Diagnosis
If you have any symptoms of pharyngeal cancer, your doctor will conduct a physical examination and ask you questions about your general health, lifestyle, and family history. 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. This specialist, called an Ear, Nose, & Throat doctor (ENT), will thoroughly examine the mouth, throat, ears, nasal cavity, jaw, lymph nodes, and other nearby structures. The doctor may perform the following procedures if pharyngeal cancer is suspected.
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Laryngeal Endoscopy/ Nasopharyngoscopy
The doctor inserts an endoscope (a thin tube with a camera and light on the end) through the nose or mouth and into the pharynx, and uses it to look for any abnormal areas. The doctor may also examine nearby areas such as the larynx and esophagus to determine if the tumor has spread beyond the pharynx. If the doctor notices anything suspicious, a special tool may be used along with the endoscope to remove a tissue sample for a biopsy.
Biopsy
If any of these diagnostic tests indicate the presence of cancer, the doctor will conduct a biopsy to be certain. A biopsy is a procedure in which the doctor removes a tissue sample and a pathologist examines it under a microscope to determine if it contains cancer cells. A biopsy is the only way to be certain of a cancer diagnosis. The doctor may recommend the following types of biopsy, depending on the location and extent of the tumor:
Endoscopic Biopsy
If the doctor notices anything suspicious during an endoscopy, a special tool may be attached to the endoscope and used to remove a tissue sample for a biopsy.
Fine Needle Aspiration (FNA) Biopsy
The doctor uses a fine needle connected to a syringe to extract a tissue sample from a tumor or suspicious area. This tissue sample is then examined in a laboratory to determine if it contains cancer cells. This procedure is commonly performed to test lymph nodes for the presence of cancer.
Imaging Tests
Imaging tests produce pictures of the body and allow the doctor to determine if a tumor is present, as well as the size, location, and extent of the tumor. Imaging tests can also detect the spread of cancer into nearby structures.
Chest X-Ray
The doctor may recommend a chest X-ray to determine if the cancer has spread to the lungs or other organs in the chest.
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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)
Magnetic resonance imaging (MRI) uses radio waves and a powerful magnet to create clear and detailed images of body parts. Magnetic waves affect the spin of the elements in the cells of the body and that energy is then released in a characteristic 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, typically labeled sugar molecules. The sugars are collected in the malignant (cancerous) cells at a much higher amount than in the rest of the patient's body. The doctor then uses a PET scanner to detect these areas in the patient's body.
Barium Swallow
The doctor may recommend this procedure if the patient has trouble swallowing. 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 throat and esophagus and clearly outlines it on X-rays, making it easy for the doctor to identify any abnormalities.
