Treatment Options for Laryngeal Cancer

Booklet: What You Need to Know about Laryngeal Cancer

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Side Effects of 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.

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