How Are Head & Neck Cancers Diagnosed?

Tumors of the head & neck can be difficult to detect in the early stages, and this can be complicated further if they are located in different areas. Combining information from several kinds of tests will help your doctors zero in on the locations of the tumors, determine whether they are malignant (cancerous) or benign (non-cancerous), and develop the treatment plan that will work best for you.

The process begins when a doctor reviews your medical history. Then you will undergo a full head & neck physical exam as the doctor checks your mouth, nose, neck, larynx (voice box), thyroid, and face for any unusual lumps or masses.

Additional tests will follow. These may include:

Diagnostic Radiology 

Your doctor may decide to order a CT scan, MRI, or PET scan. A radiologist will conduct these diagnostic imaging tests to help locate and stage the tumor. Depending on your specific case, additional imaging tests may be necessary, such as chest x-rays, dental x-rays, panorex (x-ray of the entire jaw), barium swallow (to evaluate the esophagus, or food pipe), or a radionuclide bone scan.

Endoscopy (Laryngoscopy and Panendoscopy)

  • Laryngoscopy:
    • For an indirect endoscopy, a small mirror with a long handle is inserted through your mouth to the back of your throat and tilted downward to give the doctor a view of your larynx.
    • A flexible laryngoscopy uses a flexible laryngoscope to give the doctor an even better view of your larynx. The laryngoscope—a thin, lighted tube—is inserted through your nose or mouth and down into your throat. This makes it possible for your doctor to see areas that cannot be seen using a mirror. 
  • Panendoscopy: Sometimes it’s hard to pinpoint the location of the tumor, or the tumor needs to be examined further. In that case, after your initial tests, you will be given a future appointment for a panendoscopy with biopsies. This procedure enables your doctor to see the larynx, pharynx, and nasopharynx. Then the doctor will use specialized instruments to see and biopsy the tumor.


  • Tissue biopsy: If an exam shows an abnormal area, your doctor may remove a small sample of tissue. A pathologist examines 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 (FNA): This is a special type of biopsy performed on neck masses or lumps. A needle is passed through the skin into the lump to get a sample of the tumor. A pathologist then examines the tissue under a microscope to check for cancer cells.