Survivors of head and neck cancer are more likely to commit suicide than any other group of cancer survivors besides pancreatic.
LiRA CEO Andrew Prince has become well acquainted with this fact as a head and neck surgery resident at UNC Medical Center, having watched so many patients struggle with voicelessness due to throat cancer.
Prince wanted to forge a solution to a problem he sees on a regular basis and met just the group to create one through an Innovate Carolina healthcare challenges program. The team—with backgrounds in medicine, business and engineering—focused on this problem of voicelessness for six months before the world locked down due to the Covid-19 pandemic.
But they stayed connected, committed to continuing their work as a team and leaning on each other to survive the pandemic. Chapel Hill-based LiRA officially incorporated in July 2020.
LiRA is designed to be a web-based app, accessible on any smart device. The platform, which was recently awarded a $10K MICRO grant from NC IDEA, uses a video camera to capture the live motion of someone speaking, sending the clip to a cloud-based algorithm that transfers the video into speech.
This is the exact type of technology Prince has needed during his time as a resident.
One time a patient came in with difficulty breathing, and the medical team had to put an emergency airway in her throat. Upon waking up in the hospital room, the patient was forced to not only confront the fact that she had throat cancer, but also that she was unable to speak.
An hour of unsuccessfully attempting to have a normal conversation sparked a panic attack. Even communicating about something as simple as pain medication becomes an ordeal when a patient is unable to talk.
Prince never wants anyone to be in that position of voicelessness—physically mouthing words, but with no one able to understand you because the sounds just don’t come out.
“It’s like trying to play guitar without guitar strings,” Prince said. “Vocal cords make the sound waves, but [even if they can’t make sound] they can still move their face like they’re speaking. And we’re trying to lip-read, but it’s hard.”
This sparked the idea that perhaps there was a way to build technology to solve this problem for patients.
“We can’t [lip-read] that well, but certainly a computer could learn how to do it,” Prince said. “It seemed like it could truly change the paradigm.”
So far, LiRA focuses on a limited number of things that patients desperately need to be able to communicate, like about pain medication, difficulty breathing, chest pain—the things that are truly going to save lives. But in the future, LiRA wants to explore expanding the lip-reading service for more than just patients, including for deaf individuals.
Right now, LiRA is looking for volunteers across the United States who can send in videos of themselves reading sentences that voiceless patients would need to be able to say in the hospital on their website. Prince hopes people will share the platform with their friends to grow LiRA’s ability to lip-read.
Covid-19 Pandemic Highlights Need
The lip-reading platform will be able to help people who have lost their voices due to cancer or physical trauma to the neck, or even from being intubated to spend significant time on a ventilator to battle Covid-19, Prince said. These patients are not expecting or preparing for voicelessness, and they need a way to speak immediately.
Sudden voicelessness primarily occurs at urban hospitals, which Prince said is LiRA’s key target customer.
LiRA has already raised around $130,000 in grants from places like UNC’s 1789 Student Venture Fund, the Kenan-Biddle award and the Clinton Foundation, all in their hopes to eradicate literal voicelessness in hospitals.
“I want voicelessness to become something you don’t even consider,” Prince said. “Imagine, now you break your leg. You’ve got a wheelchair, but somebody had to invent the wheelchair—and imagine how miserable it would have been before that. That’s the kind of change we’re trying to drive.”
When someone wakes up voiceless in a hospital, they are basically playing charades, Prince said. The best they have are cartoon picture boards to refer to, an overly simplified and frustrating way to communicate for fully functioning adults during critical moments in their lives. They are having discussions about what they want to do when it comes to life and death, and they are currently relying on cartoons.
“It’s like they lose part of themselves,” Prince said. “You watch them lose their color. You watch them become gray, and it’s really disheartening.”
In the current best-case scenario, patients can receive voice restoration tools, which takes a long period of time and provides people a nearly “Frankenstein” voice that people hate, Prince said. Patients often lose their livelihoods and their families are ripped apart.
LiRA could help change all that, and the pandemic has brought increased awareness over the plight of those who are voiceless, including some Covid-19 patients.
“I think Covid has helped make people realize what we’re talking about is a huge problem because voicelessness is obviously directly affected by Covid,” Prince said. “But it was an issue that was worth solving before this pandemic.”