Loss of voice after lung surgery

Posted by vic83 @vic83, May 22, 2023

I had video assisted thoracic surgery for lung cancer surgery on Friday and immediately lost my voice. It is now Monday and no improvement. I can talk in whispers but have no volume and it is quite hoarse. Anybody else have this problem? What treatments are there?
I specifically asked the attending physician of the day but she only said "she was not worried" and offered no information on what to expect or do. I live alone and if I need to talk to someone, they now have trouble hearing me. Automated systems don't hear me.
Anyone out there have similar experience?

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@jjy

Hello Dex, Vic83 and Patti!
Issue is real. Lower Lobectomy Nov 2023 I am 4 Months post Surgery, I sound like a long shoreman, gravelly, low tone, Horrible! Nothing reminiscent of a female voice. I was told by my ENT it was a partially paralyzed Vocal cord from the Vats when taking my Lymph nodes. He also said it could take 12 to 15 Months with an 80% chance of it returning. The Two options given if we choose not to wait it out are Restylane injections into our vocal cords ( Ouch!) once a month or Surgery whereby they insert a pacer of sorts so the cords can again vibrate off each other. Yes to liquids going down the wrong pipe especially if I forget and try to talk while swallowing and sometimes food gets stuck, no gag reflex it's an unexpected side affect when taking Cancer in stride and getting such a resolution as the Vats Surgery. I count my blessings and realize it could be worse but it is frustrating having to fight to be heard in a noisy Restaurant or Room. I Talk for a living and don't feel as effective making a point sounding like this, If anyone has any other suggestions or experiences that may help, I would appreciate hearing them. All the best to the others afflicted with the same issue and Blessings to your Health Journey. ~ Jody

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Hi Jody (@jjy), Welcome to Mayo Connect, I'm glad you found us. I hope this condition improves for you over time. Have you been offered any vocal therapy, or does your doctor think this wouldn't be effective?

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@jjy

Hello Dex, Vic83 and Patti!
Issue is real. Lower Lobectomy Nov 2023 I am 4 Months post Surgery, I sound like a long shoreman, gravelly, low tone, Horrible! Nothing reminiscent of a female voice. I was told by my ENT it was a partially paralyzed Vocal cord from the Vats when taking my Lymph nodes. He also said it could take 12 to 15 Months with an 80% chance of it returning. The Two options given if we choose not to wait it out are Restylane injections into our vocal cords ( Ouch!) once a month or Surgery whereby they insert a pacer of sorts so the cords can again vibrate off each other. Yes to liquids going down the wrong pipe especially if I forget and try to talk while swallowing and sometimes food gets stuck, no gag reflex it's an unexpected side affect when taking Cancer in stride and getting such a resolution as the Vats Surgery. I count my blessings and realize it could be worse but it is frustrating having to fight to be heard in a noisy Restaurant or Room. I Talk for a living and don't feel as effective making a point sounding like this, If anyone has any other suggestions or experiences that may help, I would appreciate hearing them. All the best to the others afflicted with the same issue and Blessings to your Health Journey. ~ Jody

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Hi!

I had 2 VATS in 2020 on each lung and it took 3 years to get my normal voice back. Hang in there…..it will take time. 🙏🏻

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Hang in there, it takes TIME…..
It took me 3 years !

Blessings,
Janna

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I had robotic lung segmented surgery on March 6th and yes I also have had my voice affected. My throat has never been sore but, the first week after surgery, my voice was weak and high pitched. Now it's weak and gravelly sounding. I have enough volume to be heard with no problem but it takes an effort to speak and I always feel like I need to clear my throat. I spoke to my surgeon about it and he suggested it was due to the vocal cords being irritated by the tracheal tube during surgery. He also suggested the nerves that serve the vocal cords could have been irritated during surgery as another possibility. He said if it doesn't resolve he would refer me to an ENT specialist. I am 6 weeks post op now and it's still an issue. Sometimes my voice sounds clear but it doesn't last long.

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@trudyhs

I had robotic lung segmented surgery on March 6th and yes I also have had my voice affected. My throat has never been sore but, the first week after surgery, my voice was weak and high pitched. Now it's weak and gravelly sounding. I have enough volume to be heard with no problem but it takes an effort to speak and I always feel like I need to clear my throat. I spoke to my surgeon about it and he suggested it was due to the vocal cords being irritated by the tracheal tube during surgery. He also suggested the nerves that serve the vocal cords could have been irritated during surgery as another possibility. He said if it doesn't resolve he would refer me to an ENT specialist. I am 6 weeks post op now and it's still an issue. Sometimes my voice sounds clear but it doesn't last long.

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Welcome to Mayo Connect @trudyhs. I'm hoping that you find some relief soon, it's difficult to have to strain to communicate. What type of lung cancer did/do you have? Are you experiencing any other pain or difficulties related to the surgery?

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@lls8000

Welcome to Mayo Connect @trudyhs. I'm hoping that you find some relief soon, it's difficult to have to strain to communicate. What type of lung cancer did/do you have? Are you experiencing any other pain or difficulties related to the surgery?

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Hi Lisa,
Thank you for the welcome to Mayo Connect. I'm glad to have a community to learn from. I have multifocal (or synchronous primary) lung cancer. So far I've had 5 nodules removed - one large nodule (5.2 cm) 4 years ago through a full upper left lobectomy and four smaller nodules removed 6 weeks ago through robotic segmented surgery. The second surgery was much harder than the first but I'm progressing fine. I still have a gravelly voice and a bit of soreness in my side rib area but nothing that keeps me from my life. I will be having a nodule in the lower left treated with SBRT soon and the oncologist wants to discuss chemo and/or immunotherapy, which I'm concerned about. Multifocal lung cancer is a more complex type of cancer and I'm being treated at an academic hospital to be sure I'm getting all the most up to date care for my situation. Wow, what a ride! To be honest I'd really like off this train but alas..... I'd love to connect with others who specifically have multifocal lung cancer to share treatments/experiences and stories.

