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Head & Neck Cancer Diagnosis

How are head and neck cancers diagnosed?

Sometimes changes in the mouth, neck or nose are seen during a routine visit to the doctor or dentist. But in many cases, patients will go to their doctor to treat one of the symptoms that is causing problems without realizing it was cancer. If the general practitioner or dentist isn’t able to identify the cause of the issue they may refer the patient to visit to an ENT, which is a doctor who focuses on diseases of the ear, nose, and throat.

To find the cause of the signs or symptoms of a problem in the head and neck area, an oncologist doctor evaluates a person’s medical history, performs a physical examination, and orders diagnostic tests. Exams and tests may vary depending on the symptoms, the type of cancer suspected, your age and medical condition, and the results of earlier medical tests.

The doctor will ask questions about your health and conduct a physical exam. If signs are pointing to head or neck cancer, more tests will be done. Some of the tests you may need include:

  • Complete head and neck exam: The doctor will check the head and neck area, looking and feeling for any abnormal areas. The lymph nodes in the neck will be felt for any signs of cancer. Because some parts of the mouth and throat are not easily seen, the doctor may use mirrors, lights, and/or special fiber-optic scopes to look at these areas.
  • Panendoscopy: This is a complete exam done in the operating room after you are given drugs to make you sleep. The surgeon looks at the entire area through thin tubes called scopes and may take out pieces of tissue (biopsies) to be checked under a microscope.
  • Biopsy: For this test, the doctor takes out a small piece of tissue where the cancer seems to be. The tissue is checked for cancer cells. This is the best way to know for sure if you have cancer.
  • CT scan: This is also called a “CAT scan.” It’s a special kind of x-ray that takes detailed pictures to see if the cancer has spread to the lymph nodes, lungs, or other organs.
  • MRI scan: MRIs use radio waves and strong magnets instead of x-rays to take detailed pictures. MRIs can be used to learn more about the size of the cancer and look for other tumors.
  • Barium swallow: For this test, x-rays are taken while you swallow a liquid with barium in it. Barium coats the inside surface of the throat and helps get a good picture. This test helps to see how your throat looks as you swallow.
  • Chest x-rays: X-rays may be done to see if the cancer has spread to the lungs.
  • PET scan: In this test, you are given a special type of sugar that can be seen inside your body with a special camera. If there is cancer, this sugar shows up as “hot spots” where the cancer is found. This test is useful when your doctor thinks the cancer might have spread, but doesn’t know where.
  • Blood tests: Certain blood tests can provide important information for the doctor.

Head and neck cancers are classified according to the part of the body in which they occur. Some types of head and neck cancers you could be diagnosed with can include:

  • Throat cancers such as laryngeal cancer (voice box), hypopharyngeal cancer (lower part of the throat), and oropharyngeal cancer (area of throat just behind the mouth)
  • Nasal cavity and paranasal sinus cancer (nose and surrounding nose area)
  • Salivary gland cancer
  • Oral cancer (cancers of the mouth)

If the diagnosis is cancer, your doctor will then go on to learn the extent (stage) of the disease.

Questions to ask the doctor:

  • What tests will I need to have?
  • Who will do these tests?
  • Where will they be done?
  • Who can explain them to me?
  • How and when will I get the results?
  • Who will explain the results to me?
  • What do I need to do next?