Survivorship: Life After Laryngectomy
A laryngectomy is a surgery done to remove the larynx. The person who had the procedure is called a "laryngectomee." The larynx is the "voice box" or vocal cords, which vibrate as air passes over them during exhalation (as you breathe out). This vibration makes sound, which is made into speech by the parts of our mouth. If the larynx is removed, speech sounds cannot be made. A “partial laryngectomy” may allow speech, though in many cases it will be different than the speech was before surgery and may be harder for people to understand. In addition, the trachea (breathing tube) is redirected when the larynx is removed, resulting in a stoma (hole) in the neck that the laryngectomee breathes through. This is referred to as a "neck breather." These changes bring about some practical and safety concerns of which you should be aware.
- Before you need their services, tell your local 911 and EMS of your condition so that they will respond even if you do not speak when you call.
- Get a medical alert bracelet identifying you as a "neck breather." This is important because CPR breathing, or oxygen given through your mouth is ineffective.
- Carry something that can be used as an alarm in an emergency when you would otherwise yell for help. For example, an alarm for a keychain or bell can call attention to you.
- If you cannot speak or speech is hard to understand, carry paper and pen to write messages.
- Because the air you breathe is not going through your nose, you will have decreased ability to smell, which can cause safety issues. You may not smell smoke from a fire, natural gas or sour food, for example. Make sure you have working smoke detectors and change the batteries every 6 months.
- Showering: You will need to avoid getting water in the stoma. Options to keep water out: foam filters, stoma covers, or something else that could be used to cover the stoma like a washcloth or baby bib. Many laryngectomees get comfortable with showering over time and don’t need anything to cover the stoma.
- Clean Air: Remember that the air going into the stoma when you breathe goes directly to your lungs. Be cautious about dust, pet hair, aerosol sprays, etc. – anything that can be in the air and inhaled. You may want to use a stoma cover for certain activities where the risk of inhaling something is higher.
- Humidification: Prior to surgery, the air you were breathing was humidified by your nose and mouth. After surgery, you no longer have this built in humidifier. The dry air leads to increased mucus production as the lungs try to moisten the air. You will need to learn how to increase the moisture level in the air you breathe and retain this moisture. Some ways to do this are to use a cool-mist humidifier when sleeping, saline squirts and stoma covers. You can learn much more about humidification from your healthcare team or at the resources listed below.
Speech & Swallowing
Issues with speech and swallowing are common after laryngectomy, but these issues can arise at any point in a survivor's life. If you have any difficulty swallowing at any time, notify your oncology team. A speech language pathologist (SLP) can help with any swallowing difficulties and teach you about devices and techniques to assist with your speech. SLPs can be accessed at any time in a survivor's life for new concerns or to explore newer technologies for speech.
As you recover from surgery and get back to life, you are sure to encounter situations that you weren't prepared for. Your healthcare team is there to support you and answer questions. The following resources can provide lots of practical tips from other survivors who have "been there."
Web Whispers: Throat Cancer and Laryngectomee Rehabilitation - Offers advice, tips and education from survivors.
Support for People with Oral Head & Neck Cancer (SPOHNC): Provides support groups, buddy programs, education, and awareness.
American Cancer Society. (2017). Living as a Laryngeal or Hypopharyngeal Cancer Survivor. Retrieved from https://www.cancer.org/cancer/laryngeal-and-hypopharyngeal-cancer/after-treatment/follow-up.html
Eadie, T.L., & Bowker, B.C. (2012). Coping and Quality of Life After Total Laryngectomy. Otolaryngol Head Neck Surg, 146(6), 959-965. doi: 10.1177/0194599812437315.