Cancer of the throat or voice-box is also called laryngeal cancer. It can develop in any part of the throat: the glottis (where the vocal cords are), the supraglottis (the area above the cords), or the subglottis (the area that connects the larynx to the trachea). Cancer of the larynx is usually treated with radiation therapy(with or without chemotherapy) or surgery (laryngectomy).

It is natural to be fearful and upset if the voice box must be removed. Learning to live with the changes brought about by cancer is a special challenge. After a total laryngectomy, patients must learn to speak in a new way. There are basically three options for voice following a total laryngectomy:

• Artificial Larynx
• Oesophageal Speech
• Tracheo-Oesophageal Speech

Artificial Larynx
The Electrolarynx is a hand held device that looks like a microphone and is about the same size. It has an on/off switch as well as pitch and volume control switches. This device may be powered by batteries. The device is held against the neck and the sound travels through the neck to the mouth. By mouthing words as you would always do the voice becomes speech. The voice does not sound like your old voice but makes a vibrating sound which you and your family may need time getting used to.

The Pneumatic Larynx is powered by air. It is held over the stoma (opening in the front of the neck through which you breathe) and uses air from the lungs instead of batteries to vibrate. The sound travels to the mouth through a plastic tube.

Oesophageal Speech
Oesophageal speech is produced by pushing air from the mouth to the top of the oesophagus or food pipe using the tongue and then releasing it through the mouth to produce speech.
The puff of air is like a burp. It vibrates the walls of the throat and produces sound for the new voice. The new voice is modified into speech by the lips, tongue and teeth. This voice is usually deeper than your old voice and has a limited pitch range .It can sound very good with practice. However not everyone is able to learn oesophageal speech.

Tracheo-Oesophageal Speech
This involves creating a shunt between the windpipe and the food pipe so that air can be diverted from the lungs to the mouth for speech. A small hole or fistula is made between the windpipe and the food pipe by the surgeon. A plastic or silicone valve is inserted into the opening through the stoma by the speech therapist .The valve keeps food out of the trachea. When the stoma is covered by the finger or thumb, air from the lungs passes into the oesophagus through the valve. This air produces sound by making the walls of the throat vibrate. Words are formed in the mouth. You will need to learn how to change and clean the valve.

The speech therapist will help advise you on which option is best for you but your preference is also important. It takes time and practice to learn to use whatever method of new voice that you choose. You will also need time to get used to the sound of your new voice and become comfortable with it.