Wednesday, December 18, 2013

Can A Person With Voice Box Cancer (Larynx) Speak After Surgery?

The cancer caused by tobacco consumption are on rise of which head & neck cancer top the list. The presenting symptom could be recent onset persistent change of voice or heavy voice, prolonged throat irritation, weight loss, cough. These are the symptoms of voice box cancer. After thorough investigation and biopsy test patient is confirmed that patient is suffering from cancer of voice box. If the disease is not spread to lung, liver or bone, the treatment is surgery or radiotherapy or both. As the patient is told that surgery has to be done to remove his or her cancer, patient get concerned about speaking, will he be able to speak and communicate to the fellow colleagues, near and dear ones and whether he can eat normally. YES, a person can communicate after surgical treatment of the voice box cancer and he can eat normally. This requires a doctor who has been trained in performing voice conserving surgery and speech rehabilitation.

A 64 years gentleman X came to our hospital with throat irritation and pain in the throat (neck) during eating since 4 months, he was a chronic smoker. On examination and investigations patient was diagnosed as cancer which was confined to the part of voice box. The patient was worried whether he can speak or eat as before, we assured him that voice can be preserved. His voice preserving surgery was performed taking utmost care to totally remove the cancer and to preserve the vital nerves controlling the speech and vocal cords .After the operation he was confirmed of early stage cancer and did not require any other treatment. He was discharged 10th day from the hospital. He is fine and leading a normal life.

A 50 year male who was also a smoker presented with throat irritation and heaviness in voice since 6months.On examination and investigations patient was diagnosed as cancer which was involving a larger portion of voice box even extending to one of the vocal cords, this was staged as locally advanced cancer which will require surgery and radiotherapy both. This patient had a disease which required removal of cancer which might amount to total removal of larynx if the surgeon is not well trained in doing voice preservation surgery. This patient underwent removal of the cancer with confirmation during operation by advanced pathology technique (Frozen section) .One uninvolved vocal cord was spared and valve made for the patient to speak (Near Total Laryngectomy).This patient was discharged on the 7th day after operation, he can communicate effectively.

Another 60 years gentleman came who was heavy smoker had change in voice with difficulty in breathing especially during sleeping. on investigation he was found to have advanced cancer of voice box where both vocal cord were effected, he was also worried whether he can get rid of the disease or not, if yes whether it can be managed without surgery as how he will live without speaking. I convinced him that because of advanced nature of disease he has to undergo surgery full voice box will be removed so that cancer is totally removed and he can communicate very effectively also. After that patient agreed for surgery and one speaking valve was put in the neck, he was given radiotherapy after operation at present he is leading near normal life.

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