Depending on the location of the cancer, you may have difficulty breathing. People with nasal cancer may find it hard to breathe through the nose. People with cancers of the throat and larynx may feel it is harder to get air in.
Learn more about:
- Getting a tracheostomy
- Temporary tracheostomy
- Laryngectomy stoma
- Living with a tracheostomy or stoma
- Restoring speech after a laryngectomy
Your surgeon may need to create an alternative airway in the front of your neck to bypass the tumour and help you breathe freely. This is known as a tracheostomy. The surgeon will make a hole in the front of your neck under general anaesthetic and then place a tracheostomy tube through the hole into the windpipe (trachea). You may find the thought of a tracheostomy scary, but being able to breathe easily will make you feel more comfortable.
You may have a temporary tracheostomy during radiation therapy or after some types of surgery, particularly when swelling is expected to the mouth and throat. Your surgeon will let you know if this is likely. With a temporary tracheostomy, the tube will usually be removed after a recovery period, and the hole will close up within a few days or weeks. At first your voice may be weak and breathy, but it should return to normal once the hole has healed. A speech pathologist can teach you to speak and assess your swallowing, and a physiotherapist can show you exercises and airway clearance techniques to make breathing easier.
If you have a total laryngectomy, a permanent stoma or breathing hole will be created at the time of the surgery. If you need a permanent stoma, your health care team will discuss this with you and teach you how to look after it.
Having a tracheostomy or stoma is a big change and takes some getting used to. Your specialist, nurse or speech pathologist can explain ways to manage the following changes:
- caring for the tube or stoma – your health care team will show you how to clean and care for the tracheostomy tube or stoma
- coping with dry air – the air you breathe will be much drier since it no longer passes through your nose and throat, which normally moistens and warms the air. This can cause irritation, coughing and excess mucus coming out of the tracheostomy tube or stoma. There are products available that cover the stoma or attach to the tracheostomy tube to provide heat and moisture for the trachea
- swimming and bathing – you will need to use special equipment to avoid water getting into the windpipe, even in the shower. If you have a laryngectomy stoma, you may not be able to go swimming.
Mechanical speech – A battery-powered device called an electrolarynx is used to create a mechanical voice. The device is held against the neck or cheek or placed inside the mouth. You press a button on the device to make a vibrating sound.
Tracheoesophageal puncture (TEP) speech – Your surgeon creates a puncture between your trachea and oesophagus. A small voice prosthesis (or valve) is inserted to direct air from your trachea to the oesophagus. This creates a low-pitch, throaty voice.
Oesophageal speech – You swallow air and force it up through your oesophagus to produce a low-pitched burp. This technique can be difficult and you will need training.
A/Prof David Wiesenfeld, Oral and Maxillofacial Surgeon, Director, Head and Neck Tumour Stream, The Victorian Comprehensive Cancer Centre at Melbourne Health, VIC; Alan Bradbury, Consumer; Dr Ben Britton, Senior Clinical and Health Psychologist, John Hunter Hospital, NSW; Dr Madhavi Chilkuri, Radiation Oncologist, Townsville Cancer Centre, The Townsville Hospital, QLD; Jedda Clune, Senior Dietitian (Head and Neck Cancer), Sir Charles Gairdner Hospital, WA; Dr Fiona Day, Staff Specialist, Medical Oncology, Calvary Mater Newcastle, and Conjoint Senior Lecturer, The University of Newcastle, NSW; Dr Ben Dixon, ENT, Head and Neck Surgeon, Peter MacCallum Cancer Centre and St Vincent’s Hospital Melbourne, VIC; Emma Hair, Senior Social Worker, St George Hospital, NSW; Rosemerry Hodgkin, 13 11 20 Consultant, Cancer Council WA; Kara Hutchinson, Head and Neck Cancer Nurse Coordinator, St Vincent’s Hospital Melbourne, VIC; A/Prof Julia Maclean, Speech Pathologist, St George Hospital, NSW; Prof Jane Ussher, Chair, Women’s Health Psychology, Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, NSW; Andrea Wong, Physiotherapist, St Vincent’s Hospital Melbourne, VIC. We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title.
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