How is head and neck cancer diagnosed?
You might have a number of tests to investigate your symptoms and confirm a diagnosis of head and neck cancer. The more complex tests may be best carried out in conjunction with a dedicated head and neck cancer service. These tests may include:
- medical history and physical examination of the mouth, throat and neck
- biopsy, where a small sample of tissue is removed to be examined under a microscope
- imaging tests – for example, X-ray, computed tomography (CT) scan, magnetic resonance imaging (MRI) or positron emission tomography (PET) scan
- endoscopy, where a thin tube with a light on its end is inserted through the nose to look for abnormalities in the throat
- laryngoscopy, where a thin tube with a light on its end is inserted through the mouth to look for abnormalities in the larynx
- nasoscopy, where a thin tube with a light on its end is used to look inside the nose
- exfoliative cytology, where cells are scraped from the lips, tongue, mouth or throat to be examined under a microscope
- a blood test to check for markers for Epstein–Barr virus (which is a risk factor for nasopharyngeal and salivary gland cancers)
- hearing tests.
Stages of head and neck cancer
If you are diagnosed with head and neck cancer, you might have more tests to determine the stage of the disease and whether the cancer has spread to other parts of the body. Knowing the stage of the disease helps your medical team plan the best treatment for you.
Most types of head and neck cancer (nasopharyngeal, oropharyngeal, hypopharyngeal, laryngeal, lip and oral cavity, nasal cavity and paranasal sinus cancer) have 5 stages: 0 (carcinoma in situ), I, II, III and IV. The stage depends on the size of the tumour and which other tissues it has spread to. Unlike staging conventions for most other cancers, head and neck cancers can be staged as stage IV without spread to more distant parts of the body.
Salivary gland cancers are divided into 4 stages (I–IV), rather than 5.
No standard staging system is used for metastatic squamous neck cancer with occult primary.
- National Cancer Institute (2013). Head and neck cancers.
- National Cancer Institute (2014). Salivary gland cancer treatment (PDQ®), patient version.
- American Cancer Society (2015). Salivary gland cancer.
- National Cancer Institute (2014). Metastatic squamous neck cancer with occult primary treatment (PDQ®), patient version.
- American Cancer Society (2015). Nasal cavity and paranasal sinus cancer.
- American Cancer Society (2015). Nasopharyngeal cancer.
- American Cancer Society (2015). Laryngeal and hypopharyngeal cancer.
- American Cancer Society (2015). Oral cavity and oropharyngeal cancer.
- National Cancer Institute (2015). Oropharyngeal cancer treatment (PDQ®), patient version.
- National Cancer Institute (2015). Paranasal sinus and nasal cavity cancer treatment (PDQ®), patient version.
- National Cancer Institute (2014). Nasopharyngeal cancer treatment (PDQ®), patient version.
- National Cancer Institute (2015). Hypopharyngeal cancer treatment (PDQ®), patient version.
- National Cancer Institute (2015). Lip and oral cavity cancer treatment (PDQ®), patient version.
- National Cancer Institute (2015). Laryngeal cancer treatment (PDQ®), patient version.
