| Mouth, nose & throat cancers | Diagnosing mouth, nose & throat cancer | Treatment for mouth, nose & throat cancer |
| Deciding on treatment | Recovery & follow-up care |
This information has been reviewed by:
Stephen Kleid (MB,BS FRACS); Otolaryngology/Head & Neck Surgical Oncology
Peter MacCallum Cancer Centre & Western Hospital
Jacqui Frowen (B.SpPath. Hons), Speech Pathologist, La Trobe University
How these cancers are diagnosed
Computerised tomography (CT) scan
Magnetic resonance imaging (MRI)
Positron emission tomography (PET)
A number of warning signs may indicate cancer in the mouth and throat area, although these symptoms may also be caused by other, less serious problems. Don't wait for something to hurt: pain is not usually an early symptom.
If any of the symptoms below last for more than 2 weeks, it's important to see a doctor or dentist even though they are usually harmless:
Cancers of the nasal areas may cause a range of other symptoms including hearing problems, headache, pain in the face or upper jaw, bleeding through the nose, and blocked sinuses.
Your doctor or dentist will examine you and refer you for tests to see if you have cancer. This can be a worrying and tiring time, especially if you need to have several tests.
If the tests show you have cancer or may have cancer, your doctor will refer you to a specialist, who will examine you and may ask you to have more tests. If you have cancer, one or more specialists will advise you about treatment options.
You should expect to be cared for by a team of health professionals from the relevant major fields (see following list). Ideally, all your tests and treatment should be available at your hospital. This may not be possible in some non-metropolitan areas.
Health professionals who care for people with cancers of the mouth, nose and throat include:
The doctor will examine you carefully. They may put a small mirror into the back of your mouth to look at your throat, or feel inside the mouth with a gloved finger. To see the voice box and throat more clearly, the doctor may use a laryngoscope (a thin tube with a light at the end), passed through your nose or into your mouth. This can be uncomfortable, but it doesn't hurt. An anaesthetic spray is often used to make it more comfortable.
The doctor may then do a biopsy: take a small piece of tissue from the abnormal area to send to a laboratory for examination. You may have a small injection to numb the area first. The whole procedure usually takes about 15 minutes. For a few people, a general anaesthetic may be needed, with a brief stay in hospital.
If the doctor suspects a thyroid cancer, a fine needle aspiration biopsy will be done. This takes about a minute and uses a syringe and needle.
Fine needle aspiration may also be done to diagnose other unusual lumps in the neck.
If the biopsy shows a cancer, your doctor may do other tests to find out its location, size and shape. This will help your doctor to plan your treatment.
You may need a thyroid scan if your doctor suspects you have thyroid cancer. This involves having an injection of a tiny (and safe) amount of a radioactive material, which is taken up by the cells in the thyroid gland. A special camera detects any cancer cells, which show up because they take up the material in a different way from other cells. The material loses its radioactivity very quickly so it does no harm.
The CT scan is a special type of x-ray that gives a three-dimensional (3-D) picture of the organs and other structures (including any tumours) in your body.
CT scans are usually done at a hospital or a radiology clinic. It takes about 30 to 40 minutes to complete this painless test. You may be asked not to eat or drink before the scan.
You will have an injection before the scan. This dye makes your organs appear white on the scans that are taken, so anything unusual will show more clearly.
You will be asked to lie on a table while the CT scanner, which is large and round like a doughnut, moves around you. Most people are able to go home as soon as their scan is over.
This test is like a CT scan, but it uses magnetism instead of x-rays to build up pictures of your body.
Like a CT scan, MRI is painless, and the magnetism is harmless. You will be asked to lie on a couch inside a large metal tube, which is open at both ends. The test may take up to an hour. The tube makes some people feel claustrophobic (afraid of being in a small space). You can usually take someone into the room with you to keep you company. The machine can be quite noisy.
The test takes 15 to 20 minutes.
This test looks at how the tissue in your body is behaving. It can give valuable extra information to the CT or MRI scans. You will be injected with a glucose solution containing a very small amount of radioactive material. The scanner can ‘see' the radioactive material, which shows where the glucose is being used in the body. Cancer cells show up as areas where glucose is being used by actively growing cells.
This test takes 2 to 3 hours.
The tests described on previous pages show whether you have cancer. They will also show where the primary cancer is and whether the cancer cells have spread to other parts of your body (this is known as metastasis). This helps your doctors ‘stage' the disease so they can work out the best treatment for you.
The staging system used for cancers of the mouth, nose and throat is known as the ‘TNM system' (T=tumour, N=nodes, M=metastases).
Doctors combine this information to determine the stage of the cancer, from Stage 1 to Stage 4. For example, a cancer assessed as T1, N0, M0 (small cancer, lymph nodes not affected and no metastasis) would be called a Stage 1 cancer.
Ask your doctor to explain the stage of your cancer in a way you can understand. This will help you to choose the best treatment for your situation.
