The Reverend Albert Williams had been preaching at Salem Missionary Baptist Church in Houston for nearly 10 years when he was diagnosed with laryngeal cancer, threatening his vocation. When the malignancy recurred following radiation therapy, Rev. Williams was referred by his local ENT physician to Ron Karni, MD, an assistant professor in the The University of Texas Health Science Center at Houston (UTHealth) Department of Otorhinolaryngology, and a board-certified otorhinolaryngologist affiliated with Memorial Hermann-Texas Medical Center.
During his initial consultation with Rev. Williams, Dr. Karni discussed surgical options, including the possibility of partial laryngectomy. “The least-invasive option is always our first choice, assuming, of course, that the option offers the best chance for treatment of the cancer,” the otorhinolaryngologist says. “Because of its location, the larynx plays a critical role in swallowing and breathing, as well as in speaking. We do everything we can to avoid sacrificing a patient’s voice, so if partial laryngectomy will provide a cure, that’s our preferred treatment.”
Dr. Karni took Rev. Williams to the operating room in late February 2010. As he proceeded in the six-hour surgery, he discovered that the size of the tumor and extent of the malignancy ruled out partial laryngectomy. “ Total removal of the larynx was our only option for a cure,” he says. During the surgery, he performed a formal neck dissection – removal of the lymph nodes of the neck – and laryngectomy with breathing stoma. There were no complications from the surgery, and the reverend healed well.
Following the procedure, Rev. Williams worked with Memorial Hermann-TMC speech pathologist Jade Alexander, CCC-SLP, who educated him about stoma care and his electrolarynx.
Rev. Williams didn’t speak for 11 months and 18 days. “It was hard on both of us, especially in the beginning,” says his wife Mary Louise Anderson-Williams. “But things got better with a lot of prayer and a lot of patience. We wrote notes. We read lips. We got by.”
He began doing silent devotions at his church in late 2010. “At first I was doing them without sound because I couldn’t speak,” he says. “Not being able to speak in church or sing – that was the oddest thing.”
Rev. Williams first spoke in early February 2011 after Dr. Karni performed a tracheoesophageal puncture (TEP), creating a stoma in the trachea and esophagus through which he placed a voice prosthesis. “This is a common procedure used to rehabilitate the voice, but in Rev. Williams’ case it was particularly moving because he uses his voice in such an important way,” Dr. Karni says. “He had a wonderful outcome, and the quality of his voice is amazing. It’s very impressive to hear him talk.”
After the procedure, Alexander worked with him to improve his speech. “He mastered tracheoesophageal speech with digital occlusion of the stoma, but his end goal is to learn to use the ATOS Provox Freehands device, which has an automatic tracheostoma valve that allows him to speak without having to close the stoma manually,” she says. “The device, which he is learning to operate, will make it easier for him to return to the pulpit.”
Rev. Williams, who has an excellent prognosis, considers his surgeon a godsend. “I love him! He’s really a great guy. God knew exactly what I needed and sent me Dr. Karni.
“My voice is coming back really well,” he adds. “Cancer is a lot to overcome. I tell people, number one make sure you have the right doctors caring for you and then trust in the Lord that everything will be alright. If I can make it, others can, too.”