Overview

Supraglottic Cancer is one form of laryngeal (voice box) cancer that occurs in the supraglottis, the top portion of the larynx, above the vocal cords. This includes the epiglottis, false vocal cords, aryepiglottic folds, and arytenoid cartilages. As compared to glottic cancer, supraglottic cancer is less symptomatic in its early stage and has the tendency to metastasize into the neck lymph nodes. Early detection and immediate treatment are important for improving chances of survival and maintaining swallowing, speaking, and breathing abilities.

What is Supraglottic Cancer?

Supraglottic Cancer is a malignant growth that forms in the upper area of the larynx above the true vocal cords. In most cases, the condition consists of squamous cell carcinomas (SCC), which start in the lining of the larynx.

The supraglottis is an important structure, as it helps in:

• Providing protection for the airway during the swallowing process
• Prevention of food or fluid from entering the windpipe
• Aiding in voice production
• Helping breathing

Where Does the Supraglottis Sit?

The larynx can be subdivided into three sections:

• Supraglottis - Upper portion of the vocal cords
• Glottis - Where the true vocal cords lie
• Subglottis - Lower portion of the vocal cords

The components of the supraglottis include:

• Epiglottis
• Falsetto vocal cords (vestibular folds)
• Aryepiglottic folds
• Arytenoid cartilages

Since this area is characterized by abundant lymphatics, tumors arising in it metastasize to regional lymph nodes more often than those in the glottis.

What Triggers Supraglottic Cancer?

There are several causes that predispose a person to supraglottic cancer.

These risk factors include:

• Smoking
• Mastication of tobacco
• Extensive intake of alcohol
• Tobacco and alcohol combined
• Age advancement
• Male sex (though women's incidence is on the rise)
• Exposure to occupational hazards like dust, chemicals, or asbestos
• Bad oral habits
• History of head and neck cancers
• Human papillomavirus (HPV) could also contribute in a minority of cases.

What are the Signs of Supraglottic Cancer?

Unlike glottic cancer, hoarseness can develop later, as the vocal cords do not take part at the beginning.

The most common signs are:

• Persistent sore throat
• Discomfort in swallowing
• The feeling of having an object in the throat
• Difficulty swallowing (dysphagia)
• Ear pain (referred otalgia)
• The presence of neck swelling as a result of enlarged lymph nodes
• A persistent cough
• Blood in saliva or sputum
• Bad breath
• Hoarseness due to the progression of the cancer into the vocal cords
• Difficulty breathing with advanced cancer
• Unexplained weight loss

It is necessary to consult an ENT doctor if you have persistent throat symptoms for more than two to three weeks.

How Is Supraglottic Cancer Diagnosed?

The diagnosis includes clinical examination and special diagnostic procedures.

Clinical examination

The ENT doctor examines:

• Oral cavity and throat
• Neck lymph nodes
• Ability to swallow
• The voice characteristics

Flexible Laryngoscopy

With a flexible endoscope sent through the nose, the specialist directly examines the supraglottis.

Direct Laryngoscopy with Biopsy

An anesthetized patient is examined under general anesthesia.

Imaging Tests

Based on clinical findings, the following tests can be ordered:

• Enhanced CT scan
• MRI scan
• PET-CT scan for advanced disease
• Chest CT scan as required

They help determine the extent of the tumor and any lymph node or distant metastases.

How Is Supraglottic Cancer Staged?

The staging of supraglottic cancer is done using the TNM (Tumor, Node, Metastasis) system.

Stage I

Primary tumor localized to one region of the supraglottis.
Normal vocal cord mobility
No involvement of lymph nodes

Stage II

Primary tumor growing into adjacent regions of the supraglottis or glottis.
No lymph node metastasis

Stage III

Large tumor
Vocal cord fixation and tumor extending outside the supraglottis
Maybe one involved lymph node

Stage IV

The primary tumor invades surrounding structures, including the thyroid cartilage, the base of the tongue, and the neck.
Can have multiple lymph nodes or distant metastasis

How Is Supraglottic Cancer Treated?

