Breathing changes

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.

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Getting a tracheostomy

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.


Temporary tracheostomy

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.

Laryngectomy stoma

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.


Living with a tracheostomy or stoma

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.

Restoring speech after a laryngectomy

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.

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Apple devices

The iBooks application must be installed on your Apple device before you can read the EPUB.
Different ways to download an EPUB file to your Apple device:

  • email EPUB files to yourself and transfer the attachment to iBooks.
  • copy EPUB files into DropBox (or a similar service) and use the DropBox app to send them to iBooks.
  • open EPUB files directly from Mobile Safari and open them in iBooks, where they are saved automatically by downloading the EPUB from the website.

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To download an EPUB file to your Kobo from a Windows computer:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • select “Open folder to view files” to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

To download an EPUB to your Kobo from a Mac:

  • download and save the EPUB directly onto your desktop.
  • connect your Kobo to your computer using the USB cable and tap “Connect” on your eReader.
  • open your “Finder” application.
  • select “Kobo eReader” from the listed devices to view the contents of your Kobo.
  • navigate to where you have stored your EPUB file in “Finder”, probably in documents or downloads, and drag and drop it into the Kobo window. You can now disconnect your Kobo to read the eBook.

Turn on your Kobo and your EPUB will be located in “eBooks”, while a PDF will be located in “Documents”.
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Sony Reader

To download an EPUB file on your Sony Reader™:

  • ensure you have already installed the Reader™ Library for PC/Mac software
  • select the eBook you want from our website and click the link to download it.
  • connect the Reader™ to your computer.
  • open the Reader™ Library software and click “Library” in the left-hand pane and select the eBook to view it.

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Amazon Kindle 2nd Generation devices

EPUB files can’t be read on the Amazon Kindle™. However, like most eReaders, Kindle™ 2nd Generation devices are able to display PDFs. We recommend that you download the PDF version of this booklet if you would like to read it on a Kindle™.
To transfer a PDF to your Kindle™ via USB cable from your computer or Mac:

  • download the PDF directly onto your computer.
  • connect the USB cable to your computer’s USB port, and the micro USB end of the cable to your Kindle™. Note: the Kindle™ won’t be available as a reading device while it is connected to your computer until it has been disconnected.
  • open the Kindle™ drive and several folders will appear inside. The “Documents” folder is where you will need to copy or drag the PDF to.
  • safely eject your Kindle™ from your computer and unplug the USB cable. Your content will appear on the Home Screen.

Kindle also provides a Kindle Personal Documents Service that allows users to send documents as an attachment directly to your eReader. For more information on this service, visit
For more information on accessing a PDF on your Kindle™, visit, log in to your account and click on Personal Document Settings.
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Android and PC

You can also download and open eBooks on Android devices and PCs with appropriate apps or software installed. Suitable eReader apps for Android include Google Play Books, FBReader and Moon+ Reader. Suitable software for PCs include Calibre and Adobe Digital Editions.

This information was last reviewed in September 2019
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