Living as a Laryngeal or Hypopharyngeal Cancer Survivor

For many people with laryngeal or hypopharyngeal cancer, the end of treatment can be both stressful and exciting. You may be relieved to finish treatment, yet it’s hard not to worry about cancer coming back (recurring). This is very common if you’ve had cancer.

For others, the cancer might never go away completely. Some still may get regular treatments to try and help keep the cancer in check. Learning to live with cancer that does not go away can be difficult and very stressful. 

Life after cancer means returning to some familiar things and also making some new choices.

Follow-up care

If you have completed treatment, your doctors will still want to watch you closely. It's very important to go to all follow-up appointments. People with cancer of the larynx or hypopharynx are at risk of the cancer coming back and are at risk for developing new cancers in the head and neck area, so they must be watched closely after treatment. Your cancer care team will discuss which tests should be done and how often based on the type and stage of the cancer, the type of treatment you had, and your response to that treatment.

When these cancers come back (recur), it's most often in the first couple of years after treatment, so you will see the doctor more often during this time. Your head and neck will be examined (often including laryngoscopy) about every other month during the first year or so after treatment. More time will be allowed between follow-up visits if there's no sign of cancer coming back (recurrence) as time goes by. Chest x-rays and other imaging tests may be used to watch for recurrence or a new tumor, especially if you have new symptoms.

If you were treated with radiation and it affected your thyroid gland, you might need regular blood tests to check your thyroid function. People treated with radiation may also have problems with dry mouth and tooth decay, so you may need regular dental exams. Both radiation and surgery can lead to problems with speech and swallowing. These are often checked and treated by a speech therapist after treatment.

Almost any cancer treatment can have side effects. Some last for a few weeks to months, but others can last the rest of your life. Be sure to tell your cancer care team about any symptoms or side effects that bother you so they can help you manage them.

It's very important to report any new problems to your doctor right away. This might help your doctor help find recurrent cancer as early as possible, when the cancer is small and easier to treat.

If cancer does recur, treatment will depend on the location of the cancer and what treatments you’ve had before. To learn more about this, see Recurrent Laryngeal and Hypopharyngeal Cancers. For more general information on dealing with cancer recurrence, see Understanding Recurrence.

Stoma (tracheostomy) care following total laryngectomy

Having a stoma (tracheostomy) means that the air you breathe will no longer pass through your nose or mouth, which normally help moisten, warm, and filter the air (removing dust and other particles). This means the air going into your lungs will be dryer and cooler. This may irritate the lining of your breathing tubes and cause thick or crusty mucus to build up.

It's important to learn how to take care of your stoma. You'll need to use a humidifier over the stoma as much as possible, especially right after the operation, until your airway lining has a chance to adjust to the drier air. You'll also need to learn how to suction out and clean your stoma to help keep your airway open.

Your doctors, nurses, and other health care professionals can teach you how to care for and protect your stoma. This will include precautions to keep water from getting into your windpipe while showering or bathing, as well as keeping small particles out of your windpipe.

Support groups formed by other people with tracheostomies can be good sources of information on stoma care and the use of products to protect and clean it.

Restoring speech after total laryngectomy

Total laryngectomy removes your larynx (voice box), and you won't be able to speak using your vocal cords. After a laryngectomy, your windpipe (trachea) is separated from your throat, so you can no longer send air from your lungs out through your mouth to speak. But there are ways you can learn to talk after total laryngectomy:

  • Tracheo-esophageal puncture (TEP): This is the most common way that surgeons try to restore speech. It can be done either during the surgery to treat the cancer or later. This procedure creates a connection between the windpipe and esophagus through a small hole at the stoma site. A small one-way valve put into this hole makes you able to force air from your lungs into your mouth. After this operation, you can cover your stoma with a finger to force air out of your mouth, producing sustained speech. (Some newer “hands-free” models do not require you to cover the stoma to speak.) This takes practice, but after surgery you can work closely with a speech therapist to learn how to do this.
  • Electrolarynx: If you cannot have a TEP for medical reasons, or while you are learning to use your TEP voice, you may use an electrical device to produce a mechanical voice. The battery-operated device is placed at the corner of your mouth or against the skin of your neck. When you press a button on the device, it makes a vibrating sound. By moving your mouth and tongue, you can form this sound into words. You'll need training with a speech therapist to learn to use it properly.
  • Esophageal speech: With training, some people learn to swallow air into the esophagus (the tube that connects your mouth to your stomach) and force it out through their mouth. As the air passes through the throat it will cause vibrations which, with training, can be turned into speech.This is the most basic form of speech rehabilitation. New devices and surgical techniques often make learning esophageal speech unnecessary.

Learning to speak again will take time and effort, and your voice will not sound the same. You will need to see a speech therapist who is trained in helping people who have had a laryngectomy. The speech therapist will play a major role in helping you to learn to speak.

