Prologue | 9 P Prologue This is the story of mr. T., a 66-year-old man. He is healthy, although he has a known high blood pressure for which he takes medication. He works as a janitor at a high school, but he is nearing retirement. In his free time, he enjoys being at home with his wife and dog, and playing cards at the community center. They have two daughters, and one grandson. However, recent months have brought unwelcome health concerns. Persistent hoarseness and worsening coughing have disrupted his routine, making communication increasingly difficult as his voice weakens, impacting both his personal and professional life. Concurrently, he experiences discomfort in his throat, occasionally extending to his left ear. Initially, his general practitioner prescribed antibiotics, suspecting a throat or airway infection, but unfortunately, these provided no relief. Consequently, Mr. T. was referred to the ENT department, where a thorough examination uncovered concerning abnormalities in his vocal cords during an endoscopy procedure. Recognizing the urgency of the situation, the ENT specialist promptly referred him to the Head and Neck Oncology department, where he was scheduled for evaluation the following day. During this evaluation, it was revealed that Mr. T. had been a heavy smoker since the age of 16, with unsuccessful attempts at quitting. Additionally, he regularly indulged in alcohol, consuming five cans of beer post-work and whiskey during Friday card games. Following extensive evaluation, Mr. T. and his wife received devastating news from the doctor: laryngeal carcinoma, which had metastasized to his lymph nodes. After consultations with medical experts, it was determined that a total laryngectomy offered the best chance of survival. Radiation treatment was considered as an alternative, but with a significant risk of rendering his larynx nonfunctional, ultimately leading to the need for a total laryngectomy. Back home, they feel overwhelmed and full of questions, after consultations with the head and neck surgeon, radiation oncologist, and oncologist. “What is metastasis anyway?” asks his wife. “And will you never be able to talk again?” “I think I can talk again, the doctor mentioned something about a voice prosthesis and a humidifier or something,” says Mr. T. “But what should I do? Everything sounds terrible. Am I going to die?”
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