Diagnosis & Staging

How are head and neck cancers diagnosed?

If you have any of these signs or symptoms, there are several steps your doctor will take. Common exams, tests and procedures for all types of head and neck cancers include:

  • Taking a medical history and a physical exam to check for signs of disease.
  • A biopsy to see a tissue sample under a microscope.
  • Imaging that can show “pictures” of tumors in the body:
    • CT (CAT) scan that makes pictures of areas inside the body with a computer linked to an X-ray machine
    • MRI (magnetic resonance imaging) using a magnet, radio waves and a computer to make a series of detailed pictures of areas inside the body
    • PET scan that uses a small amount of radioactive sugar to light up cancer cells in the body, making them easy to see
    • X-rays of the head and neck.
  • Laboratory blood tests to see how advanced the cancer may be.
  • Endoscopy, a procedure that inserts a thin tube with a light and lens for looking at organs and tissues inside the body

Some cancers have other specific tests, depending on your signs and symptoms and which part of the head and neck are affected.

Lip and Oral Cavity Cancer

  • Exfoliative cytology involves scraping and collecting cells with a brush or small stick to look at under a microscope
  • Bone scan to see if the cancer has spread to the bones
  • Barium swallow, which involves X-rays of the esophagus and stomach after swallowing a metallic compound

Oropharyngeal Cancer

  • Laryngoscopy to check the voice box with a mirror or a laryngoscope, a thin tube with a lens and light for looking at tissue
  • Oral brush exam uses a small brush to remove cells to see under a microscope to check for cancer
  • HPV test examines sample tissue for the human papillomavirus infection as it can be a cause of cancer

Nasopharyngeal Cancer

  • Neurological exam to assess mental status, coordination, mobility and reflexes. This exam involves questions and test of the brain, spinal cord and nerve function
  • Nasoscopy uses a thin tube with a light and lens to look at tissue inside the nose. It may include a tool to remove tissue samples to see under a microscope
  • Epstein-Barr virus blood test to find evidence of the infection, which is linked to cancer
  • Hearing test to detect any problems

Hypopharyngeal Cancer

  • Barium esophagogram, which is an X-ray of the esophagus after swallowing a metallic compound
  • Esophagoscopy, which uses a thin tube with a light and lens to look inside the trachea and large airways in the lungs (tissue samples may be taken)

Laryngeal Cancer

  • Laryngoscopy to check the voice box with a mirror or a laryngoscope, a thin tube with a lens and light for looking at tissue
  • Bone scan to see if the cancer has spread to the bones
  • Barium swallow, which involves X-rays of the esophagus and stomach after swallowing a metallic compound

Paranasal Sinus and Nasal Cavity Cancer

  • Laryngoscopy to check the voicebox with a mirror or a laryngoscope, a thin tube with a lens and light for looking at tissue.
  • Nasoscopy uses a thin tube with a light and lens to look at tissue inside the nose. It may include a tool to remove tissue samples to see under a microscope.

What does staging mean?

Staging is the term used to describe how far your cancer has spread. Once you have been diagnosed with head and neck cancer, your doctor will check to see if it has spread to other organs in your body. This is called ‘staging.’ It is important to know the stage of your cancer in order to make your treatment plan.

Once you know your diagnosis and stage, you can learn more by visiting the American Cancer Society.