Developed rasping voice 9 weeks after radiation

Hi Trish,

I know exactly what that sounds like to me, because I had the same thing.  It sounds like it is down to acid reflux, which is very common for H&N radiotherapy patients.

Basically, the radiotherapy kills or temporarily disables the saliva glands, which means that little or no saliva is reaching the stomach.  Saliva is alkaline, and usually moderates the stomach acid, so when it is not present (at least in the normal amounts), the balance of acid in the stomach is upset.  The reason you experience it as worse in the mornings is because when you are lying down, the acid creeps back up the oesophagus and causes inflammation both there and in your vocal chords.

There are some things that you can do to help yourself:

- Leave at least three hours between eating and going to bed

- Notice if there are any trigger foods that make things worse for you, and avoid them if you can (for me it was dairy and tomatoes)

- sleep on extra pillows or with the head of your bed slightly raised, so that gravity helps to keep the acid where it should be

- eat smaller meals, but more of them, so the food can pass through your stomach more quickly

- ask your team or your GP for proton pump inhibitors (PPIs) such as Omeprazole or Lansoprazole, or any other similar thing that ends in -azole.  These are a temporary fix only, and are not recommended for long term use, but can be useful to suppress the acid while the tissue inflammation heals

I panicked when I started getting a sore throat again a few weeks after treatment, and it came as a huge relief to find that there was a perfectly logical and far less sinister explanation.

Best wishes,

Josie

Hi Trish u can inkybexhinwhat Josip says I had the same problem took a while to realise and several bites if GAvisxon  dual action tablets before I finally got  Omaprazoke 20 mg prescribed ,wow what a difference they made within days voice stopped rasping and heart burn which in my previous 61 years had never had went. Downside 4 month starts later still taking one a day have tried to stop them but within a day it’s back so obviously the healing not finished yet. Warning that if yiu haven’t lost saliva yet it’s possible it will get worse before it’s  gets better I am now 8  month post radiotherapy and this week have noticed I am dribbling slightly yep old lady sat in a corner throw dribble , well sat in my bike dribble really .

good luck ,as I say uts the cancervthat just keeps on giving 

hazel x

Excuse typing am out while doing this what I meant to say is I can echo what  Josie has alreatvsaid  x

Many thanks Josie, that explains it and yes I have been having a little heartburn too.  It is so kind of everyone to help here and it makes me feel so much better.

Thank you Hazel, I think I will go to the docs and get something.  LOL I too will be that old lady dribbling in the corner. :-)

Hi Hazel,

Not being able to come off them quickly is one of the reasons why people are not recommended to take PPIs long term.  What is happening is that when the stomach acid is depressed, the stomach recognises that there is too little and so steps up production to restore the level.  If you then stop taking the tablets, the stomach is still producing acid at the higher rate and so you experience excess acid in the form of heartburn.  It takes a couple of weeks for the acid production to step down again, but it does gradually return to balance again - you just have to wait it out.  It will never go away on its own, and if you stop taking the tablets after all this time, you will always have to deal with this problem somehow.

Best wishes,

Josie