Throat cancer survivors speak again, a burp does the trick

Babies learn to burp even before they begin to talk. For throat cancer survivors who have lost their larynx (voice box) to cancer, it is this instinct of a baby that they are reminded to go back to and produce a sound. The technique is neither simple nor does everyone learn to master it, but for those who do, talking again feels like a rebirth.

"Drink water and then try again," Pradeep Lahiri, 74 tells Nayan Shah, who has mastered the technique after months of trying. They are carrying out a demonstration for new patients. "I run a printing business and before my operation, I used to take 100 calls a day. Losing my voice was very difficult but now I take calls again," Shah, 57, says in a low pitch nasal sound, even though the sound has been created by breathing through the mouth and using the oesophagus to modulate it.

Twice a week — on Wednesdays and Saturdays — for three hours in the morning, cancer survivors sit and train others in oesophagal speech at the Cancer Rehabilitation Centre of Prince Aly Khan Hospital in Mazgaon.

Pradeep Lahiri, who at 49 lost his voice following a bout of cancer, joined the centre in 1998, two years after it was started by Anita Vesuvala, a breast cancer survivor. He taught himself to speak using the oesophagus and then learned the nuances in Japan following which he started training others.

"Communication is a basic need. A common person cannot understand what it is to lose one's voice. But our body is amazing. When we lose one organ, we have another to fall back on," Lahiri explains.

When cancer survivors first come, the are taught to turn the burps into vowels and create simple sounds. Creating the sound without a voice box takes a lot of effort and some give up but return eventually when the need to learn to communicate overpowers.

"The patient needs a lot of psychological support and needs counselling. They gradually become more confident," says Meena Kamdar who is associated with the centre. In any given session, there are close to nine patients and volunteers who drop by to help.

The centre also has patients who are learning to talk using an electrolarynx, a small medical device. Then there are others like Naima and Santosh Mhatre, 35, who tried three electrolarynxes, but found it troublesome and wanted to learn to speak without it.

"I used the electrolarynx five years back, but the sound was very robotic, so I came here to learn to speak without it," says Naima Kakahiwala, 73, who continues to volunteer.

"Patients with laryngeal cancer require surgical removal of their larynx or voice box. We have to teach them to make their oesophagus vibrate. The electrolarynx too allows patients to speak continuously but it gives a very metallic sound," said Dr Sujatha Gandhi, audiologist and speech therapist, Nanavati Super Speciality Hospital.

What is oesophagal speech training?

• It is a method of speech production that involves using the oesophagus instead of traditional laryngeal (voice box) speech. Air is injected into the upper oesophagus and then released in a controlled manner to create sound used to produce speech. Because of the high level of difficulty in learning oesophagal speech, some patients are unable to master the skill.
   
• Good oesophagal speakers can produce an average of 5 words per breath and 120 words per minute.