Hello Doctor, my 80 year old mother, other wise in good health, recently developed swallowing difficulties.  A visit to the ENT specialist revealed recently a 1.8 centimeter mass on the epiglotis free edge with no apparent spreading to other near by structures.  We are preparing for a biopsy and in the process of prepafring for the worst, but praying for the best.  My question is, if in deed the biopsy reveals a malignancy, and she is staged at stage 1, can it be removed surgery, or better known as curative treatment?  I have been doing some research, and I am finding out that chemo and radiation is always curative> please help us, we are beside our selves with anxiety.  Thank you
Hi, Thanks for writing in. There are certain areas including the head and neck region where the structures are closely situated, and it is difficult to operated completely. Epiglottis is considered supraglottic part of larynx. A cancer in the epiglottis is a difficult to operate region and if biopsy confirms malignancy then the patient should be given chemotherapy and radiation therapy to reduce the tumor volume. Once tumor volume is reduced then attempts can be made to try and operate the area if it is accessible. If the cancer is free from surrounding structures than an experienced surgeon might decide to operate on the supraglottic component and provide adjunct chemotherapy and radiation therapy for complete treatment. Lymph node enlargement in the neck should be evaluated by doing a CT scan neck and if present then a biopsy should be done to know metastasis and do staging. Please do not worry.