On Thursday morning, Marty Kedian did something that was beyond his abilities for years: He sat at a table with his wife and friends and had a conversation.
Diagnosed with larynx cancer a decade ago, Kedian had suffered through his voice being reduced to a whisper. By last year, he wasn’t able to speak at all. Without the ability to communicate, he avoided social events, he said.
But in February, Kedian, 59, had his larynx removed and received a donor organ in its place. For almost six months, he recovered and relearned to speak, eat, and breathe near the Mayo Clinic in Arizona. On Thursday, his friends and family spanning three generations welcomed the Haverhill man home.
“I’m able to speak again,” he said Thursday, loud enough for a crowd of two dozen to hear him clearly. “You’re never going to shut me up.”
“It’s great to hear your voice again,” shouted his cousin Nina Cullen-Hamzeh, of Swampscott.
Kedian’s voice, soft but clear and steady, is his own, recognizable and with his Boston accent intact, his family said.
“The feeling of being able to pick up the phone and call him is out of this world,” said his son Robert.
Kedian is the first of an anticipated 10 people participating in a clinical trial at the Mayo Clinic in Arizona exploring ways to restore voices to people with damaged or removed larynxes. Just three Americans have received total larynx transplants, the clinic reported.
Despite being colloquially called a voice box, the larynx also plays an important role in breathing and eating. Vocal cords are critical to allowing air into the lungs and keeping food and drink down.
Kedian has had a hole in his throat that assists his breathing, called a tracheostomy, for about five years, he said. Swallowing has been difficult, and before the transplant, he hadn’t breathed through his mouth and nose for four years. Now, he is doing both, and he is hopeful that as his recovery continues, the trach tube will be removed.
Dr. Girish Mour, medical director of the Mayo Clinic’s Larynx and Trachea Transplant Program, hopes the clinical trial will lead to larynx transplants becoming more common. They are rare now, because patients can live without larynxes, and the immunosuppressive drugs that transplant patients must take have their own side effects.
Yet removing a larynx, the more common treatment for patients with laryngeal cancer, can have devastating consequences, including the need for a tracheostomy to breathe and the risk of losing speech or replacing their own voice with a robotic-sounding voice box. The result, doctors said, is that patients withdraw socially.
“It may not be life-saving, per se,” said Dr. David Lott, chair of the Mayo Clinic’s Department of Otolaryngology and one of Kedian’s six surgeons, of the transplant procedure, “but it is life-giving, because these people are so reclusive.”
Transplants are often a poor option for cancer patients because the immunosuppressive drugs can make it more likely their cancer will return, doctors said.
Kedian was a particularly good candidate, because he was already taking immunosuppressive drugs after a kidney transplant and because his cancer was a slow-growing one.
Before the transplant, Kedian received more than a dozen surgeries as he attempted to stay ahead of his rare laryngeal cartilage cancer. Kedian’s 21-hour transplant surgery included removing his thyroid and parathyroid glands, his upper esophagus, blood vessels, and nerves. Lott described essentially rewiring Kedian’s nerves in a laborious process designed to ensure he could properly breathe and swallow with his new larynx. It takes six months to a year to fully determine how well the patient’s nerves regenerate after the procedure, Lott said, but so far Kedian’s recovery is going well.
Dr. Derrick Lin, chief of head and neck oncology at Mass Eye and Ear, said that ideal patients for this procedure are those who cannot tolerate living with a tracheostomy. Otherwise, the risk of nerves not regenerating properly and of the cancer coming back may make physicians wary of recommending the procedure.
“For people who really cannot imagine having that hole in your neck and really frustrated by it, that would be somebody you consider doing a transplant for,” he said.
He is interested in seeing how patients such as Kedian progress in the years after their transplants.
As Kedian talked with his wife Gina and friends, he glanced at his son Robert and grinned.
“I haven’t seen him smile in over a year,” his son marveled.
Kedian’s other son, Nik, helped organize the Thursday reunion at his workplace, Steeple Hall at Mission Oak Grill, an event venue in Newburyport. If Kedian was the star of the event, Nik’s daughter Charlotte was the co-star, getting almost as much attention. She’s almost 2 years old and is Kedian’s only grandchild, though another is on the way. His desire to be an involved grandparent was a major factor in his decision to undergo the rare procedure.
“He wants to be able to take her to the park,” Nik said. “He wants to be able to read her a bedtime story.”
Kedian, now cancer-free, also wants to advocate to expand access to the surgery he received.
“Everybody should have a voice,” he said.
The Associated Press contributed to this report.
Jason Laughlin can be reached at jason.laughlin@globe.com. Follow him @jasmlaughlin.