Diagnosis
If you have any symptoms of head and neck cancer, see your doctor as soon as possible. It may be necessary to see a physician who specializes in diseases of the head and neck. These physicians are trained to do specialized examinations of the head and neck and to diagnose cancer. Your doctor will conduct a physical examination, take your medical history, and ask you about symptoms and risk factors. He will examine your head and neck for any lumps or masses, and the inside of your mouth and throat for any precancerous lesions. Your doctor may also order blood and urine tests to check for any conditions that may be related to cancer. If your doctor finds anything out of the ordinary, he will order more diagnostic tests to see if it is related to cancer. These tests may include:
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Endoscopy
The doctor uses an endoscope, a thin tube with a camera and light on the end, to examine the inside of the head and neck and search for any irregularities. If your doctor notices an abnormality, he will pass a special tool through the endoscope and use it to take a tissue sample. A pathologist must examine this tissue under a microscope to determine whether or not you have cancer.
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Ultrasound
An ultrasound uses high-frequency sound waves to create images that allow doctors to see how deep the tumor has grown through tissues.
Barium Swallow
For this test, the patient drinks a chalky liquid called barium and undergoes a series of X-rays. The barium coats the lining of the lower pharynx and clearly outlines it on X-rays, making it easy for the doctor to identify any abnormalities.
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Panorex
A panorex is a panoramic X-ray of your teeth and jawbone commonly used by dentists. Doctors use panoramic X-rays to help find cancer and to evaluate dental health prior to radiation therapy.
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Computed tomography (CT) scan
If symptoms or examination raise concerns for the presence of cancer, your doctor may order a CT scan. A CT scanner rotates around your body taking pictures, and produces detailed cross-sectional images of your body. It allows doctors to pinpoint the exact location of the tumor and check for cancer spread.
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Magnetic resonance imaging (MRI) scan
Magnetic resonance imaging (MRI) uses radio waves and a powerful magnet to produce detailed images of body parts. Radio waves are absorbed by the body and then released in a certain pattern, which is translated by a computer in order to show "slices" of the body. This test is very useful for examining specific areas of the body, especially the soft tissues in the head and neck region.
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Positron emission tomography (PET) scan
For a PET scan, the doctor injects a radioactive substance into the patient's bloodstream. This substance collects in malignant (cancerous) cells in the patient's body. The doctor then uses a PET scanner to detect these areas of radioactivity and to find the exact location of cancer in the patient's body.
Biopsy
If any of these diagnostic tests indicate that you might have cancer, your doctor will conduct a biopsy to be certain. A biopsy is a procedure in which the doctor removes a tissue sample and has a pathologist examine it under a microscope to determine if it contains cancer cells. A biopsy is the only way to be certain if you have cancer. Your doctor will most likely remove a tissue sample for a biopsy while performing an endoscopy. Doctors also commonly perform fine needle aspiration biopsies when an enlarged lymph node is present in the neck and the suspicion for cancer is high. In this procedure, the doctor removes a tissue sample using a thin needle and a syringe. Either way, the biopsy procedures for head and neck cancer are minimally invasive and will not cause much discomfort.
