Patient information about laser treatment

Head and Neck

You will have been given this information sheet having visited our Head and Neck Oncology Clinic. Your case will have been discussed by a team of head and neck cancer specialists who have recommended lasering as part of your treatment plan.

We recognise that you may have questions at this time. This information sheet will provide answers to some of the more common questions that are asked by our patients, about this surgery.

Although it will provide you with some of the information that applies to your individual care, it is important to remember that every case is different.

This information is therefore not exhaustive and does not constitute medical advice.

The Head and Neck Oncology team will discuss any treatment that you require, with you. If you have any further questions about your treatment, you should contact a member of the team via the contact numbers listed in the Head and Neck service patient information leaflet.

Why do I need a laser treatment?

Lasering is recommended as a treatment option when:

1. Early cancerous cells or an invasive cancer have developed on one of the vocal cords.
2. Occasionally, it is used for larger cancers. This is usually to reduce the size of the cancer and thereby any symptoms that the cancer may be causing.

What is a laser?

The term Laser means - Light Amplification by Stimulated Emission of Radiation. There are different types of lasers depending upon the source of the laser beam.

A carbon dioxide laser will be used during your operation.

A high energy light beam can be used to very precisely cut through tissue, in a similar way to a surgeon’s scalpel. Lasering can also be used over a wider area to remove abnormal cells on the surface lining of the throat.

Besides from being precise, there is usually less bleeding when a laser is used and therefore the recovery time is quicker. This means that you can often go home on the same day of the operation

If vocal cord treatment is planned for me, what is a vocal cord?

There are two vocal cords positioned at the top of the windpipe (trachea) within the voice box (larynx) in the neck. When these vocal cords come together and vibrate they produce voice.

What will the surgery involve?

You will need to have a general anaesthetic. The operation routinely takes approximately half an hour, but may take longer when a cancer is larger. The surgeon will aim to laser away all of the cancerous growth on the vocal cord in a single go. However, you sometimes need further surgery to remove a vocal cord cancer completely.

How will I look after the surgery?

The surgeon will get access to the cancer through your mouth and throat to undertake lasering. You will therefore have no external wounds or scars after this surgery, however, there is a small risk of damage to your teeth, lips and/or gums.

What will happen before my operation?

You will be asked to attend a pre-admission clinic before your surgery. At this appointment you may undergo investigations to prepare you for surgery.

Please bring any prescribed medications with you and inform the nurse of any drug allergies that you have at this time.

It is usual to be admitted to the ward on the day of your surgery. You will meet the nursing team and also the surgeon and anaesthetist before the operation. Once in hospital, the nurses will be able to inform you of the approximate time of your surgery.

** Please note that every effort will be made to ensure that your operation will proceed on the planned date. However, it may be necessary for you to contact the hospital before your admission, to ensure that a bed is available for you.

What will happen on the day of my operation?

On the morning of surgery you will need to prepare for surgery. Please have a bath or shower before you leave home. Once on the ward you will be asked to change into a theatre gown and to wear anti-embolism stockings that will be provided by the nurses. It is advisable to leave any jewellery/valuables at home. The nurses can tape any wedding bands or jewellery that you are unable to remove.

After being taken to the Operating Department Reception by a nurse from the ward, you will be moved to a smaller room where you will receive your anaesthetic. This usually involves a small injection to the back of the hand. The anaesthetic will work quickly, and you will be unaware of events until your operation is completed.

What happens after surgery?

Once you have left the operating room, the nurses in the recovery area will take care of you until you are fully awake following your anaesthetic.

During this time:

1. Your blood pressure and pulse will be monitored using a cuff that will be secured around your arm; this will tighten when readings are taken.
2. Your temperature will be recorded using a small blunt ear probe (this does not penetrate deeply)
3. You will receive oxygen therapy via a mask that will cover your nose and mouth. Your oxygen levels will be monitored using another plastic probe that will be clipped gently onto your finger.
4. The nurses will monitor any discomfort that you experience. It is important that you inform them if you experience pain, as they can give you pain relief.

Once awake, you will be transferred back to the ward where these observations are likely to continue, but with less frequency, as you recover from your anaesthetic and surgery.

What tubes and attachments will I have?

You may not have any tubes or attachments after your surgery. However, sometimes a drip is given (Intravenous infusion) if you have been without fluids for some time before your surgery.

A drip (Intravenous infusion)

This is used to give fluids into your blood stream using a small tube that is inserted into a vein in your arm. It is normally painless. The infusion will be discontinued once you are fully awake and eating and drinking, usually within a few hours after surgery. The nurses will be able to remove the drip on the ward, with minimal discomfort.

If my vocal cords are lasered, how will my voice sound after surgery?

Your voice may sound hoarse (gruff) and it may not be as powerful as it was before the surgery. You may be asked to rest your voice for a period after surgery and it can take 4-8 weeks for any voice improvement thereafter. After surgery you may be referred to a Speech and Language Therapist for therapy to help get the best from your voice.

How will I feel after surgery?

You will able to be ‘up and about’ and will also be able to start eating and drinking as soon as you have woken fully from your anaesthetic. This is usually within a few hours of your surgery.

Any area that has been lasered is likely to feel sore afterwards. If you do experience any pain, please inform the nursing staff on the ward. They will be able to provide you with pain relief.

When will I be discharged?

Discharge is usually the same day of surgery, or the following day if your surgery occurs later in the day.

Please note, you will not be allowed to drive, operate heavy machinery or sign any important documents for at least 24 hours after your anaesthetic and you should also not be left unaccompanied over this time (ie. left alone in the house).

Please notify the nurses on the ward if this will be a problem.

What happens next?

We will arrange to see you in the head and neck oncology clinic approximately two to six weeks after you have been discharged. At this time the surgeon will check the lasered area, often using a camera (nasendoscope) through your nose. The results of any tissue samples taken during surgery should also be available. You will be monitored regularly in the clinic after your surgery.

If you have received vocal cord treatment

These appointments will be between 4-6 weeks initially, decreasing gradually over time. This monitoring will continue for at least 5 years. It may also be necessary for you to have a short anaesthetic from time to time over this period, so that the surgeon can fully examine your voice box and re-biopsy if necessary.

Where can I find further support?

Feelings of anxiety, guilt, anger and fear of the unknown, are some of the more common emotions that people experience having been told that they have cancer. We understand that this can be a stressful time for both yourself and those close to you.

If you would like further information about the support services that are available to you, please speak to your specialist nurse.

Privacy and dignity

Same sex bays and bathrooms are offered in all wards except critical care and theatre recovery areas where the use of high-tech equipment and/or specialist one to one care is required.