UAE: Heavy smoker regains voice after multiple surgeries for cancer

He was a heavy smoker for many years. A few months ago, he realised that there was a change in his voice and he had difficulty in breathing. He was diagnosed with advanced laryngeal carcinoma.

Afraid that he might loss his voice, long-time UAE resident Julius Gomez consulted Dr Sameh Aboamer, a surgical oncology consultant at Zulekha Hospital Sharjah.

Initial medical investigations revealed an advanced tumour in his larynx and vocal cords. A biopsy was also done to confirm the diagnosis of laryngeal carcinoma.

Dr Aboamer said the loss of voice happened due to non-functioning or fixed vocal cords, most commonly due to cancer in the different parts of the larynx (voice box), which originated in the larynx that spread from nearby organs with cancer.

Multiple treatment plan

“Once we diagnosed cancer, we did the staging of the cancer to plan to manage and treat it. We advised Gomez on a detailed treatment plan, most importantly focusing on the treatment of his cancer to save his life and restore his voice,”

The medical team faced a tough choice and conducted surgery to remove the larynx, neck lymph nodes, and half of the thyroid gland as Gomez had an advanced form of laryngeal cancer.

The seven hours of sophisticated rare procedures included a radical surgical removal of the larynx, part of the pharynx, the neck lymph nodes, and half of the thyroid gland, with permanent tracheostomy (a neck opening to breathe). The surgery was successful without any post-operative problems.

Regaining his voice

Gomez had temporarily lost his voice as a natural result of removing the larynx. “After he underwent the chemo-radiotherapy, it was time for another procedure, a reconstructive surgery to help him regain his voice and ability to talk. A tracheo-esopfageal puncture (TEP) was done with the insertion of provox voice prosthesis,” said Dr Sameh.

Despite all the complexities, Gomez felt extremely happy talking again after a period of voice loss and complete loss of communication. His only concern was that he had to close the tracheostomy opening with his hand every time he had to talk. To solve this issue, a hands-free flexi voice prosthesis insertion was done. He can now talk freely without the need to use his hand.

Dr Sameh said, “He now has a very small voice prosthesis in his trachea connecting it as a valve to the esophagus. He is able to speak again as the direction of the lung's expiration air is towards his mouth instead of the tracheostomy opening, which enables him to produce the voice through this voice prosthesis,”

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