Caring for the Laryngectomy Patient

Abstract

aryngeal cancer is the most common type of cancer of the upper respiratory tract. Though it comprises less than 2% of all cancers in the United States, approximately 12,500 new cases are diagnosed each year, with about 3.5% resulting in death. The most common treatment of advanced laryngeal cancer is total laryngectomy-surgical removal of the larynx, hyoid bone, preepiglottic space, strap muscles, and one or more of the tracheal rings. The disease most often afflicts men in their 50s and 60s, but the number of women affected is rising because more women are smoking. Major risk factors for laryngeal cancer include the use of tobacco products, excessive alcohol consumption, family history, and occupational exposure to dust, fumes, gases, and cleaners. The functional and structural changes that occur after laryngectomy can initially be psychologically and emotionally overwhelming for these patients. The combination of loss of voice and normal respiration through the nose and mouth, olfactory changes, physical disfigurement, financial concerns, and lifestyle alterations may produce a sense of hopelessness for the entire family. But by providing comprehensive preand postdischarge teaching, being sensitive to the patient's fears, and assessing his self-care capabilities, you can play an important role in helping him adjust to these changes.