How is oral cancer diagnosed?

It is important that your doctor establishes the diagnosis of oral cancer, assesses the size of the cancer and whether it has spread to the lymph nodes in the neck or elsewhere in the body.

To answer these questions your doctor may need to do the following things:

  • talk with you about your medical history. This includes signs you may have noticed, any other health conditions, medications that you are taking, and whether you smoke or drink alcohol

  • perform a physical examination by feeling and looking inside your mouth, throat and neck

  • order diagnostic tests, which may include scans.

Not everyone will need to have every test for oral cancer. Your doctor will recommend the tests that are right for you.

The most common tests include:

Nasoendoscopy

Your doctor will use a very thin flexible tube with a tiny light and camera on it to look inside your nose to see your nasopharynx. 

   

Biopsy

This involves taking a small piece (sample) from the cancer. The sample is then examined under a microscope to check for cancer cells. This is often the only sure way to tell if you have cancer. Your doctor may recommend one of the three types of biopsies: 
  • Excision biopsy: This is when the doctor removes the cancer completely. This will usually be done for small cancers in the clinic or the operating room.

  • Incision biopsy: This is when the doctor removes a small piece of tissue using a surgical knife. This can be done in the clinic using local or general anaesthesia, so that you don't feel any pain. Depending on the size and location of the biopsy, you may need stitches. There may be some bleeding after the biopsy. If you take blood thinners (e.g. warfarin), you may need to stop these for a few days before the biopsy.

  • Needle biopsy (Fine Needle Aspiration or FNA): This is used when there is a lump (enlarged lymph node) in the neck that could have cancer cells in it. During the procedure, your doctor will take some cells from the lump using a needle. Usually this is done with guidance from an ultrasound to make sure the needle is in the right spot. You may feel a bit uncomfortable during the biopsy.

 

CT (Computed Tomography) scan

This uses X-rays to take pictures of the inside of the body. If the person has cancer, a CT scan can help the doctor to see where it is, measure how big it is, and if it has spread into nearby organs or other parts of your body.

 

MRI (Magnetic Resonance Imaging) scan

This uses magnetic fields to take pictures of the inside of the body. This helps the doctor see how far a cancer has grown into the tissue around it. Not all people with oral cancer need a MRI scan. 

 

PET (Positron Emission Tomography) scan

This is a whole body scan that uses a radioactive form of sugar, which can show if oral cancer has spread to the lymph nodes or elsewhere in the body. Many patients with oral cancer do not need a PET scan. 

 

dental x-ray

This X-ray will help the dental team assess your oral health

 

blood tests

Although there is no blood test specific for oral cancer, other blood tests are important to check your health and fitness for treatment.