Effects of Post Laryngeal Cancer Treatment on Voice Function and Communication among Survivors at Kenyatta National Hospital, Nairobi City County, Kenya
Araka, Salome Gatakaa
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While voice production is known to occur naturally to facilitate functional human communication on a regular basis, this is usually not the case among laryngeal cancer survivors. The treatment approaches for laryngeal cancer often impact negatively on the survivors‟ ability to communicate as they experience persisting voice problems and inability to speak normally. The study sought to assess the effects of post laryngeal cancer treatment on voice function and communication of laryngeal cancer survivors at Kenyatta National Hospital (KNH). The objectives included: establishing how laryngeal cancer treatment approaches affect the voice structure, its effects on voice production and vocal quality, and assessing the approaches for remediation of voice function and communication difficulties. The study utilized a concept based on Myoelastic Aerodynamic theory of voice production. The study population included 28 laryngeal cancer patients who had undergone treatment, 2 oncologists and 1 speech therapist drawn from Ear Nose and Throat clinic at Kenyatta National Hospital in Nairobi County. The research adopted a cross sectional study design and data was collected using questionnaires. The study findings show that post laryngeal cancer treatment had significant effects on voice function and communication of laryngeal cancer survivors. Majority of the survivors mentioned that the treatment was successful but experienced post treatment challenges such as finding their voice unintelligible, while three-quarters indicated that they had no voice for speech production. Patients on combination of Laryngectomy, Radiotherapy and Chemotherapy had the worst effects on speech production, vocal quality and general physical functioning post treatment. Surgery, radiotherapy, and chemotherapy or combinations of the modalities were the treatment options available for patients. The study further established that the available therapy option for improvement of voice and communication of the patients after laryngeal cancer treatment was vocal therapy and rehabilitation by a speech therapist. Artificial larynx speech, as well as pen and paper were the alternative means of communication of survivors post treatment. The study recommends the use of other alternative modalities such as laser therapy matched appropriately with the needs of the patients so as to preserve their voice function. The study further recommends training or employment of more skilled human resource to train survivors on other techniques of speech such as tracheo esophageal speech to enhance survivors‟ communication.