Medical Oncologist
CION Cancer Clinics
Tracheostomy: what it is and why a cancer team may suggest one | CION Cancer Clinics
A tracheostomy is a small opening in the front of the neck into the windpipe, with a tube placed through it so you can breathe below the mouth and throat. In cancer care it is done when a tumour, or the swelling after surgery or radiotherapy, narrows the airway. It does not treat the cancer. It keeps breathing safe, and for many people it is temporary. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- What is a tracheostomy, in plain words?
- Why is a tracheostomy done for people with cancer?
- How is a tracheostomy actually done?
- Which words will you hear on the ward?
- What do families fear about a tracheostomy, and what is true?
- What should you ask, and what can this page not tell you?
- Common questions about tracheostomy
The short answer
What is a tracheostomy, in plain words?
A tracheostomy is a small opening made in the front of the neck, into the windpipe, with a short curved tube placed through it. You then breathe through the tube in your neck instead of through your nose and mouth.
Why a cancer team might suggest one
Air normally travels from the nose and mouth, past the tongue and the voice box, and down the windpipe to the lungs. A cancer in the mouth, throat, voice box or thyroid can narrow that path. So can the swelling after a large operation in the mouth or neck, or after radiotherapy to the throat. The tube goes in below the narrow part, so breathing no longer depends on it.
Is it an operation for the cancer itself?
No. A tracheostomy does not remove or treat the tumour. It protects the airway while the cancer is diagnosed, operated on or treated with radiotherapy or chemotherapy. For many people it is temporary, and the tube comes out once the airway has recovered. For some it stays for longer, or for good.
A tracheostomy is not the same as the opening left after the whole voice box is removed. That is a laryngectomy stoma, and it is a different thing with different rules.The reasons
Why is a tracheostomy done for people with cancer?
There are four common reasons. Your team will tell you which one applies to you, and it shapes how long the tube is likely to stay.
A tumour is narrowing the airway
A growth in the voice box, the throat or the thyroid can press on the breathing passage. Noisy breathing, breathlessness when lying flat and a changing voice are the usual signs.
Sometimes done
- Before a biopsy under anaesthesia
- As an urgent operation
Swelling after major surgery
After an operation on the tongue, jaw, floor of the mouth or throat, the tissues swell for some days. A planned tracheostomy keeps you breathing safely while that settles.
Swelling during radiotherapy
Radiotherapy to the throat can make the lining swell. When the airway is already tight from the tumour, the team may place a tube before treatment starts rather than wait for trouble.
Help with breathing and phlegm
Some people need a breathing machine for a longer time in intensive care, or cannot cough up phlegm well enough. A tube in the neck is easier to keep clean and is more comfortable than one through the mouth.
Not sure whether this applies to you?
Ask an oncologistIn the operating theatre
How is a tracheostomy actually done?
Anaesthesia
Most planned tracheostomies are done under general anaesthesia, so you are asleep. When a tumour makes it unsafe to pass a breathing tube through the mouth, the team may do it with the neck numbed while you stay awake.
The opening
The surgeon makes a short cut low in the front of the neck, moves the neck muscles aside and opens the windpipe below the voice box.
The tube
A curved tube is slipped into the windpipe. Its flat plate sits on the skin and is held with soft ties around the neck, and sometimes a few stitches for the first days.
The first days
Nurses clear phlegm from the tube, keep the air moist and check the ties. The first tube change is done by the team, not by the family.
On your notes
Which words will you hear on the ward?
- Trachea
- The windpipe. The tube that carries air from the throat down to the lungs.
- Stoma
- The opening in the neck that the tube passes through.
- Inner tube or inner cannula
- A thinner tube that sits inside the main one and slides out for cleaning, so phlegm does not block the airway.
- Cuff
- A small soft balloon near the tip of some tubes. When filled, it seals the windpipe around the tube.
- Suctioning
- Clearing phlegm from the tube with a thin, soft catheter attached to a suction machine.
- Decannulation
- Taking the tube out for good once you can breathe safely without it.
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Did you know
With the right type of tube and a one-way speaking valve, many people with a tracheostomy can talk. Speech usually needs some help at first, so keep a pen, a notepad or a phone by the bed for the early days.
Commonly believed
What do families fear about a tracheostomy, and what is true?
"A tube in the neck means the cancer has spread."
It does not. The tube is about the airway, not the stage of the cancer. Many people have one only for the days of swelling after surgery, on the way to a planned recovery.