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@trudyhs

Hi Lisa,
Thank you for the welcome to Mayo Connect. I'm glad to have a community to learn from. I have multifocal (or synchronous primary) lung cancer. So far I've had 5 nodules removed - one large nodule (5.2 cm) 4 years ago through a full upper left lobectomy and four smaller nodules removed 6 weeks ago through robotic segmented surgery. The second surgery was much harder than the first but I'm progressing fine. I still have a gravelly voice and a bit of soreness in my side rib area but nothing that keeps me from my life. I will be having a nodule in the lower left treated with SBRT soon and the oncologist wants to discuss chemo and/or immunotherapy, which I'm concerned about. Multifocal lung cancer is a more complex type of cancer and I'm being treated at an academic hospital to be sure I'm getting all the most up to date care for my situation. Wow, what a ride! To be honest I'd really like off this train but alas..... I'd love to connect with others who specifically have multifocal lung cancer to share treatments/experiences and stories.

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Welcome! Me too, I have multifocal lung cancer. I am happy to hear about the experiences of others.
Having these nodules in both lungs means we are also bilateral multifocal.
Diagnosed in Dec 2021. I have had two VAT surgeries (RUL and LUL) removing stage 1 cancers. They were in the 3 cm range. Lastly, I had SBRT on 2 nodules in RUL Several months later I had an episode of radiation-induced pneumonitis. Right now my other nodules are "stable", but I will be limited in choice of treatments going forward because of the pneumonitis episode. Immunotherapy and other cancer drugs may trigger new episodes of pneumonitis. And radiation therapy causes it. I have existing pulmonary fibrosis/interstitial disease in lower lobes and inflammation from SBRT which the Radiation Oncologist told me should decrease.
But my recent Pulmonary Function Test showed a severe decline in diffusing capacity in last 4 months, so future treatments need to consider all factors. I tell my doctors they need to plan strategically because there is always another nodule. That is why it is important to have a Tumor Board of specialists from different areas to discuss the pros and cons of any treatment option. Pulmonary Function tests are important.

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Hi Vic83. Glad to meet you and to hear of your experiences. My original pulmonary function before any surgeries was 120% and before my recent surgery it was still very good at 105%. I haven’t had a pulmonary function test yet as I’m only 6 weeks post op.
Has chemotherapy or immunotherapy ever been recommended as a adjuvant therapy for you? My first nodule removed was 5.2 cm and I was staged at 2b. I’m not sure what the staging is yet for my recent surgery. I had chemo after first surgery and I think it did more harm than good so I’m not too keen on agreeing to more. I don’t yet know a lot about immunotherapy. By the way, in all of this I’ve had many lymph nodes tested from the surgical sites as well as the mediastinal space and all have been negative.

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@trudyhs

Hi Vic83. Glad to meet you and to hear of your experiences. My original pulmonary function before any surgeries was 120% and before my recent surgery it was still very good at 105%. I haven’t had a pulmonary function test yet as I’m only 6 weeks post op.
Has chemotherapy or immunotherapy ever been recommended as a adjuvant therapy for you? My first nodule removed was 5.2 cm and I was staged at 2b. I’m not sure what the staging is yet for my recent surgery. I had chemo after first surgery and I think it did more harm than good so I’m not too keen on agreeing to more. I don’t yet know a lot about immunotherapy. By the way, in all of this I’ve had many lymph nodes tested from the surgical sites as well as the mediastinal space and all have been negative.

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Hi Trudy - there is a thread for multifocal lung cancer, perhaps one of Connect mentors can move our discussion there as I don't know how.
My first VAT surgery I was a stage 1b (because over 3cm) or based on the TNM staging system it was a pT2a. My second VAT had a pT1b (smaller), however pathology said STAS present - that means "spread through air spaces". There is now a new means of spread - the tumor is "shedding" but they don't know a whole lot about it. Tumor Board chose not to give me adjuvant therapy but only put me under close observation. Where do those cells go?
They need to find a blood supply, and how long can they survive? Not much known.
Anyway all my lymph nodes have been clean and my PET scans have indicated no spread and the other notable nodules are stable so I guess one can call this type of cancer "well behaved".
I have not needed chemo because they got it all and I have no metastasis.
I have been told I am not a candidate for immunotherapy because of my episode of pneumonitis. They can't be sure that the drugs will not trigger another inflammation causing more lung scarring. My numbers are already moderate obstruction, and the last test showed a severe drop in diffusion. They need to preserve lung function to preserve quality of life. My best option going forward will be ablation.

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@trudyhs

Hi Lisa,
Thank you for the welcome to Mayo Connect. I'm glad to have a community to learn from. I have multifocal (or synchronous primary) lung cancer. So far I've had 5 nodules removed - one large nodule (5.2 cm) 4 years ago through a full upper left lobectomy and four smaller nodules removed 6 weeks ago through robotic segmented surgery. The second surgery was much harder than the first but I'm progressing fine. I still have a gravelly voice and a bit of soreness in my side rib area but nothing that keeps me from my life. I will be having a nodule in the lower left treated with SBRT soon and the oncologist wants to discuss chemo and/or immunotherapy, which I'm concerned about. Multifocal lung cancer is a more complex type of cancer and I'm being treated at an academic hospital to be sure I'm getting all the most up to date care for my situation. Wow, what a ride! To be honest I'd really like off this train but alas..... I'd love to connect with others who specifically have multifocal lung cancer to share treatments/experiences and stories.

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Did you happen to wear a Philips CPAP machine prior to your lung cancer? What is the name of the doctor and treatment facility?

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