Diagnosing Oral Cancer

In honor of Oral Cancer Awareness Month this April, we’re looking to raise awareness of this disease that’s more prevalent than many realize. Now, we’re looking at how oral cancer is diagnosed and what you can expect if you’re in that situation.

 

How is Oral Cancer Diagnosed?

If the doctor finds a suspicious area during their exam, they will recommend follow up with a biopsy. During the biopsy the affected tissue is removed and sent to a lab for analysis to determine if it is cancer or not. Not all areas that get biopsied are cancerous, but only a biopsy can confirm an oral cancer diagnosis. If the results come back positive for cancer, the provider will inform the patient and determine the next steps. Oral cancer screenings, biopsies and early detection can help save lives.

- Dr. Colleen Holtz, White Bear Dentists in White Bear Lake, MN and Dr. Kate Egan, Dentists of Highland Park in St. Paul, MN

 

Dental Exam

A dentist will perform a traditional head and neck exam being sure to look and feel for abnormal areas in the oral cavity and oropharynx.

 

Indirect Pharyngoscopy and Laryngoscopy

Some parts of the throat are extremely difficult to see, and the dentist may perform either an indirect pharyngoscopy or indirect laryngoscopy. For both procedures, a dentist may use a numbing spray for the nose and/or throat and with a small mirror on a long, thin handle they can look at the base of your tongue, throat, and larynx.

 

Barium Swallow

Barium swallow is a test that may be used to determine the cause of painful swallowing and may show irregularities in the mouth and throat.

 

Biopsy

A sample of cells or tissue is removed and tested in a lab. There are two types of biopsies typically used for diagnosing oral cancer:

  1. Incisional biopsy – a small piece of tissue is cut from the abnormal looking area and tested.
  2. Exfoliative Cytology (brush biopsy)– an abnormal looking area is gently scraped to collect cells which are then tested with dye. If the cells appear abnormal, a deeper biopsy will be performed.  

 

Endoscopy

Most areas of the nose and mouth may be examined without the use of the instrument.  However, doctors may perform an endoscopy (a nonsurgical procedure using an endoscope, a flexible tube with a light and camera attached) to view hard-to-see areas like the larynx.

 

Panendoscopy

If your doctor suspects oral cancer, your doctor will perform a panendoscopy which is usually performed in an operating room. Using different types of endoscopes (laryngoscopy, esophagoscopy, and a bronchoscopy) to thoroughly examine the oral cavity, oropharynx, larynx, throat, trachea and bronchi. If any tumors are found, the doctor will biopsy them immediately.

 

Imaging Tests

  1. Chest X-Ray: An X-ray to determine whether the cancer has spread to your lungs.
  2. Computed tomography (CT) scan: A CT scan creates a series of images to help the doctor determine the size, shape, and location of the tumor.
  3. Magnetic resonance imaging (MRI): An MRI provides a very detailed picture of soft tissues in the body and can help determine if the cancer has spread (especially useful in to look in the brain and spinal cord.)
  4. Position emission tomography (PET) scan: If you have been diagnosed with cancer then a PET scan may be used to determine where the cancer has spread.