Klaske van Sluis

Life after total laryngectomy 145 and ”Persistent vulnerability” are likely to occur with men as well. Furthermore, the study necessarily included participants who had a relatively high level of speaking proficiency with their voice prosthesis and were therefore able to ex- press themselves verbally. Despite this bias, our findings illustrate a wide range of issues beyond communication. This paper therefore provides an impression of an extensive range of possible issues women may be confronted with after total laryngectomy. 8.6 Conclusions The accounts provided by the women interviewed in this study show that un- dergoing total laryngectomy has a major impact on their everyday life. The disease and its treatment form a turning point in their lives, after which they experience challenges in while returning to everyday activities and persistent vulnerability. Women-specific issues are present in returning to work, the per- formance of informal care work, the spousal relationship, intimacy, and social interaction (mostly stigmatisation due to voice and appearance). The aim of this study was to reveal women-specific issues, but we nevertheless assume that some of the reported issues are present for men as well. Based on the findings of this study it is recommended to include information on changes in daily func- tioning in the pre-treatment counselling procedures, and the contribution of an aged-matched and gender-matched patient visitor would be valuable. Tai- lored rehabilitation for women following total laryngectomy is recommended to enhance participation in social roles and work-related activities. Within this process of treatment and rehabilitation, it is important to involve the partner in order to discuss the impact of the surgery on the relationship and family roles. To fully understand the gender-specific aspects of total laryngectomy, fu- ture research should focus on the particular ways in which the procedure affects both women and men in specific areas of daily life (e.g. returning to work, care activities, and intimate relationships). 8.7 Acknowledgements The Netherlands Cancer Institute received a research grant from Atos Medical (Malmö, Sweden), which contributes to the existing infrastructure for quality of life research of the Department of Head and Neck Oncology and Surgery. The authors have no other funding, financial relationships or conflicts of interest to disclose. References [1] L. van der Molen, A. F. Kornman, M. N. Latenstein, M. W. van den Brekel, and F. J. Hilgers, “Practice of laryngectomy rehabilitation inter-