Diagnosing Head and Neck Cancer

The Clinical Examination and Edoscopy

Biopsy

For most types of cancer, a biopsy is the only sure way for the doctor to know if an area of the body has cancer. In a biopsy, the doctor takes a small sample of tissue for testing in a pathology laboratory. For surface of mucosal lesions or cancer a punch biopsy if most commonly performed. For tumours within deep seated organs such as thyroid or salivary glands -an FNAC (Fine needle aspiration cytology) is the most commonly advised for diagnosis.

If a person has symptoms and signs of head and neck cancer, the doctor will take a complete medical history, noting all symptoms and risk factors. In addition, the following tests may be used to diagnose head and neck cancer.

• Clinical examination -
  The head and neck cancer surgeon will do a thorough examination of the head and neck and all its subsites to look for any suspicious growth or lesion. The doctor will also inspect the nose, mouth, throat, and tongue for abnormalities, often using a light and a mirror for a clearer view.
• Endoscopy -
  An endoscopy allows the doctor to see inside the body with a thin, lighted, rigid or flexible tube called an endoscope. Endoscopic examination of nose, nasal cavity, nasopharynx is termed as Diagnostic Nasal Endoscopy. It is usually performed as an office procedure in outpatient department with the use of some local anaesthetic agent in nose. A flexible nasolaryngoscope is generally used in the outpatient department to evaluate and see the larynx , Oropharynx and hypopharynx. Biopsy from these sites will generally require rigid Direct Laryngoscopy under general anaesthesia. Sedation is giving a person medication to become more relaxed, calm, or sleepy. When these procedures are combined, they are sometimes referred to as a pan endoscopy.
• Biopsy
  
• Ultrasound -
  An ultrasound uses sound waves to create a picture of internal organs.
• Computed tomography -
  (CT or CAT) scan.
• Magnetic resonance imaging (MRI)
  
• Positron emission tomography (PET) or PET-CT scan -
  A PET scan is usually combined with a CT scan (see above), called a PET-CT scan.
• After diagnostic tests are done, doctor will review all of the results with you. If the diagnosis is cancer, these results also help the doctor describe the extent of the cancer. This is called staging.