Long-term and late effects of laryngeal cancer treatment

Some side effects of treatment can take time to get better. Sometimes side effects may become permanent. Other side effects may develop some time after treatment has finished. These are called late effects. You may not have any late effects, or they may range from being mild to more severe.

Always tell your cancer doctor or specialist nurse about any problems you have. There may be things they can do to help.

Problems swallowing

Treatments for laryngeal cancer can cause the wall of the gullet (oesophagus) to become thicker. This makes the gullet narrower, which can cause problems with swallowing. Treatments can also cause a loss of sensation when swallowing.

If you notice any problems when eating and drinking, tell your cancer doctor or specialist nurse straight away. They can refer you to a speech and language therapist (SLT). Your SLT can help with any feeding and swallowing problems. They can suggest foods that may be easier for you to swallow.

Dry mouth

Radiotherapy can damage your salivary glands, causing a dry mouth. This effect may be temporary, but sometimes it can be permanent. Sometimes, having a dry mouth can make eating and speaking difficult.

You may need to carry water with you, or eat softer foods with plenty of sauce or gravy. These will be easier to swallow. Some people keep a humidifier by their bed at night to help stop their mouth and throat getting dry. Others keep a glass of water by the bed to sip if they wake up.

You can also use mouthwashes and protective gels to coat the lining of your mouth. Your cancer doctor or GP can give you these. You can talk to staff at the radiotherapy outpatient department about ways to cope with a dry mouth.

We have more information about dry mouth and changes in saliva after head and neck cancer treatment which you might find useful.

Dental problems

If you have a dry mouth, you are more at risk of problems with your teeth. This is because saliva protects your teeth from decay. It is important to have regular check-ups every 3 to 6 months with your dentist and oral hygienist.

You should also follow a regular daily mouth care routine to prevent tooth decay. Your dentist may give you fluoride products and advise you on brushing your teeth and keeping your gums healthy.

Underactive thyroid

The thyroid is a small gland in the front of the neck, just below the larynx. It makes hormones, including thyroxine, that help keep the body working at the correct speed. Surgery or radiotherapy to the larynx can affect the thyroid gland so it produces less thyroxine. When this happens, it is called an underactive thyroid or hypothyroidism.

You will have blood tests to monitor your thyroid hormone levels. Symptoms of hypothyroidism include:

  • tiredness
  • weight gain
  • dry skin and hair
  • feeling cold.

If you develop this condition, your cancer doctor may give you thyroid hormone replacement tablets.

Lymphoedema

Lymphoedema happens when a fluid called lymph causes swelling in the neck, face or under the chin. It can develop when lymph nodes have been removed or damaged by surgery or radiotherapy.

The earlier lymphoedema is diagnosed, the easier it is to treat. It is important to tell your cancer doctor or specialist nurse if you have any swelling. They may refer you to a lymphoedema specialist.

Changes in your appearance and how you talk

Cancer of the larynx and its treatments can cause changes to how you look and talk. These changes can sometimes affect your body image. This is the picture you have of yourself in your mind. If your voice sounds different to how it did before treatment, it can affect your confidence.

Thoughts and feelings about your body image can be difficult to deal with. You may find that you go through many different emotions.

It takes time to adjust to a change in how you look and talk. But there is no set time or way of doing this. For some people it may take weeks, for others it may take months or even years. This experience will be individual to you. But you may meet other people who have similar thoughts and feelings.

You can get advice and support from organisations such as Changing Faces or Let’s Face It. You will also get support from your healthcare team.

Meeting other people

After your treatment, you and the people close to you will become more familiar with how you look and talk. As this happens, you may think about seeing other people and going back to work. Avoiding social situations for a long time might make it harder to go out. It is best to start by going somewhere familiar. You may want to take someone with you for support.

Be prepared for mixed reactions. You may find that people take far less notice of you than you expected. But some people may make insensitive comments or unhelpful suggestions. Children are often openly curious and may ask why you look or sound different. You may want to decide in advance how to answer. Share as much as you feel comfortable with. But saying that you have had an operation should be enough. You do not have to go into detail.

Coping successfully with social situations will help build your confidence.

You can get more information about how to manage people’s reactions from organisations such as Changing Faces or Let’s Face It.

Eating and socialising

Many social activities involve eating and drinking. If you have difficulty chewing or swallowing, you may feel anxious or unsure about eating in front of other people. Everyone has their own way of dealing with these issues.

If you feel self-conscious about eating with others, it may help to get used to eating at home with people you know first. When you feel ready to try eating away from home, do something simple to start with. For example, you could go for an ice cream. You can start to do other things as your confidence grows. We have more information about eating and socialising. Your speech and language therapist (SLT) can give you more advice about eating out.

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