When Sherry Wittenberg learned a cancerous tumor was taking over her larynx, her doctor told her something frightening: to save her life, he'd need to remove her voicebox. The procedure would rob the 58-year-old Michigan woman of her ability to speak normally, and she'd have to use a hole in her neck to breathe for the rest of her life.
Wittenberg nodded along during the appointment, too shocked and scared to be able to fully grasp the doctor's words. When she got home, she did what Internet-era cancer patients do: she hopped online to learn more about her form of cancer and the laryngectomy her doctor had recommended -- a common procedure for laryngeal cancers. That's when it hit her: "I thought, Oh, god. I wouldn’t be able to talk."
If she couldn't talk, she couldn't keep her job. Wittenberg, who lives with her husband on a dairy farm in Cement City, Mich., is a sales representative for a steel company, so she's on the phone constantly during the day, chatting with clients all over the country. She loves her job, and she's great at it. No voice, no job, she feared.
Terrified of what that would mean for her life and her family, Wittenberg sought a second opinion, which led her to Dr. Douglas Chepeha, director of microvascular surgery in the Department of Otolaryngology, Head and Neck Surgery, at the University of Michigan Medical School. He offered her another option: a never-before-done reconstructive surgery that would remove the cancerous tumor from her larynx, while allowing her to keep her voice.
With this procedure, surgeons would remove the cancerous tumor, which was in the larynx's cricoid, a circular cartilage that helps to hold the windpipe open, Chepeha explains. To remove the tumor, surgeons would have to partially remove the cricoid cartilage, so they'd use the tip of Wittenberg's shoulder blade to rebuild it; this would help keep the larynx together, while still allowing enough room for Wittenberg to breathe through the airway. Surgeons would also use a graft of tissue from inside Wittenberg's mouth to reconstruct the larynx's lining. (The novel procedure is described online in the journal The Laryngoscope.)
"My biggest concern was making sure Sherry wouldn’t suffer just because I was trying this technique," says Chepeha. Because like any major surgery, this one came with risks: She could die on the operating table. Or, once she was under, Chepeha could discover the cancer had spread more than he'd realized, and he'd have to remove her voicebox, anyway.
Wittenberg decided to go for it, scheduling the procedure for January 2010 -- but a few weeks before the surgery, the thought of all she could lose made her briefly lose her nerve. "I couldn’t even talk, I was just so upset," says Wittenberg, who was diagnosed in October 2009. In January of that year, her adult son had died. Her family -- consisting of herself, her husband, and her adult daughter, who lives in a nearby Michigan town -- were already missing one member; she worried what would happen to her husband and daughter if she were to die, too.
"I think I just needed extra time," she says. They pushed the surgery back to March. This time, she was ready. The procedure went as well as they'd hoped: Wittenberg was able to go home 13 days later, and she returned to work that June.
"I knew I was never going to talk the same. And I definitely can’t sing now, I’m as flat as can be. But, you know, who cares," Wittenberg says. She describes her voice as lower than it used to be -- but it's not noticeable to anyone who didn't know her before the surgery. "I still can remember what I used to sound like," she says. "It's different. But it’s not bad. I'm just so thankful."