Diagnosis of head and neck cancer

Diagnostic tests that are run by the doctor. The patient is usually subjected to a pan-endoscopy of the upper aerodigestive tracts (i.e. the patients is examined by mirror examination of the larynx and fibreoptic endoscopy of the nose, nasopharynx, pharynx and larynx as well as a thorough examination of the mouth. Any abnormality – typically a lump or ulcer is biopsied for analysis of the specimen by micrcoscopy (histological examination). If the patient presents with neck nodal mass(es) then these may be biopsied to see if the patient does indeed have squamous cancer and therefore requires a rigorous examination of all head and neck sites.

 

A chest x-ray is required to rule out more distant spread and to rule out a co-incident lung cancer given that the predisposing factors are commonly shared with squamous head and neck cancer. Of course, occasionally the patient who presents with a neck nodal mass, which contains squamous cancer on biopsy, may in fact have a lung cancer which has spread to the neck nodes and the patient may not have a primary in the head and neck region at all.

 

An MR scan from the base of skull to the clavicles – the collar bones – is required as this is the best scan to assess the degree of local invasion by the cancer (i.e. has it spread into other adjacent structures? – a feature of a worse behaving/prognosis tumour) and to pick up early nack nopdal disease that has not been palpated by the examining doctor.