Help for swallowing and nutrition problems

Cancers of the larynx or hypopharynx and their treatments can sometimes cause problems such as trouble swallowing, dry mouth, or even loss of teeth. This can make it hard to eat, which can lead to weight loss and weakness due to poor nutrition.

Some people may need to adjust what they eat during and after treatment or may need nutritional supplements to help make sure they get the nutrition they need. Some people may even need to have a feeding tube placed in the stomach.

A team of doctors and nutritionists can work with you to help you manage your individual nutritional needs. This can help you maintain your weight and get the nutrients you need. They can also talk to you about swallowing exercises that can help keep these muscles working and give you a better chance of eating normally after treatment.

Restoring your sense of smell

If you have lost your sense of smell, or are smelling odors that aren't really there, olfactory rehabilitation might be another part of your recovery. Problems with smell (called olfactory disorders) can affect your appetite, sense of taste, food enjoyment, and how much you eat. Nearly all people who have had a laryngectomy will find they cannot smell things the way they did before. This is because air no longer travels through your nose.

With olfactory rehabilitation, you can be taught techniques that cause nasal airflow and may help you recover your sense of smell. Examples are the nasal airflow-inducing maneuver (NAIM) and polite yawning. Olfactory rehabilitation (rehab) is available at some large medical centers. Talk to your health care team to learn more.

Sexual impact of laryngectomy

Laryngectomy, with the resulting tracheostomy (stoma), can change the way you look as well as the way you talk and breathe. Sexual intimacy may be affected by these changes, but there are things you can do that can help during intimacy. Learn more details in Sex and the Man With Cancer and Sex and the Woman With Cancer.

Ask your doctor for a survivorship care plan

Talk with your doctor about developing a survivorship care plan for you. This plan might include: 

  • A suggested schedule for follow-up exams and tests
  • A schedule for other tests you might need in the future, such as early detection (screening) tests for other types of cancer, or tests to look for long-term health effects from the cancer or its treatment
  • A list of possible late- or long-term side effects from your treatment, including what to watch for and when you should contact your doctor
  • Diet and physical activity suggestions
  • Reminders to keep your appointments with your primary care provider (PCP), who will monitor your general health care 

Keeping health insurance and copies of your medical records

Even after treatment, it’s very important to keep health insurance. Tests and doctor visits cost a lot, and even though no one wants to think of their cancer coming back, this could happen.

At some point after your cancer treatment, you might find yourself seeing a new doctor who doesn’t know about your medical history. It’s important to keep copies of your medical records to give your new doctor the details of your diagnosis and treatment. Learn more in Keeping Copies of Important Medical Records.

Can I lower my risk of the laryngeal or hypopharyngeal cancer progressing or coming back?

If you have (or have had) laryngeal or hypopharyngeal cancer, you probably want to know if there's anything you can do that might lower your risk of the cancer growing or coming back, such as exercising, eating a certain type of diet, or taking nutritional supplements. But it’s not yet clear if there are things you can do that will help.

Adopting healthy behaviors such as not smokingeating wellgetting regular physical activity, and staying at a healthy weight might help, but no one knows for sure. But we do know that these types of changes can have positive effects on your health that can extend beyond your risk of laryngeal or hypopharyngeal cancer or other cancers.

About dietary supplements

So far, no dietary supplements (including vitamins, minerals, and herbal products) have been shown to clearly help lower the risk of laryngeal or hypopharyngeal cancer progressing or coming back. This doesn’t mean that no supplements will help, but it’s important to know that none have been proven to do so.

Dietary supplements are not regulated like medicines in the United States – they do not have to be proven effective (or even safe) before being sold, although there are limits on what they’re allowed to claim they can do. If you’re thinking about taking any type of nutritional supplement, talk to your health care team. They can help you decide which ones you can use safely while avoiding those that might be harmful.

Could I get a second cancer after treatment?

People who’ve had laryngeal or hypopharyngeal cancer can still get other cancers. In fact, laryngeal or hypopharyngeal cancer survivors are at higher risk for getting some other types of cancer. Learn more in Second Cancers After Laryngeal or Hypopharyngeal Cancer.

Getting emotional support

Some amount of feeling depressed, anxious, or worried is normal when cancer is a part of your life. Some people are affected more than others. But everyone can benefit from help and support from other people, whether friends and family, religious groups, support groups, professional counselors, or others. Learn more in Life After Cancer.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Croy I, Nordin S, Hummel T. Olfactory disorders and quality of life--an updated review. Chem Senses. 2014;39(3):185-194.

Hilgers FJ, Jansen HA, Van As CJ, et al. Long-term results of olfaction rehabilitation using the nasal airflow-inducing ("polite yawning") maneuver after total laryngectomy. Arch Otolaryngol Head Neck Surg. 2002;128(6):648-654.

Riva G, Sensini M, Corvino A, Pecorari G, Garzaro M. Smell and Taste Impairment After Total Laryngectomy. Ann Otol Rhinol Laryngol. 2017;126(7):548-554.

Last Revised: November 27, 2017

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