The treatment is based on:

• The stage of the tumor
• The size of the tumor
• Lymph node involvement
• General health
• Speech and swallowing ability

Surgery

The types of surgeries that may be done include:

• TLM for select early-stage tumors
• Partial supraglottic laryngectomy
• Total laryngectomy for advanced tumors
• Reconstruction, where required

The surgical technique depends on the tumor staging and whether it is possible to preserve laryngeal function.

Neck Dissection

Since supraglottic cancer has a tendency to spread to neck lymph nodes, neck dissection is often done even in selected cases without clinically evident node involvement.

Radiotherapy

Radiotherapy is one of the best treatments available for most early-stage diseases. Radiotherapy is used after surgery in some instances.

Radiotherapy may be done if:

• The surgical margin is close or positive.
• Lymph nodes are involved.
• There is an advanced disease.
• Surgery cannot be done.

Chemotherapy

Chemotherapy is usually used with radiotherapy in cases where there is advanced disease for larynx conservation if needed.

If there is a recurrence of the disease or metastasis, then chemotherapy, targeted therapy, or immunotherapy may be used as needed.

Does Supraglottic Cancer Metastasize?

Yes.

Due to the abundant lymphatic drainage in the supraglottis, this cancer metastasizes to neck lymph nodes more often than glottic cancer.

Metastasis at an advanced stage may occur in:

• Neck lymph nodes
• Lungs
• Bones
• Liver

Prompt treatment helps to improve disease management.

How Is the Prognosis?

There are many factors that affect the prognosis, such as:

• Tumor staging at diagnosis
• Tumor size
• Lymph node metastasis
• Reaction to treatment
• Overall condition

Cancers in early stages have a very good prognosis. But in advanced cases, more serious treatment is required.

What Follow-up Is Required after Treatment?

Follow-up is crucial in monitoring recovery and detecting relapse.

In particular, patients are checked for:

• Cancer relapse
• Swallowing ability
• Voice quality
• Breathing
• Nutritional state
• Discipline in giving up smoking and drinking alcohol

After treatment, speech and swallowing rehabilitation may be needed.

Frequently Asked Questions (FAQs)

Are Supraglottic Cancer and Glottic Cancer the Same Disease?

No. Supraglottic cancer originates above the vocal cords, whereas glottic cancer grows in the true vocal cords. Supraglottic cancer metastasizes more often to neck lymph nodes.

Which is the initial sign of the disease?

Chronic pain in the throat, difficulties swallowing, or a mass in the neck are among the most common early signs of supraglottic cancer. The hoarseness appears later than in glottic cancer.

Is it curable?

Yes. In early stages, this disease can be effectively treated with surgery, radiation therapy, or both.

Why does it metastasize to lymph nodes more often?

A good lymphatic vessel supply makes the supraglottic area prone to metastasis to adjacent neck lymph nodes.

Will I be able to speak after treatment?

Not necessarily. Many patients are able to speak even after partial larynx surgery or radiation therapy. There is an option for voice restoration for those who undergo a total laryngectomy.

Does smoking cause the development of supraglottic cancer?

Yes. Smoking is the main risk factor for supraglottic cancer.

Prevention

The risks of developing supraglottic cancer may be lowered through:

• Avoiding the use of all kinds of tobacco products
• Drinking alcohol only in moderation
• Good oral hygiene
• Protective gear during exposure to occupational dust and chemical irritants
• Immediate medical examination in cases of prolonged sore throat, trouble swallowing, and/or neck mass

Diagnosis at an early stage ensures the most effective treatment.

Why choose Tender Palm Super-Speciality Hospital for Supraglottic Cancer Treatment in Lucknow, India?

Tender Palm Super-Speciality Hospital offers advanced Supraglottic Cancer treatment in Lucknow, India, at an affordable cost. We have a team of experienced head and neck surgeons and oncology specialists who provide accurate diagnosis and both non-surgical and surgical treatment options including supraglottic laryngectomy, radiation therapy, and chemotherapy. Our Head and Neck Surgery and Oncology team has decades of experience in successfully treating Supraglottic Cancer in Lucknow, India.

To seek an Expert consultation for Supraglottic Cancer Treatment in Lucknow , India:

Call us at +91-9076972161
Email at care@tenderpalm.com

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