AUDIE CORNISH, host: The biggest selling pop artist of the year has gone silent. The British pop/soul singer Adele was forced to cancel the rest of her 2011 tour. Earlier this year, she suffered two vocal hemorrhages and will need to undergo surgery.

As NPR's Elizabeth Blair reports many famous have singers have needed similar treatment.

ELIZABETH BLAIR: Take a listen to some of the great vocal cords that have gone under the knife.

(SOUNDBITE OF SONGS, "DO-RE-M, "TINY DANCER," "IGNITION," "WAITING ON THE WORLD TO CHANGE")

JULIE ANDREWS: (Singing) Doe, a deer. A female deer...

ELTON JOHN: (Singing) Blue jean baby, L.A. lady...

R. KELLY: (Singing) Now it's like murder she wrote, once I get you out them clothes...

JOHN MAYER: (Singing) So we keep on waiting, waiting, waiting on the world to change...

BLAIR: John Mayer had his surgery in the last few weeks. Singers are in a high risk business. Dr. Steven Zeitels is director of the Voice Center at Massachusetts General Hospital.

DR. STEVEN ZEITELS: Essentially people who sing are vocal athletes, so you can look at this as a not unusual scenario in someone who's an athlete getting an injury in that area.

BLAIR: Dr. Zeitels is now working with Adele. The list of his patients is like a who's who of great singers: Julie Andrews, Roger Daltrey, and opera singer Denyce Graves.

(SOUNDBITE OF OPERA, "CARMEN")

DENYCE GRAVES: (Singing in foreign language)

BLAIR: Denyce Graves says, in 2000, her vocal cords hemorrhaged while she was backstage, in the middle of an engagement.

GRAVES: I sneezed. It was that simple. I sneezed and I hemorrhaged.

BLAIR: Graves says it was clear something serious had happened.

GRAVES: I lost my voice immediately. And it was one of the most frightening and terrifying experiences ever.

BLAIR: She had surgery but says she kept it a secret for fear the news would hurt her career.

The causes for vocal injuries aren't always the same. But, unlike athletes or even other musicians, what singers all share is the fact that their voice - their instrument - is being used constantly.

ROGER LOVE: What people don't seem to understand is that the voice, the vocal cords are incredibly fragile.

BLAIR: Roger Love is a voice coach who's worked with a number of celebrities: Maroon 5, John Mayer and Gwen Stefani, among others. He says when they're working they put their voices through a tremendous amount of wear and tear.

LOVE: They're traveling. Maybe they didn't sleep well. They're out of their own element. Then they have radio interviews, press interviews, then they head to sound check. Then they've got to make it through the afternoon into the evening, talking to all the technical people, talking to the managers - more using the voice.

BLAIR: And then, after all that...

(SOUNDBITE OF CHEERING)

BLAIR: ...there's the show.

(SOUNDBITE OF SONG, "ROLLING IN THE DEEP")

ADELE: (Singing) There's a fire starting in my heart, reaching a fevered pitch and it's bringing me out the dark...

BLAIR: After surgery, Adele will most likely need a number of months to recover, says Dr. Steven Zeitels. Denyce Graves credits him with practically saving her career. But she says she and other singers still have to watch what they do all the time. She remembers one early morning voice class she had when she was in college.

And my voice teacher said, your voice doesn't sound the same as it did, you know, a couple of days ago. What were you doing last night? And I said, oh, I was out with friends and we were laughing. And she said, you were laughing on the night before a voice lesson?

(SOUNDBITE OF LAUGHTER)

BLAIR: And I thought, yikes, what have I getting myself into?

Adele is learning the hard way. This has been her breakout year. And she wrote on her blog that she is heartbroken and frustrated she can't perform.

Elizabeth Blair, NPR News.

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