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How is oral cancer diagnosed?

The tests and procedures used in the oral cancer diagnosis include:

Physical examination
Endoscopy
Biopsy
Oral brush biopsy
HPV testing
X-ray
Barium swallow/modified barium swallow
Computed tomography (CT) scan
Magnetic resonance imaging (MRI)
Ultrasound
Positron emission tomography (PET)

Physical examination:

Dentists and physicians often identify lip and oral cavity cancers during routine examinations. If a person has signs of oral or oropharyngeal cancer, the doctor should take a full medical history, inquiring about the symptoms and risk factors of the patient. The doctor should check at the neck, lips, gums and cheeks for any lumps. Since people with oral or oropharyngeal cancer have an elevated risk of other cancers elsewhere in the region of the head and neck, the doctor will examine the area behind the ear, the larynx, and the lymph nodes.

Endoscopy

An endoscopy helps the doctor see the mouth and throat inside. A thin, flexible tube with an attached light and view lens called an endoscope is typically inserted through the nose to examine areas of the head and neck. A rigid endoscope is a hollow tube with a light and vision lens is positioned in the back of the mouth for a more detailed view of the back of the throat. The test has different names depending on the area of the body being examined, such as laryngoscopy for viewing the larynx, pharyngoscopy for viewing the pharynx, or nasopharyngoscopy for viewing the nasopharynx. Such tests are done using an anesthetic spray to numb the region and make the patient more relaxed. If any examined area looks suspicious, a biopsy for oral cancer would be done by the doctor.

Biopsy

A biopsy is the removal of a small amount of tissue for microscope analysis. There are other tests that indicate the presence of cancer but a definitive diagnosis can be made only through a biopsy. The type of biopsy performed will depend on where the cancer is located. Cells are removed during a fine needle aspiration biopsy using a thin needle which is inserted directly into the suspicious area. The cells are then analysed by a pathologist.

Oral brush biopsy

Many dentists use a modern, simple procedure to detect oral cancer during routine dental exams, in which the dentist uses a small brush to extract cell samples from a suspect area. The specimen is then forwarded for examination to a laboratory. This procedure is possible with very little or no pain in the dentist’s chair. If cancer is found using this method, it is recommended to do a traditional biopsy to confirm the results.

HPV testing

Testing for HPV may be done on a tumor sample removed during biopsy. HPV has been linked with a greater risk of oropharyngeal cancer. Knowing that an individual has HPV will help assess the stage of the cancer and the treatment options which are likely to be most successful. ASCO recommends that all patients newly diagnosed with oropharyngeal squamous cell carcinoma undergo HPV examination.

X-ray

An x-ray is a way of using a small amount of radiation to produce an image of the structures within the body. It can help the doctor to identify abnormal findings in the mouth or neck.

Barium swallow/modified barium swallow

There are 2 barium swallow tests usually used to look at the oropharynx and check swallowing of a patient. The first is a traditional barium swallow. The patient is asked to swallow liquid barium during an x-ray examination. This helps the doctor to check for any changes in oral cavity, throat structure and to see if the liquid moves quickly to the stomach. A modified barium swallow, or videofluoroscopy can be used to determine swallowing difficulties.

Computed tomography (CT) scan

A CT scan produces images that allow doctors to look for the size and location of an oral cancer. A CT scan for oral cancer takes pictures of the interior body using x-rays from different angles. A computer uses these images and combine into a detailed 3-dimensional image that reveals any abnormalities or tumors. A CT scan can be used to measure the size of the tumor. A special dye called a contrast medium is given before the scan to provide more detail on the image. Such dye can be injected into the vein of a patient, or given to swallow as a pill or liquid.

Magnetic resonance imaging (MRI)

The MRI for oral cancer uses magnetic fields to create accurate images of the body especially images of soft tissue, such as the tonsils and the base of the tongue. It can also be used to measure the size of the tumor. Before the scan is done, a special dye called a contrast medium is injected into the vein of a patient, or given to swallow as a pill or liquid to produce a clear image.

Ultrasound

The ultrasound uses sound waves to produce the image of the organs inside. This test will detect cancer spread to lymph nodes in the neck, called the cervical lymph nodes.

Positron emission tomography (PET)

In general, a PET scan is combined with a CT scan called as PET-CT scan. A PET scan for oral cancer is a means of generating pictures of tissues and organs within the oral cavity. A small quantity of a radioactive sugar is injected into the patient’s body. Cells which use the most energy consume this sugar content. Since cancer appears to aggressively use radiation, it consumes more of the radioactive material. Then a scanner detects the material to create images inside of the oral cavity.

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Oral Cancer

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1800 208 2000

+91 73311 91919

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