Many of these cancers require surgery that generally changes the way patients chew, swallow and talk.
By Judy Neuman, CTR Princeton HealthCare System
When most people learn they have cancer, they often experience feelings of shock and fear and question what their lives will be like after treatment.
Answers, of course, are hard to come by and are largely determined by the individual and his or her specific type of cancer, more than anything else. Many patients, however, turn to support groups for help and guidance from people who share their worries and concerns and understand the challenges they face.
University Medical Center at Princeton is partnering with the American Cancer Society to offer a newly formed support group for individuals with head and neck cancer in central New Jersey. The group meets on the third Wednesday of each month and provides a safe setting for sharing concerns and problems related to life after head and neck cancer, including laryngeal cancer; education on laryngectomee issues for people who have had some or all of their larynx removed; and a social outlet for laryngectomee and other patients, their families and loved ones.
Laryngeal cancer is one of several types of cancers considered cancers of the head and neck. Other head and neck cancers include cancer of the oral cavity, salivary glands, paranasal sinuses and nasal cavities, pharynx, and lymph nodes in the upper neck. Cancers of the brain, eye and thyroid, as well as those of the scalp, skin, muscles and bones of the head and neck are not usually grouped with head and neck cancer.
Head and neck cancers account for approximately 3 percent to 5 percent of all cancers in the United States, according to the National Cancer Institute, which estimates that 39,000 people in the United States develop head and neck cancer each year. Head and neck cancer is more common in patients age 50 and older and is generally linked to tobacco use.
Survivors of head and neck cancer often face a unique set of challenges after treatment, given that many of these cancers require surgery that generally changes the way patients chew, swallow and talk.
For instance, patients with oral cancer may require surgery to rebuild bones or tissues in the mouth. In some cases when reconstructive surgery isn’t feasible, the patient may be fitted with a prosthesis to assist with swallowing and speaking.
Patients with laryngeal cancer may require the removal of part or all of their larynx (voicebox) and the creation of a stoma, a new airway through a hole in the front of the neck that is kept open through a tracheostomy tube. In the case of a partial laryngectomee, the stoma may be temporary, but in a complete laryngectomee, a stoma is permanent, and patients must learn new ways of speaking.
Working with a speech pathologist, head and neck cancer patients who have lost their ability to speak learn how to communicate using a variety of alternative techniques. Laryngectomee patients can learn how to inject air into their esophagus to create sound and speak; they may use a mechanical larynx that is held up to the neck to create sound that travels through the neck to the mouth; or they may have a surgical procedure that creates an opening just behind the stoma, allowing air to pass from the airway into the esophagus where it is shaped into sound. Other alternative means of communication may include writing on a notepad and typing thoughts on a computer.
Whatever method a patient adopts, the challenges of losing his or her voice can be overwhelming.
Many patients often feel that they don’t want to speak or communicate at all because it is hard for people to understand what they are saying and to carry on a conversation. Women often are concerned that their voice no longer sounds feminine. Others may be concerned about possible stares and whispers by people who are unaccustomed to hearing a different type of voice. Parties and large social gatherings become daunting because of the inability to speak loud enough to be heard over the noise.
Because of these challenges, many individuals tend to withdraw from friends and family and want to stay at home.
In this new support group, individuals facing the challenges of head and neck cancer, as well as their loved ones, can share their experiences with other members who are experiencing similar ups and downs and who can truly understand what they’re going through. The support group provides a safe social outlet and enables individuals recovering from head and neck cancer to practice speaking using their new voice. Through planned group activities such as dinners out, individuals learn to feel more comfortable communicating in public and begin to overcome the feeling that they don’t want to speak.
Moreover, there are little things we all can do to help make life easier for survivors of head and neck cancer.
• First, try to avoid staring at someone who uses a mechanical larynx or speaks differently. If you are curious, talk to the person. Most individuals welcome questions.
• Be open to what you are hearing and tell the person if you don’t understand what he or she is saying. Many people simply go along with the conversation without understanding, which leaves the individual feeling frustrated.
• Ask if there is anything you can do to help. Be conscious of the surroundings, and if it’s noisy try to move to a quieter place.
For more information or to join the Head and Neck Cancer Support Group sponsored by University Medical Center at Princeton in partnership with the American Cancer Society, call the American Cancer Society at 732-951-6303. Meetings are held on the third Wednesday of the month from 11 a.m. to noon at the Medical Society of New Jersey, 2 Princess Road, Lawrence.
Judy Neuman, CTR, is the manager of the Cancer Program at the University Medical Center at Princeton, a clinical research affiliate of The Cancer Institute of New Jersey and an approved oncology teaching program of the American College of Surgeons’ Commission on Cancer.
To find a physician affiliated with Princeton HealthCare System, call 888-742-7496 or visit www.princetonhcs.org.