Tests for mouth cancer
This page tells you about tests to diagnose mouth and oropharyngeal cancers. You can find information about
Tests for mouth or oropharyngeal cancer
If you have symptoms that could be due to mouth or oropharyngeal cancer you usually begin by seeing your GP. Your doctor will examine you and ask about your general health and about your symptoms. They may refer you to a specialist, who will examine you and then arrange for you to have tests in the hospital outpatient department.
Nasoendoscopy for oropharyngeal cancer
A nasoendoscopy or laryngoscopy lets the specialist look at all your upper air passages. They pass a narrow, flexible tube (a nasoendoscope) up your nose and down your throat. The tube has a light at the end and a camera. You can have a local anaesthetic for this test if you want to.
Having a biopsy
The only way to make a definite diagnosis of mouth or oropharyngeal cancer is to take a sample of tissue (a biopsy) and look at it under a microscope. There are different ways of taking a biopsy. A scalpel biopsy means cutting out a small piece of tissue from the affected area under local anaesthetic.
Your doctor may ask you to go into hospital for a panendoscopy. A panendoscope is a series of connected telescopes that a head and neck surgeon uses to look at your upper airways. You have this test under general anaesthetic. The doctor can use the panendoscope to take a biopsy.
Fine needle aspiration
If your doctor can feel a lump in your neck, you may need to have a fine needle aspiration. This means putting a thin needle into the lump and drawing out cells and fluid. Your doctor may also use a fine needle biopsy to see if the cancer has spread to any lymph nodes in your neck.
You can view and print the quick guides for all the pages in the Diagnosing mouth cancer section.
If you are worried about symptoms that could be due to mouth or oropharyngeal cancer, you usually begin by seeing your GP. Your doctor will examine you and ask about your general health and about your symptoms. They will ask when you get the symptoms and whether anything you do makes them better or worse.
Your doctor will examine your mouth and throat. They may also feel the lymph nodes (glands) in your neck and under your arms. After examining you, your doctor may refer you to hospital for tests and X-rays or directly to a specialist. The specialist is usually a head and neck surgeon.
If you see a specialist, they will ask you about your medical history and symptoms. They will then examine you and may look at the back of your throat using a small mirror that they put into your mouth. This is called indirect laryngoscopy.
You may have blood tests and a chest X-ray to check your general health. Then your specialist will arrange for you to have tests in the outpatient department. You may have a biopsy, nasoendoscopy or fine needle aspiration. You may need to have a panendoscopy which will be done as an in patient, under general anaesthetic.
To make a definite diagnosis of any mouth or oropharyngeal cancer your doctor needs to take a sample of tissue from the affected area (a biopsy) and look at it under a microscope for signs of cancer. If the area is easy to get at (for example, in your mouth) your doctor will be able to remove a very small amount of tissue and send it to the laboratory. There are different ways of taking a biopsy to diagnose mouth and oropharyngeal cancers. They include scalpel biopsy and panendoscopy. If you have a lump in your neck, your doctor may take a sample of cells using fine needle aspiration.
A scalpel biopsy means cutting out a small piece of tissue from the affected area. Your doctor will inject some local anaesthetic into the area to numb it. Then the doctor cuts round the biopsy area, gently lifts the piece of tissue using a pair of tweezers and cuts it off. This is uncomfortable but only lasts a short time. For many people, the most uncomfortable part is the local anaesthetic injection.
A nasoendoscopy (sometimes spelt nasendoscopy) or laryngoscopy allows your specialist to look at all your upper air passages. This includes the back of your throat (the pharynx).
The specialist passes a narrow, flexible telescope (a nasoendoscope) up your nose and down your throat. It can be a bit uncomfortable, so your doctor may use an anaesthetic spray to numb your throat first. But if you have the anaesthetic spray you can’t eat or drink until it wears off so you may choose not to have it. If the specialist sees any abnormal area in your throat, they will need to take a biopsy from that area.
Fine needle aspiration is also called FNA. If your doctor can feel a lump in your neck, you may need to have a fine needle aspiration. This means putting a thin needle into the lump. The specialist will first feel the lump, so that they know where to put the needle. Once the needle is in the lump, the doctor draws out cells and fluid. The doctor sends the cells to the laboratory, where a specialist called a pathologist examines them to see if they are cancerous.
Your doctor may also use a fine needle biopsy to see if the cancer has spread to the lymph nodes in your neck. The doctor puts the needle into one of the large lymph nodes and draws out fluid and cells for testing.
Your doctor may ask you to go into hospital to have a panendoscopy. This is usually if they can't get a good view using the mirror or nasoendoscope, or if they see something abnormal and need to take a biopsy. The nasoendoscope is too fine to use for a biopsy. But a panendoscope is thicker so your specialist can use it to remove a sample of the affected tissue. A panendoscope is a series of connected tubes that a head and neck surgeon uses to look at your upper airways. There is a camera and light at one end, and an eyepiece at the other.
You have this test while you are under general anaesthetic. The doctor gently puts the panendoscope up your nose and down into your throat. They will look at all parts of your pharynx, as well as the larynx (voice box), food pipe (oesophagus), windpipe (trachea) and breathing tubes (bronchi). This is because people with mouth and oropharyngeal cancers are at a greater risk of developing cancers in other areas of the head and neck.
Your doctor will ask you to go back to the hospital when your test results have come through. But this is bound to take a little time, even if only a few days. This is a very anxious time for most people. You may have contact details for a cancer specialist nurse and you can contact them for information if you need to.
While you are waiting for results it may help to talk to a close friend or relative about how you are feeling. You may want to contact a cancer support group to talk to someone who has been through the same experiences.
You can phone the Cancer research UK nurses on freephone 0808 800 4040, from 9am to 5pm, Monday to Friday. Our mouth and oropharyngeal cancer organisations page gives details of other people who can help and support you. You can find details of counselling organisations in our counselling section. Our mouth and oropharyngeal cancer reading list has information about books and leaflets about mouth and oropharyngeal cancers and their treatment.
If you want to find people to share experiences with online, you could use CancerChat, our online forum. Or go through My Wavelength. This is a free service that aims to put people with similar medical conditions in touch with each other.
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