Coping and Support
Some people who have had a laryngectomy are very worried about the change in their appearance. You may feel embarrassed about the stoma, which can affect your self-confidence and may be distressing. It can take time for you to adjust, but help is available.
In the hospital your doctor, nurse and speech and language therapist can give you expert advice. They can give information and support and put you in touch with someone in your area who has had a laryngectomy, to get practical advice. The National Association of Laryngectomee Clubs and the Cancer Laryngectomee Trust have national networks. The support of a partner, family member or close friend can also be very helpful at this time.
Effects of a tracheostomy
After a laryngectomy, the air breathed in through the stoma goes directly into the lungs and so is no longer warmed and moistened by the nasal passages. The cooler, dry air going into the throat can irritate the lining of the throat and lungs. This can increase the production of mucus (sputum) and may cause coughing.
Itís very important to keep the stoma covered with a stoma cover or filter. You will be shown different types of stoma filter while you are on the ward and will be taught how to use them. Itís also important to avoid getting any liquid into the stoma.
You wonít be able to sniff or blow your nose. If you have a cold or a chesty cough the mucus (phlegm) will be coughed up through the tracheostomy, not through your mouth.
Reduced sense of smell and taste
After a total laryngectomy, you do not breathe through your nose and mouth and may lose your sense of smell. After a few months this can go back to normal. You may be able to have some sense of smell by learning the 'polite yawning technique', where you yawn with closed lips. This draws air in through the nose, allowing you to smell. It can also improve your sense of taste. Your speech and language therapist may be able to teach you how to do this.
Small devices known as stoma filters are available. They are also known as heat and moisture exchangers (HMEs). These can be attached over the stoma or put onto the tracheostomy tube to warm and moisturise the air. HMEs can reduce the production of sputum and help to prevent coughing and chest infections. Your doctor, nurse or speech and language therapist can show you these devices.
Hands-free valves allow people using a voice prosthesis to speak without needing to cover the stoma with a finger. As well as being known as hands-free valves they are sometimes called Tracheostoma valves. They are not suitable for everyone, but you could ask your specialist or speech and language therapist whether they would be appropriate in your case. They are available on prescription.
A tracheostomy can make you more likely to get chest infections. If you notice any change in the colour of your sputum, or have a cough that does not go away, itís important to report it to your doctor straight away. They may prescribe antibiotics for you.
Shower aids are available to prevent water going into the stoma whilst you have a shower. You can ask your specialist nurse or speech and language therapist about these.
Once you have a tracheostomy, you wonít be able to swim without using specialist equipment. This equipment can be used to stop water from going into the stoma. It is only available (in the UK) through the National Association of Laryngectomee Clubs, which give training to make sure that people can use the equipment safely.
Follow-up after treatment for laryngeal cancer
After your treatment has ended, your cancer specialist will ask you to go back to the hospital for regular check-ups and possibly scans or x-rays. These will often continue for several years. If you have any problems or notice any new symptoms in between appointments, let your doctor know as soon as possible.
For people whose treatment is over apart from regular check-ups, our booklet on adjusting to life after cancer treatment gives useful information and advice.
Two things that may increase your risk of cancer of the larynx coming back are smoking and alcohol. Your cancer specialist or GP can advise you on your alcohol intake and give information on how to stop smoking. There is also a free NHS smoking helpline and QUIT, which both give help and support if you are trying to give up smoking.
Living with and after cancer
Information on the emotions you might experience as a result of your cancer diagnosis, ways that you might manage them and other sources of support.
Relationships and communication
Advice on how to talk to other people, talking to children, relationships and sexuality.