A second important indication of the SCPL is as an alternative to non-surgical approaches such as radiation or chemotherapy and radiation when the risk for treatment failure may be high. The final indication is for patients who already underwent radiation therapy for very early cancers of the voice box and then had the cancer recur. Unfortunately, if a patient undergoes radiation or chemotherapy and radiation for an intermediate or advanced cancer and then has a recurrence in the voice box, they are almost never a candidate for a SCPL at that point. The cure rate in the voice box following SCPL, however, is consistently in the 90 percent range. Quality of post-operative life is a key concern for surgeons and patients alike.
All medical treatments have some degree of acute and chronic side effects.
The expected outcome after SCPL is temporary difficulty swallowing, a tracheostomy and some degree of permanent hoarseness. In addition, post-surgical voice box swelling occurs. Although this swelling is temporary, a temporary tracheostomy tube is put into the windpipe, but typically removed after two weeks. Speech after total removal of the voice box is frequently facilitated by either an implanted or hand-held prosthetic device. Evidence suggests that the absence of such prosthetic devices has a significant positive effect on the patient's physical functioning, general health, vitality and emotional state.