clinical trials make an
important contribution to medical science and may have the first chance to
benefit from improved treatment methods.
Many clinical trials of new treatments for larynx cancer are
under way. Doctors are studying new types and schedules of radiation
therapy, new drugs, new drug combinations, and new ways of combining
various types of treatment. Scientists are trying to increase the
effectiveness of radiation therapy by giving treatments twice a day
instead of once. Also, they are studying drugs called "radiosensitizers."
These drugs make the cancer cells more sensitive to radiation.
People who have had cancer of the larynx have an increased risk of
getting a new cancer in the larynx or in the lungs, mouth, or throat.
Doctors are looking for ways to prevent these new cancers. Some research
has shown that a drug related to vitamin A may protect people from new
cancers.
Patients who are interested in taking part in a trial should talk with
their doctor.
One way to learn about clinical trials is through PDQ, a computerized resource developed
by the National Cancer Institute. PDQ contains information about cancer
treatment and about clinical trials in progress all over the country. The
Cancer Information Service can provide PDQ information to doctors,
patients, and the public.
Side Effects of Treatment
The methods used to treat cancer are very powerful. It is hard to limit
the effects of therapy so that only cancer cells are removed or destroyed;
healthy cells also may be damaged. That's why treatment often causes
unpleasant side effects.
The side effects of cancer treatment vary. They depend mainly on the
type and extent of the treatment. Also, each person reacts differently.
Doctors try to plan the patient's therapy to keep problems to a minimum.
Doctors, nurses, dietitians, and speech pathologists can explain the side
effects of treatment and suggest ways to deal with them. It may also help
to talk with another patient. In many cases, a social worker or another
member of the medical team can arrange a visit with someone who has had
the same treatment.
Radiation Therapy
During radiation therapy, healing after dental treatment may be a
problem. That's why doctors want their patients to begin treatment with
their teeth and gums as healthy as possible. They often recommend that
patients have a complete dental exam and get any needed dental work done
before the radiation therapy begins. It's also important to continue to
see the dentist regularly because the mouth may be sensitive and easily
irritated during cancer therapy.
In many cases, the mouth is tender during treatment, and some patients
may get mouth sores. The doctor may suggest a special rinse to numb the
mouth and reduce the discomfort.
Radiation to the larynx causes changes in the saliva and may reduce the
amount of saliva. Because saliva normally protects the teeth, tooth decay
can be a problem after treatment. Good mouth care can help keep the teeth
and gums healthy and can make the patient feel more comfortable. Patients
should do their best to keep their teeth clean. If it's hard to floss or
brush the teeth in the usual way, patients can use gauze, a soft
toothbrush, or a special toothbrush that has a spongy tip instead of
bristles. A mouthwash made with diluted peroxide, salt water, and baking
soda can keep the mouth fresh and help protect the teeth from decay. It
may also be helpful to use a fluoride toothpaste and/or a fluoride rinse
to reduce the risk of cavities. The dentist may suggest a special fluoride
program to keep the mouth healthy.
If reduced saliva makes the mouth uncomfortably dry, drinking plenty of
liquids is helpful. Some patients use a special spray (artificial saliva)
to relieve the dryness.
Patients who have radiation therapy instead of surgery do not have a
stoma. They breathe and talk in the usual way, although the treatment can
change the way their voice sounds. Also, their voice may be weak at the
end of the day, and it is not unusual for the voice to be affected by
changes in the weather. Voice changes and the feeling of a lump in the
throat may come from swelling in the larynx caused by the radiation. The
treatment can also cause a sore throat. The doctor may suggest medicine to
reduce swelling or relieve pain.
During radiation therapy, patients may become very tired, especially in
the later weeks. Resting is important, but doctors usually advise their
patients to try to stay as active as they can. It's also common for the
skin in the treated area to become red or dry. The skin should be exposed
to the air but protected from the sun, and patients should avoid wearing
clothes that rub the area. During radiation therapy, hair usually does not
grow in the treated area; if it does, men should not shave. Good skin care
is important at this time. Patients will be shown how to keep the area
clean, and they should not put anything on the skin before their radiation
treatments. Also, they should not use any lotion or cream at other times
without the doctor's advice.
