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Cancer patient finds voice again thanks to groundbreaking transplant

Rare voice box transplant helps U.S. man speak, part of a pioneering study
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In this photo provided by the Mayo Clinic, Marty Kedian greets his dog, Baxter, on his first trip outside the Mayo Clinic Hospital after his surgery in Phoenix, on March 16, 2024. Kedian regained his voice after surgeons removed his cancerous larynx and, in a pioneering move, immediately replaced it with a donated one. (Mayo Clinic via AP)

A Massachusetts man has regained his voice after surgeons removed his cancerous larynx and, in a pioneering move, replaced it with a donated one.

Transplants of the so-called voice box are extremely rare, and normally arensa国际传媒檛 an option for people with active cancer. Marty Kedian is only the third person in the U.S. ever to undergo a total larynx transplant sa国际传媒 the others, years ago, because of injuries sa国际传媒 and one of a handful reported worldwide.

Surgeons at the Mayo Clinic in Arizona offered Kedian the transplant as part of a new clinical trial aimed at opening the potentially lifechanging operation to more patients, including some with cancer, the most common way to lose a larynx.

sa国际传媒淧eople need to keep their voice,sa国际传媒 Kedian, 59, told The Associated Press four months after his transplant sa国际传媒 still hoarse but able to keep up an hourlong conversation. sa国际传媒淚 want people to know this can be done.sa国际传媒

He became emotional recalling the first time he phoned his 82-year-old mother after the surgery sa国际传媒渁nd she could hear me. sa国际传媒 That was important to me, to talk to my mother.sa国际传媒

The study is small sa国际传媒 just nine more people will be enrolled. But it may teach scientists best practices for these complex transplants so that one day they could be offered to more people who cansa国际传媒檛 breathe, swallow or speak on their own because of a damaged or surgically removed larynx.

sa国际传媒淧atients become very reclusive, and very kind of walled off from the rest of the world,sa国际传媒 said Dr. David Lott, Mayosa国际传媒檚 chair of head and neck surgery in Phoenix. He started the study because sa国际传媒渕y patients tell me, sa国际传媒榊eah I may be alive but Isa国际传媒檓 not really living.sa国际传媒檚a国际传媒

Lottsa国际传媒檚 team reported early results of the surgery Tuesday in the journal Mayo Clinic Proceedings.

The larynx may be best known as the voice box but itsa国际传媒檚 also vital for breathing and swallowing. Muscular tissue flaps called vocal cords open to let air into the lungs, close to prevent food or drink from going the wrong way sa国际传媒 and vibrate when air pushes past them to produce speech.

The first two U.S. larynx transplant recipients sa国际传媒 at the Cleveland Clinic in 1998 and the University of California, Davis, in 2010 sa国际传媒 had lost their voices to injuries, one from a motorcycle accident and the other damaged by a hospital ventilator.

But cancer is the biggest reason. The American Cancer Society estimates more than 12,600 people will be diagnosed with some form of laryngeal cancer this year. While today many undergo voice-preserving treatment, thousands of people have had their larynx completely removed, breathing through whatsa国际传媒檚 called a tracheostomy tube in their neck and struggling to communicate.

Although the earlier U.S. recipients achieved near normal speech, doctors havensa国际传媒檛 embraced these transplants. Partly thatsa国际传媒檚 because people can survive without a larynx sa国际传媒 while antirejection drugs that suppress the immune system could spark new or recurring tumors.

sa国际传媒淲e want to be able to push those boundaries but do it as safely and ethically as we can,sa国际传媒 Lott said.

Head-and-neck specialists say the Mayo trial is key to helping larynx transplants become a viable option.

sa国际传媒淚t isnsa国际传媒檛 a sa国际传媒榦ne-off,sa国际传媒檚a国际传媒 but an opportunity to finally learn from one patient before operating on the next, said Dr. Marshall Strome, who led the 1998 transplant in Cleveland.

This first attempt in a cancer patient sa国际传媒渋s the next important step,sa国际传媒 he said.

Other options are being studied, noted Dr. Peter Belafsky of UC Davis, who helped perform the 2010 transplant. His patients at high risk of larynx loss record their voice in anticipation of next-generation speech devices that sound like them.

But Belafsky said theresa国际传媒檚 sa国际传媒渟till a shotsa国际传媒 for larynx transplants to become more common while cautioning it likely will take years more research. One hurdle has been achieving enough nerve regrowth to breathe without a trach tube.

Kedian was diagnosed with a rare laryngeal cartilage cancer about a decade ago. The Haverhill, Massachusetts, man underwent more than a dozen surgeries, eventually needing a trach tube to help him breathe and swallow sa国际传媒 and struggled even to muster a raspy whisper through it. He had to retire on disability.

Still the once gregarious Kedian, known for long conversations with strangers, wouldnsa国际传媒檛 let doctors remove his entire larynx to cure the cancer. He desperately wanted to read bedtime stories to his granddaughter, with his own voice rather than what he called robotic-sounding speech devices.

Then Kediansa国际传媒檚 wife Gina tracked down the Mayo study. Lott decided he was a good candidate because his cancer wasnsa国际传媒檛 fast-growing and sa国际传媒 especially important sa国际传媒 Kedian already was taking antirejection drugs for an earlier kidney transplant.

It took 10 months to find a deceased donor with a healthy enough larynx just the right size.

Then on Feb. 29, six surgeons operated for 21 hours. After removing Kediansa国际传媒檚 cancerous larynx, they transplanted the donated one plus necessary adjoining tissues sa国际传媒 thyroid and parathyroid glands, the pharynx and upper part of the trachea sa国际传媒 and tiny blood vessels to supply them. Finally, using new microsurgical techniques, they connected nerves critical for Kedian to feel when he needs to swallow and to move the vocal cords.

About three weeks later, Kedian said sa国际传媒渉ello.sa国际传媒 Soon hesa国际传媒檇 relearned to swallow, working up from applesauce to macaroni and cheese and hamburgers. He got to say hi to granddaughter Charlotte via video, part of his homework to just keep talking.

sa国际传媒淓very day itsa国际传媒檚 getting better,sa国际传媒 said Kedian, who moves back to Massachusetts soon. His tracheostomy remains in place at least a few more months but sa国际传媒淚sa国际传媒檓 pushing myself to make it go faster because I want these tubes out of me, to go back to a normal life.sa国际传媒

And just as Lott had assured him, Kedian retained his beloved Boston accent.

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