Throat Cancer Diagnosis

Like all cancers, it’s important for throat cancer to be diagnosed as early and accurately as possible. This helps increase your chance of being cured while at the same time maintaining your quality of life, including your ability to speak and swallow.

If you have symptoms that may signal throat cancer, your doctor will examine you and ask you questions about your health and lifestyle, including smoking habits, drinking habits and family medical history.

The tests doctors use to diagnose throat cancer and find out if it has spread depend on the type of cancer that is suspected. Tests also may be used to monitor the disease and how it is responding to treatment. One or more of the following tests may be used for throat cancer.

Fiberoptic Laryngoscopy

A fiberoptic laryngoscopy is often the first test in a throat cancer diagnosis. During this procedure, a doctor passes a small camera through the nose and examines the nasopharynx, oropharynx and larynx. This allows the doctor to determine if a biopsy is needed.

Biopsy

In a biopsy, doctors retrieve suspected cancer tissue for study under a microscope. A biopsy is the only way to definitively diagnose throat cancer. Different methods are used to obtain this tissue, depending on where the tumor is located. Common biopsy methods for throat cancer include:

• Fine-needle-aspiration biopsy (FNA): This type of biopsy may be used if you have a lump in your neck that can be felt from the outside. A thin needle is inserted into the area, and cells are withdrawn and examined under a microscope. This is often coupled with an ultrasound to verify the placement of the needle.
  
• Conventional incisional biopsy: The doctor surgically removes part of the tissue where cancer is suspected.
  
• Excisional biopsy: A type of biopsy that removes most or all of the suspected cancer tissue. This is frequently done with a tonsillectomy in the operating room.
  
• Endoscopic biopsy: During this procedure, an endoscope (a long, thin tube with a light and lens through which the doctor can view organs and tissue) is inserted through the mouth, nose or an incision. The endoscope has a tool to remove tissue samples. This is used primarily for nasal cavity or nasopharyngeal cancers.
  

Imaging exams

Imaging exams can help locate the suspected cancer and show whether it has spread. They can also be used to monitor the disease’s progression and how it is responding to treatment.

Throat cancer imaging exams may include:

• CT or CAT (computed axial tomography) scans
  
• PET (positron emission tomography) scans
  
• MRI (magnetic resonance imaging) scans
  
• Ultrasound
  
• Chest and dental X-rays
  

Learn more about imaging exams.

Swallowing tests

Doctors use swallowing tests to understand how the patient’s throat is performing and help them plan treatment. There are different types of swallowing tests.

• Barium swallow: The patient drinks liquid barium, which makes certain areas of the body show up more clearly during X-rays. This study evaluates the passage from the throat to the stomach. It is used to look for changes in structure and muscle movement.
  
• Modified barium swallow: During a modified barium swallow, the patient ingests liquid, pudding and solid food, all containing barium. A speech pathologist and radiologist observe the swallowing in real time using a specialized X-ray exam, called a fluoroscopy. They then evaluate the structures and movements associated with swallowing.
  
• Fiberoptic endoscopic examination of swallowing (FEES): FEES relies on a small, flexible endoscope that is inserted through the nose. It allows the doctor or speech pathologist to examine swallowing.