Some patients complain that radiation therapy makes their tongue
sensitive. They may lose their sense of taste or smell or may have a
bitter taste in their mouth. Drinking plenty of liquids may lessen the
bitter taste. Often, the doctor or nurse can suggest other ways to ease
these problems. And it helps to keep in mind that, although the side
effects of radiation therapy may not go away completely, most of them
gradually become less troublesome and patients feel better when the
treatment is over.
Surgery
Keeping the patient comfortable is an important part of routine
hospital care. If pain occurs, it can be relieved with medicine. Patients
should feel free to discuss pain control with the doctor.
For a few days after surgery, the patient isn't able to eat or drink.
At first an intravenous
(IV)
tube supplies fluids. Within a day or two, the digestive tract is getting
back to normal, but the patient still cannot swallow because the throat
has not healed. Fluids and nutrition are given through a feeding tube (put
in place during surgery) that goes through the nose and throat to the
stomach. As the swelling in the throat goes away and the area begins to
heal, the feeding tube is removed. Swallowing may be difficult at first,
and the patient may need the guidance of a nurse or speech pathologist.
Little by little, the patient returns to a regular diet.
After the operation, the lungs and windpipe produce a great deal of
mucus, also called sputum.
To remove it, the nurse applies gentle suction with a small plastic tube
placed in the stoma. Soon, the patient learns to cough and to suction
mucus through the stoma without the nurse's help. For a short time, it may
also be necessary to suction saliva from the mouth because swelling in the
throat prevents swallowing.
Normally, air is moistened by the tissues of the nose and throat before
it reaches the windpipe. After surgery, air enters the trachea directly
through the stoma and cannot be moistened in the same way. In the
hospital, patients are kept comfortable with a special device that adds
moisture to the air.
For several days after a partial laryngectomy, the patient breathes
through the stoma. Soon the trach tube is removed; within the next few
weeks, the stoma closes. The patient then breathes and speaks in the usual
way, although the voice may not sound exactly the same as before.
After a complete laryngectomy, the stoma is permanent. The patient
breathes, coughs, and "sneezes" through the stoma and has to learn to talk
in a new way. The trach tube stays in place for at least several weeks
(until the skin around the stoma heals), and some people continue to use
the tube all or part of the time. If the tube is removed, it is usually
replaced by a smaller tracheostomy
button (also called a stoma button). After a while, some
laryngectomees get along without either a tube or a button.
After a laryngectomy, parts of the neck and throat may be numb because
nerves have been cut. Also, following surgery to remove lymph nodes in the
neck, the shoulder and neck may be weak and stiff.
Chemotherapy
The side effects of chemotherapy depend on the drugs that are given. In
general, anticancer drugs affect rapidly growing cells, such as blood
cells that fight infection, cells that line the digestive tract, and cells
in hair
follicles. As a result, patients may have side effects such as
lower resistance to infection, loss of appetite, nausea, vomiting, or
mouth sores. They may also have less energy and may lose their hair.
Effects of Treatment on Eating
Loss of appetite can be a problem for patients treated for laryngeal
cancer. People may not feel hungry when they are uncomfortable or
tired.
Patients who have had a laryngectomy may lose their interest in food
because the operation changes the way things smell and taste. Radiation
therapy also tends to affect the sense of taste. The side effects of
chemotherapy can also make it hard to eat. Yet good nutrition is
important. Eating well means getting enough calories and protein to
prevent weight loss, regain strength, and rebuild normal tissues.
After surgery, learning to swallow again may take some practice with
the help of a nurse or speech pathologist. Some patients find liquids
easier to swallow; others do better with solid foods. If eating is
difficult because the mouth is dry from radiation therapy, patients may
want to try soft, bland foods moistened with sauces or gravies. Others
enjoy thick soups, puddings, and high-protein milkshakes. The nurse and
the dietitian will help the patient choose the right kinds of food. Also,
many patients find that eating several small meals and snacks during the
day works better than trying to have three large meals.
Rehabilitation
Learning to live with the changes brought about by larynx cancer
is a special challenge. Rehabilitation is a very important part of the
treatment plan. The medical team makes every effort to help patients
return to their normal activities as soon as possible.
Each laryngectomee must be able to care for the stoma. Before leaving
the hospital, the patient learns to remove and clean the trach tube or
stoma button, suction the trach, and care for the area around the stoma.
The skin is less likely to become irritated if it is kept clean.
When shaving, men should keep in mind that the neck may be numb for
several months after surgery. To avoid nicks and cuts, it may be best to
use an electric shaver until normal feeling returns.
