Just over 20 years ago, suffering from persistent hoarseness, I was diagnosed with a stage 2 cancer of the larynx, and I had radiotherapy. Disappointingly, after 8 months the cancer recurred, and I needed a laryngectomy. I was aware head and neck cancer patients are susceptible to further cancers, but this never troubled me unduly.
My 20+ years as a laryngectomee have been relatively trouble free, with no complications until last year. I was aware of some changes, notably some problems with swallowing and eating. This turned out to fortuitous because in August, whilst dealing with this problem, my ENT consultant noticed a suspicious area in my throat during an examination using a nasoendoscope. Fortuitous because I had not noticed any of the classic early signs of head and neck cancer. A biopsy then revealed that cancer was back, though at a very early stage.
Quite a lot has changed since my laryngectomy. Clinicians have more tools at their disposal to aid diagnosis. From having one option for examining the likely extent of the problem, a CT scan, there are now two more. I have had both, an MRI scan and a PET-CT scan. MRI scans are not pleasant for those of an anxious, claustrophobic disposition and the noise is disconcerting. Mine took 50 minutes but the experience was eased by the excellent awareness and consideration of the clinicians involved. The PET-CT scan was much less of a problem.
The investigations showed my cancer was at a very early stage and surgery may be able to get rid of it, though immunotherapy could also have a role to play. As with any head and neck cancer survival is not the only consideration about the treatment. Functional outcomes around swallowing and speech are so important for future quality of life and this an area which poses many questions. Will my earlier surgery and radiotherapy affect the likely outcomes? In the next few weeks, I have important decisions to make about the treatment path I will follow and will post updates as necessary.
I have a couple of reasons to be thankful. The swallowing problems I have been experiencing have been time-consuming to deal with, but had they not happened the cancer would not have been found. I am being treated at a specialist head and neck cancer centre in which I have great confidence and sadly not all patients can say that.
Malcolm Babb
