Head and Neck Cancer Diagnosis
Diagnosing head and neck cancers begins with a history taking from the patient followed by a full head and neck physical exam. The doctor will check your mouth, nose, neck, voice box, thyroid, and face for any unusual lumps or masses. He or she then may do any of the following:
Laryngoscopy: To look at the larynx (voice box) the doctor can either use a mirror to look in the throat or use a flexible laryngoscope. The doctor first sprays a local anesthetic into the nose to ease discomfort or gagging. Then he/she inserts a thin, lighted tube called a laryngoscope through your nose or mouth. As the scope goes down your throat, the doctor can look at areas that cannot be seen with a mirror. Either procedure is done in the office.
Biopsy: If an exam shows an abnormal area, the doctor may remove a small sample of tissue. Removing tissue to look for cancer cells is called a biopsy. For a biopsy, you receive local anesthesia (numbing medication like lidocaine), and the doctor removes tissue samples in the office. A pathologist then looks at the tissue under a microscope to check for cancer cells. A biopsy is the only sure way to know if a tumor is cancerous.
Fine needle aspiration: This is a special type of biopsy that is done for neck masses or lumps. A local anesthetic is given to the skin over the lump. Then a needle is passed through the skin into the lump to get a sample of the tumor. A pathologist then looks at the tissue under a microscope to check for cancer cells.
Radiology: The doctor may decide to get a CT scan, MRI, or PET scan. These are various types of images that are obtained by a radiologist to help localize the tumor.
Pan-endoscopy: Sometimes, the location of the tumor is not obvious, or needs to be further examined. In this case, you will be scheduled to have a pan-endoscopy with biopsies at a later date. You will receive a general anesthetic (i.e. be put to sleep) in the operating room. Then the doctor can use specialized instruments to see and biopsy the tumor.
