If you have a condition or symptom but don’t yet know the cause, your doctor may order tests to gather more information. Common tests include biopsy and state-of-the-art imaging. Once your tests are complete, you and your doctor will discuss the results, confirm your diagnosis and decide on next steps.
You may have one or more of these tests to help your doctor confirm diagnosis:
During a biopsy a small sample of tissue is removed from the tumor for testing. There are two primary types of biopsies you might experience:
- Minimally invasive biopsy: A minimally invasive biopsy uses a special needle to sample an abnormal area. Most commonly, this will be performed in radiology with use of an ultrasound or CT scan to guide the needle and to ensure that the tissue sampling is accurate. Image-guided needle biopsy usually requires a very small (2-5mm) incision, but does not typically need stitches or sutures. Results of the biopsy are usually available within two working days, and recovery from the procedure usually occurs within 48 hours.
- Surgical biopsy: A surgical biopsy requires a small incision to remove a small sample of tissue or a tumor lump. You are given some form of anesthesia to prevent discomfort and may have a surgical scar.
- Fine-needle aspiration biopsy: In fine needle aspiration, a thin needle is inserted into an area of abnormal-appearing tissue or body fluid. A small amount of tissue or fluid is taken from the suspicious area and checked for cancer cells.
CT scan (computed tomography scan)
A CT scan is a series of x-ray pictures of a part of the body put together by a computer to give doctors a detailed picture.
MRI scan (Magnetic Resonance Imaging scan)
An MRI test uses magnetic fields and radio waves to capture detailed images of the head and neck region. During the procedure you will lie flat and very still on a padded platform, which then slides into the center of a tube shaped MRI machine. You will not feel the magnetic fields or radio waves around you, but you will hear a loud thumping sound.
PET scan (Positron Emission Tomograpy scan)
A PET scan is an imaging test that uses a special radioactive dye (called a tracer) injected into a vein to reveal how your tissues and organs are functioning on a cellular level. This scan can sometimes detect disease before it shows up on other imaging tests.
Ultrasounds use sound waves to take images of organs and soft tissues. This is a non-invasive method of evaluation and diagnosis. It is often used as a follow-up test after an abnormal finding on other imaging or clinical exam. In instances where a needle biopsy has been recommended, ultrasounds can be used to help guide the procedure.
Two forms of endoscopy are performed as part of the work up for head and neck cancer: office-based fiberoptic laryngoscopy and direct laryngoscopy performed in the operating room. During flexible fiberoptic laryngoscopy, a flexible tube with a light and camera attached to it, called an endoscope, is passed through the nose and into the back of the throat, allowing the doctor to view the nasal cavity, throat, and voice box (larynx). A direct laryngoscopy is performed in the operating room. During this procedure, the surgeon places a special scope into the mouth and throat (called a laryngoscope) and is able to take samples (biopsies) from the mouth, throat, and voice box. This is often and important staging procedure to determine the extent of your cancer and aids in determining the best treatment approach.