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February 10, 2012

Larynx Cancer (cont.)

Surgery

Surgery is a common treatment for people with cancer of the larynx. The surgeon may use a scalpel or laser. Laser surgery may be performed with a laryngoscope. You and your surgeon can talk about the types of surgery and which may be right for you:

  • Removing part of the larynx: The surgeon removes only the part of the larynx that contains the tumor.
  • Removing all of the larynx: The surgeon removes the entire larynx and some nearby tissue. Some lymph nodes in the area may also be removed.

It takes time to heal after surgery, and the time needed to recover is different for each person. It's common to feel weak or tired for a while, and your neck may be swollen.

Also, you may have pain or discomfort for the first few days. Medicine can help control your pain. Before surgery, you should discuss the plan for pain relief with your doctor or nurse. After surgery, your doctor can adjust the plan if you need more pain control.

Surgery may change your ability to swallow, eat, or talk. You may need to have reconstructive or plastic surgery to rebuild the tissue. The surgeon may use tissue from another part of your body to repair the throat. You can have reconstructive or plastic surgery at the same time as you have the cancer removed, or you can have it later on. Talk with your doctor about which approach is right for you.

If you lose the ability to talk for a short time after surgery, you may find it helpful to use a notepad, writing toy (such as a magic slate), cell phone, or computer to write messages. Before surgery, you may want to make a recording for your answering machine or voicemail that tells callers that you have lost your voice.

Some people may need a temporary feeding tube.

Stoma

The surgeon may need to make a stoma. The stoma is a new airway through an opening in the front of your neck.

Air enters and leaves the trachea and lungs through this opening. A metal or plastic tube (a trach tube) keeps the new airway open.

Before you leave the hospital, your health care team will teach you how to care for the stoma. You will learn to remove and clean the trach tube, clean out your airway, and care for the skin around the stoma.

You may want to follow these tips:

  • Keep the skin around the stoma clean.
  • If the air is dry, use a humidifier.
  • If the air is dusty or smoky, cover your stoma with a scarf, tie, or specially made cover.
  • Protect your stoma from water.Cover your stoma before you take a shower.
  • Cover your stoma when you cough or sneeze.

For many people, the stoma is needed only until recovery from surgery. Several days after surgery, the tube will be removed, and the stoma will close up. If your entire larynx is removed, the stoma will be permanent.

People with stomas work in almost every type of business and can do nearly all of the things they did before surgery. However, they can't hold their breath, so heavy lifting may be hard. Also, swimming and water skiing are not possible without a special device and training to keep water out of the lungs.

Some people may feel self-conscious about the way they look and speak with a stoma. They may be concerned about how other people feel about them. They may also be concerned about how their sex life may be affected. Many people find that talking about these concerns is helpful.

You may want to ask your doctor these questions before having surgery:

  • Do you recommend surgery to remove the tumor? Why? Do I need any lymph nodes removed? Will other tissues in my neck need to be removed?
  • After surgery to remove the cancer, will my throat area need to be repaired with tissue from another part of my body?
  • What is the goal of surgery?
  • How will I feel after surgery? How long will I be in the hospital?
  • What are the risks of surgery?
  • Will I have trouble swallowing, eating, or speaking? Will I need to see a speech-language pathologist for help?
  • What will my neck look like after surgery? Will I have a scar?
  • If I need a stoma, do you recommend that I get a medical bracelet that says "neck breather"?
  • Will I need reconstructive or plastic surgery? When can that be done?

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