"Once it is put in, it can never come out."
Many tracheostomies are temporary. When the swelling or narrowing settles, the team tests your breathing with the tube blocked and then removes it. The opening usually closes on its own.
"He will never speak or eat again."
A tracheostomy leaves the voice box in place. Speech and swallowing are often affected for a while, and a speech and swallowing therapist helps with both. What the cancer operation itself does to speech is a separate question to ask your surgeon.
"We should refuse it and wait to see."
That is your right, and the team will respect it. Ask them plainly what could happen to the airway if you wait, and how quickly, so that the choice is made with the full picture.
Being straight with you
What should you ask, and what can this page not tell you?
This page cannot tell you whether you need a tracheostomy. That depends on where the tumour sits, how narrow the airway is, the operation planned and your lungs and general health. Only your treating team can weigh those together.
Who it may not suit
Not everyone with a head and neck cancer needs one. Smaller operations in the mouth often do not, and some people can be kept safely on a breathing tube through the mouth overnight instead. In people who are very unwell, the team will talk through whether a tube would add comfort or only add burden. There is no single right answer to that.
Questions worth asking
Why is it needed in my case? Is it likely to be temporary? Who will teach my family to care for it before we go home? What should we do if the tube blocks or comes out? Can I speak with it, and when can I eat? Write the answers down, because the first days are tiring and it is easy to forget.
Before discharge, make sure at least two family members have been shown suctioning, cleaning and what to do in an emergency.Questions we are asked
Common questions about tracheostomy
Does a tracheostomy hurt?
The operation is done under anaesthesia or with the neck numbed. Afterwards the neck is sore for some days, and coughing and suctioning feel uncomfortable. Pain relief is given regularly. Tell the nurses early if it is not enough, because pain makes coughing and breathing harder and is easier to control before it builds.
Can I talk with a tracheostomy?
Often, yes, but not always straight away. Air has to pass up through the voice box to make sound. With the cuff let down, or a one-way speaking valve fitted, many people can speak. Your team decides when it is safe to try, and a speech therapist helps with the first attempts.
Can I eat and drink normally?
The tube itself can make swallowing harder, and food may slip towards the windpipe. After mouth or throat surgery you may also be fed through a thin tube in the nose for a time. A swallowing assessment is done before you start eating again. Do not try food or drink until the team says so.
How long does the tube stay in?
It depends on why it was put in. After planned mouth or throat surgery, it often comes out once the swelling settles, while you are still in hospital or soon after. When a tumour is blocking the airway, it stays until treatment has opened the passage, which can be much longer, or permanently.
Will there be a scar?
Yes. Once the tube is out, the opening usually closes on its own, and a small scar remains low on the front of the neck. It often fades and flattens with time. If it stays puckered or pulls when you swallow, a small operation to tidy it can be discussed later.
Can the family look after it at home?
Yes. Many families do, once they have been trained on the ward. You will learn to suction, clean the inner tube, change the dressing and ties and keep the air moist. You go home with a spare tube, supplies and a number to call. Practise with the nurses until you feel confident, not just once.
What if the tube blocks or falls out at home?
This is the emergency every family needs to know about before discharge. You will be taught to remove the inner tube, suction and, if needed, put in the spare tube. If breathing does not improve, call for emergency help at once and say the person breathes through a tube in the neck.
Is a tracheostomy covered by Aarogyasri or insurance?
When it is part of approved cancer treatment, it is usually included with the main operation. Aarogyasri, CGHS, ECHS, EHS and most cashless insurers are accepted at CION. Home supplies such as spare tubes and suction catheters are often not covered, so ask about them before discharge. Call the helpline to check your own cover.
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MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
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Dr. Vinay Mamidala
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Sources
- NHS — Tracheostomy
- Cancer Research UK — Laryngeal cancer
- Macmillan Cancer Support — Head and neck cancer
- National Cancer Institute — Head and Neck Cancers
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Temporary vs Permanent TracheostomyHow long the tube is likely to stay, and whyPlanned Tracheostomy Before Head and Neck SurgeryWhy it is often done during mouth and throat operationsTracheostomy vs Laryngectomy Stoma: Not the Same ThingTwo openings in the neck with very different rulesBlocked Tube: The Emergency Every Family Must KnowWhat to do if breathing through the tube gets hardTracheostomyEvery page in this guide
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Told you may need a tracheostomy?
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