Most people continue to use a stoma cover after the area heals. Stoma
covers -- such as scarves, neckties, ascots, and special bibs -- can be
attractive as well as useful. They help keep moisture in and around the
stoma. Also, laryngectomees may be sensitive to dust and smoke, and the
cover filters the air that enters the stoma. The cover also catches any
discharge from the windpipe when the person coughs or sneezes.
Whenever the air is too dry, as it may be in heated buildings in the
winter, the tissues of the windpipe and lungs may react by producing extra
mucus. Also, the skin around the stoma may get crusty and bleed. Using a
humidifier
at home or in the office can lessen these problems.
A person who has had neck surgery may find that the neck is somewhat
smaller. Also, the neck, shoulder, and arm may not be able to move as well
as before. The doctor may advise physical therapy to help the person move
more normally.
After surgery, laryngectomees work in almost every type of business and
can do nearly all of the things they did before. However, they cannot hold
their breath, so straining and heavy lifting may be difficult. Also,
laryngectomees have to give up swimming and water skiing unless they have
special instruction and equipment because it would be very dangerous for
water to get into the windpipe and lungs through the stoma. Wearing a
special plastic stoma shield or holding a washcloth over the stoma keeps
water out when showering or shaving.
Learning To Speak Again
It's natural to be fearful and upset if the voice box must be removed.
Talking is part of nearly everything we do, and losing the ability to talk
-- even temporarily -- can be frightening. Patients and their families and
friends need understanding and support during this very difficult
time.
Until patients learn to talk again, it is important for them to be able
to communicate in other ways. In the beginning, everyone who has had a
laryngectomy has to communicate by writing, gesturing, or pointing to
pictures, words, or letters. Some people like to use a "magic slate" for
writing notes. Others use pads of paper and pens or pencils. It's handy to
have a supply of pads that fit easily in a pocket or purse. In addition,
some patients use a typewriter or computer. Others carry a small
dictionary or a picture book (sometimes called a picture dictionary) and
point to the words they need. Patients may want to select some of these
items before the operation.
Within a week or so after a partial laryngectomy, most people can talk
in the usual way. After a total laryngectomy, patients must learn to speak
in a new way. A speech pathologist usually meets with the patient before
surgery to explain the methods that can be used. In many cases, speech
lessons can begin before the person leaves the hospital.
Patients may try out various new ways of talking. One way is to use air
forced into the esophagus to produce the new voice (esophageal
speech). Or the voice can come from some type of mechanical
larynx. Some people rely on a mechanical larynx only until they learn
esophageal speech, some decide to use this device instead of esophageal
speech, and some use both.
Even though esophageal speech may sound low-pitched and gruff, many
people want to use this method instead of a mechanical larynx because it
sounds more like regular speech. Also, there's nothing to carry around,
and the person's hands are free. A speech pathologist teaches the
laryngectomee how to force air into the top of the esophagus and then push
it out again. The puff of air is like a burp. It vibrates the walls of the
throat, producing sound for the new voice. The tongue, lips, and teeth
form words as the sound passes through the mouth.
For some laryngectomees, air for esophageal speech comes through a
tracheoesophageal
puncture. The surgeon creates a small opening between the trachea
and the esophagus. A plastic or silicone valve is inserted into this
opening through the stoma. The valve keeps food out of the trachea. When
the stoma is covered, air from the lungs is forced into the esophagus
through the valve. The air produces sound by making the walls of the
throat vibrate. Words are formed in the mouth.
It takes practice and patience to learn esophageal speech, and not
everyone is successful. How quickly a person learns, how natural the new
voice sounds, and how understandable the speech is depend partly on the
type and extent of the surgery. Other important factors are the patient's
desire to learn and the help that's available. Patience and support from
loved ones are important, too.
A mechanical larynx may be used until the person learns esophageal
speech or if esophageal speech is too difficult. The device may be powered
by batteries (electrolarynx)
or by air (pneumatic
larynx). The speech pathologist can help the patient choose a
device and learn to use it.
One kind of electrolarynx looks like a small flashlight. It has a disk
that makes a humming sound. The device is held against the neck, and the
sound travels through the neck to the mouth. (This device may not be
suitable for people who have had radiation therapy.) Another type of
electrolarynx has a flexible plastic tube that carries sound to the
person's mouth from a hand-held device.
