Recovery after surgery for laryngeal cancer (cancer of the voice box) involves more than the closing of the wound; regaining the functions of breathing, swallowing and speech forms the main part of the process. This process differs according to the type of operation and is carried out with the support of a team made up of a speech and swallowing therapist, nurses and your doctor. Patience and regular exercise are the most important aids to recovery.
The first days
In the first days after surgery, swelling, pain and tiredness in the neck are normal. Pain is kept under control with regularly given painkillers; the drains in the wound area are removed within a few days. Until swallowing is safe, nutrition is provided through a temporary thin tube running from the nose to the stomach. Getting out of bed early and taking short walks protects the lungs and speeds up recovery.
Relearning to swallow
After partial or complete laryngeal operations, swallowing may be difficult for a while. The speech and swallowing therapist determines which food consistencies are safe and teaches swallowing exercises. Usually you start with liquids and puréed foods, and move on to solid foods over time. If you cough or feel as if you are choking while swallowing, you should tell your therapist. Adequate nutrition is decisive for wound healing and general strength.
Stoma care
After operations in which the larynx is removed completely, breathing takes place through the permanent opening in the neck (stoma). Because the air you breathe no longer passes through the nose, it is not warmed and humidified; for this reason, heat and moisture exchange filters fitted in front of the stoma are used. Cleaning the stoma daily, softening and removing crusts, and protecting it from water while showering are taught before discharge. Over time this care becomes an ordinary part of daily life.
Voice rehabilitation
The voice is regained in different ways, depending on the type of operation:
- After partial operations: the remaining vocal cords or neighbouring tissues continue to vibrate and produce sound; voice therapy improves the strength and clarity of the voice.
- Voice prosthesis (speech prosthesis): in patients whose larynx has been removed completely, a small one-way valve placed between the windpipe and the gullet allows air from the lungs to pass into the gullet and set up a vibration there. It is today the most widespread method and the one closest to the natural voice.
- Oesophageal speech: sound is produced by swallowing air and releasing it in a controlled way; it takes time and patience to learn, but requires no device.
- Electrolarynx: a small vibration-producing device held against the neck or cheek makes speech possible; it is especially helpful for communication in the early period.
The therapist determines the most suitable method for you and teaches you how to use it in regular sessions.
Returning to daily life
Returning to work and social life may take from a few weeks to a few months, depending on the extent of the operation and your general health. Exercises that maintain the movement of the neck and shoulders prevent shoulder stiffness, especially after a neck dissection. Staying away from smoking and alcohol speeds up recovery and reduces the risk of a new tumour. It is natural to go through emotional strain; family support and, when needed, psychological support are part of the process.
When to see a doctor
If you notice bleeding or a foul-smelling discharge from the wound, fever, difficulty breathing, constant coughing while swallowing, or redness and pain around the stoma, contact your doctor without delay.
Frequently asked questions
If my larynx has been removed completely, will I never speak again?
You will be able to speak. With methods such as a voice prosthesis, oesophageal speech or an electrolarynx, and with the support of a therapist, it is possible to speak intelligibly again.
Can I shower or swim with a stoma?
You can shower using a special cover that protects the stoma from water; swimming, however, is not safe without special equipment, because water can pass directly into the lungs.
When can I return to work after the operation?
This depends on the extent of the operation and the nature of your work; it usually ranges from a few weeks to a few months, and the decision is made together with your doctor.
This page is general information. Decisions about diagnosis and treatment are made for you personally, and only after an examination. If you have symptoms, see a doctor.