Before treatment for laryngeal cancer starts, you will see your doctor or specialist nurse. They will give you information about the treatment and help you prepare. You may also see a:
- speech and language therapist (SLT)
You can ask your cancer doctor or specialist nurse to refer you to anyone in the multidisciplinary team (MDT) at any time. This can be before, during or after your treatment.
If you smoke or drink alcohol, your cancer doctor or specialist nurse will give you advice on stopping.
If you smoke, there are lots of benefits of stopping before treatment. Stopping smoking means:
- you are likely to have fewer side effects from cancer treatment
- the side effects of treatment may be less severe.
We have more information about giving up smoking that you may find helpful.
Not drinking alcohol, particularly spirits, may help make some side effects of treatment less severe. Stopping drinking alcohol can also reduce your risk of developing another head and neck cancer.
Your specialist nurse or cancer doctor can give you support to reduce how much alcohol you drink. There is more information about alcohol and drinking guidelines at drinkaware.co.uk.
Your cancer doctor may refer you to a dentist with experience in treating people who have laryngeal cancer. Or you might need to see your own dentist. This is to make sure your teeth or dentures are in good condition. This can reduce the risk of mouth problems during and after treatment. If you are going to have radiotherapy and some of your teeth are unhealthy, you may need them removed before your treatment starts.
You may also see an oral hygienist. They can give you advice on how to look after your teeth and gums. Knowing how to look after your mouth is very important. This is because cancer treatment may make it more sensitive and likely to get infections. This can happen particularly if you have radiotherapy.
Before treatment for cancer of the larynx, you will see a speech and language therapist (SLT). Treatment can affect your breathing, speech and voice in different ways. Your SLT will talk to you about possible effects of treatment. They will also explain how to cope with these changes.
If you have radiotherapy, you will breathe and speak in the same way, but your voice may become hoarse.
If you have surgery, you may need to learn how to breathe and speak in a different way. Effects on your breathing and speech will depend on the type of surgery you have. Your surgeon and SLT will talk to you about what changes to expect from your surgery. Remember, you will get lots of support to help you cope with any changes.
If your team think treatment may affect your swallowing, you may see a dietitian and speech and language therapist (SLT). They can help with any swallowing and dietary problems you have before treatment. Your SLT can also tell you about any effects treatment is likely to have on your swallowing. They will talk to you about what can help.
Sometimes radiotherapy can make it very difficult to swallow. This can happen particularly if radiotherapy is combined with chemotherapy (chemoradiation). Your SLT can show you exercises to help improve swallowing after treatment. These will depend on the type of swallowing difficulties you have. Usually, swallowing improves within a few months of finishing treatment. Some people find it takes longer to improve. Rarely, some swallowing difficulties are permanent.
If your team thinks you may develop swallowing difficulties during treatment, they may suggest you are fed through a tube for a while. This is to make sure you have enough calories to maintain or gain weight.
If you have a feeding tube
There are different ways you can be fed by a tube:
- Nasogastric (NG) feeding – a thin tube is passed up the nose and down into the stomach. It is used for shorter periods of time, for example less than 4 weeks.
- Gastrostomy feeding – a tube is passed through the skin and muscle of the tummy (abdomen) into the stomach. This is called a percutaneous endoscopic gastrostomy (PEG) or radiologically inserted gastrostomy (RIG) tube. This depends on how the tube is put into the stomach. You may have this if you need to be fed through a tube for a longer period of time.
If you have problems swallowing and need to be tube fed, your healthcare team will explain which type will be best for you. When your swallowing improves, and you can eat and drink more through your mouth, the tube may be removed.
You may need to go home with a feeding tube. If this happens, your dietitian or a nurse can teach you, and your family members or friends, how to use and look after it safely. You may also have home visits from community nutritional care nurses. These nurses can help with feeding tube care and setting up the feeds.
We have more information about nutritional support and artificial feeding.