Diagnosis

Cancer may be present even in the absence of classic symptoms. It is important to consider that some of the symptoms indicative of head and neck cancer can also be caused by diseases other than cancer. Patients experiencing prolonged abnormalities, or those at high risk (frequent tobacco and alcohol use), should seek the advice of a medical practitioner who specializes in the diagnosis and treatment of oral cancer to obtain a definitive diagnosis. This usually involves a visit to an otolaryngologist who specializes in head and neck surgery; however, a diagnosis may also be made by an oral surgeon (a physician who specializes in surgery of the mouth and jaw), or by a family dentist during routine examinations.

The otolaryngologist will assess your medical history and perform a physical examination of the outside of the face and neck and the inside of the mouth and oral cavity. Pending the result of the examination, suspicious lesions or tumors may be biopsied. A biopsy is the only way to confirm for certain whether cancer is present in tissue.

Biopsies are performed by excising a sample portion of a tumor or suspicious lesion. This sample is sent to a laboratory for microscopic examination by a pathologist (a physician who is skilled at examining cells for the presence of cancer or other abnormalities). Some biopsies can and may be performed under the administration of local anesthetic in the physician's office. Biopsies of tumors in deeper regions of the throat (oropharynx or larynx) are done under general anesthesia in the operating room with the use of an endoscope. An endoscope permits careful evaluation of a tumor's dimension and depth. In addition, the throat, esophagus and lungs may also be examined for further signs of cancer.

To complete a diagnosis, imaging studies such as CAT or MRI scans may be performed. A CAT (computerized axial tomography) scan is a series of computer generated x-rays which form detailed pictures of areas of the body. Magnetic Resonance Imaging (MRI) creates pictures through the use of a magnet which is linked to a computer. Imaging studies, when compared with histological (biopsy) results, assist the practitioner in determining the stage and extent of the cancer (whether it has spread to other areas); and allows the clinician to determine appropriate treatment methods.