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
Regular followup is very important after treatment for cancer of the
larynx. 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 does a complete physical exam, blood and urine tests,
and x-rays. People treated with radiation therapy or partial laryngectomy
will have a laryngoscopy.
People who have been treated for cancer of the larynx have a
higher-than-average risk of developing a new cancer in the mouth, throat,
or other areas of the head and neck. This is especially true for those who
smoke. Most doctors strongly urge their patients to stop smoking to cut
down the risk of a new cancer and to reduce other problems, such as
coughing.
Living With Cancer
The diagnosis of cancer can change the lives of patients and the people
who care about them. These changes can be hard to handle. It's natural for
patients and their families and friends to have many different and
sometimes confusing emotions.
At times, patients and their loved ones may feel frightened, angry, or
depressed. These are normal reactions when people face a serious health
problem. Most people handle their problems better if they can share their
thoughts and feelings with those close to them. Sharing can help everyone
feel more at ease and can open the way for people to show one another
their concern and offer their support.
Worries about tests, treatments, hospital stays, learning to talk
again, and medical bills are common. Doctors, nurses, speech pathologists,
social workers, and other members of the health care team can help calm
fears and ease confusion. They can also provide information and suggest
resources.
Patients and their families are naturally concerned about what the
future holds. Sometimes they use statistics to try to figure out the
chance of being cured. It is important to remember, however, that
statistics are averages based on large numbers of patients. They can't be
used to predict what will happen to a certain patient because no two
cancer patients are alike. The doctor who takes care of the patient is the
best one to discuss that person's outlook (prognosis).
People should feel free to ask the doctor about their prognosis, but
not even the doctor knows for sure what will happen. Doctors may talk
about surviving cancer, or they may use the term remission
rather than cure. Even though many people with larynx cancer
recover completely, doctors use these terms because the disease can recur.
Support for Larynx Cancer Patients
Living with a serious disease isn't easy. Cancer patients and those who
care about them face many problems and challenges. Finding the strength to
cope with these difficulties is easier when people have helpful
information and support services.
People who have cancer of the larynx may have concerns about the
future, family and social relationships, and finances. Sometimes they
worry that changes in how they look and talk will affect the way people
feel about them. They may worry about holding a job, caring for their
family, or making new friends.
The doctor can explain the disease and give advice about treatment,
going back to work, or daily activities. It may also help to talk with a
nurse, social worker, counselor, or member of the clergy, especially about
feelings or other very personal matters.
Many patients find that it's useful to get to know other people who are
facing problems like theirs. They can meet other cancer patients through
self-help and support groups. Often, a social worker at the hospital or
clinic can suggest local and national groups that can help with emotional
support, rehabilitation, financial aid, transportation, or home care.
Cause and Prevention
Cancer of the larynx occurs most often in people over the age of 55. In
the United States, it is four times more common in men than in women and
is more common among black Americans than among whites. Scientists at
hospitals and medical centers all across the country are studying this
disease to learn more about what causes it and how to prevent it.
Doctors cannot explain why one person gets larynx cancer and
another does not, but we are sure that no one can "catch" cancer from
another person. Cancer is not contagious.
One known cause of cancer of the larynx is cigarette smoking. Smokers
are far more likely than nonsmokers to develop this disease. The risk is
even higher for smokers who drink alcohol heavily.
People who stop smoking can greatly reduce their risk of cancer of the
larynx, as well as cancer of the lung, mouth, pancreas, bladder, and
esophagus. Also, by quitting, those who have already had cancer of the
larynx can cut down the risk of getting a second cancer of the larynx or a
new cancer in another area. Special counseling or self-help groups are
useful for some people who are trying to stop smoking. Some hospitals have
groups for people who want to quit. Also, the Cancer Information Service
and the American Cancer Society may have information about groups in local
areas to help people quit smoking.
Working with asbestos
can increase the risk of getting larynx cancer. Asbestos workers
should follow work and safety rules to avoid inhaling asbestos fibers.
People who think they might be at risk for developing cancer of the
larynx should discuss this concern with their doctor. The doctor may be
able to suggest ways to reduce the risk and can suggest an appropriate
schedule for checkups.
Keeping on Top of Your Condition
Keeping in tune with your disease or condition not only makes treatment less intimidating but also increases its chance of success, and has been shown to lower a patients risk of complications. As well, as an informed patient, you are better able to discuss your condition and treatment options with your physician.
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