If there is a suspicion of cancer, you will be referred to an
otolaryngologist (ear, nose, and throat specialist), or possibly an oncologist
(cancer doctor) who specializes in those areas. You will be given a complete
head and neck exam, which consists of the following:
Nasopharyngoscopy (the back
of the nose)
Laryngoscopy (the voice box)
Pharyngoscopy (the throat)
For these procedures, special fiberoptic scopes (thin, flexible,
lighted tubes inserted through the nose or mouth) and mirrors are used for a
closer look at the affected areas. People with oral or oropharyngeal cancer are
at higher risk for other cancers of the head and neck, so the larynx and the
lymph nodes are also carefully examined.
In some cases, a panendoscopy is required. This is a very thorough
exam of the oral cavity, esophagus, larynx, oropharynx, and the trachea and
bronchi (airways for breathing that lead to the lungs). This is done in the
hospital and you are put to sleep for the procedure. If a tissue sample of the
tumor has not already been taken (biopsy), the surgeon will remove a
piece during this exam.
To be certain of cancer (or the absence of it), a tissue sample must be
observed by a pathologist, a doctor who specializes in examining cells
and tissues in order to diagnose diseases and illnesses. The method used for
the biopsy, and where it is performed (office or hospital) depends on several
factors, including the size and location of the lesion. The sample may be taken
with a needle (FNA-fine needle aspiration), removed with a scalpel (incisional
biopsy), or scraped off the area (similar to a PAP smear).
Another part of the complete examination includes looking for signs that the
cancer has metastasized to other organs. This is done using imaging
tests such as the following:
Chest x-ray: a picture of inside your chest to see if cancer has
spread to your lungs.
Magnetic resonance imaging (MRI): a scan done with radio waves and
magnets instead of x-rays for detailed images of internal areas in the body.
Computed tomography (CT or CAT scan): an advanced form of x-ray that
takes a lot of pictures as it rotates around you. A contrast dye is injected
into your veins before the procedure so that your organs will show up better.
Positron emission tomography: A special camera is used with a
radioactive sugar to highlight cancerous cells in the body.
A routine blood test is also part of the examination. No blood test
can diagnose oral cancers, but the results are useful for determining the
overall health of the patient as well as any secondary conditions.