Diagnostic and Staging Work Up
Oral cancer symptoms can be similar with other medical conditions and only a specialist can establish a correct diagnosis. The diagnostic procedure involves a certain number of steps which include:
Detailed medical review of past health state
One of the first steps in establishing an oral cancer diagnosis is a detailed and complex medical review of a patient′s past health problems and general health state, family medical history, oral cancer risk factors (especially smoking habits, tobacco and alcohol use), and symptoms.
During a physical examination, the doctor examines the lips oral cavity, pharynx (back of the mouth, face, neck looking for signs of oral cancer. The specialists looks for any possible lump, abnormal or discolored tissue, or sores.
Biopsy, Imaging and Endoscopy
If any suspicious lesion or ulcer is present then Biopsy is performed, which is followed by endoscopic examination and imaging investigation to properly stage the disease.
- Biopsy: This is a painless medical procedure that removes a certain amount of tissue for a microscopic examination. This procedure allows the pathologist to establish the nature of the cells and determine whether they are cancerous or not, and the stage of the cancer. In some cases, the doctor might perform a scalpel biopsy. A scalpel is a thin, straight surgical knife used in dissection and surgery. This type of procedure is performed under anesthesia to reduce patient discomfort.
- Endoscopy: This is a minimally invasive, painless diagnostic procedure used to visualize interior surfaces of certain organs and cavities. During this procedure, a flexible tube, called an endoscope, is inserted into the body in order to provide a clear image of the targeted area. This procedure is used to investigate tissues within the pharynx area which cannot be visualized during a normal mouth examination.
- Computed Tomography (CT): This imaging test is similar to an x-ray test, and creates a detailed, cross-sectional image of the body. This test can identify abnormal mass tissues.
A CT scan is usually performed in two steps for a better diagnosis outcome:
1). First, the targeted area is scanned without a contrast agent.
2). Second, the targeted area is scanned after a contrast agent is administrated.
For patients who suffer from oral cancer, this technique is used to localize metastases.
- Magnetic resonance imaging (MRI): An MRI is an advanced technique that uses radio waves and strong magnets to reveal a complete image of a targeted area of the body. The energy from the radio waves is absorbed by the tissues and then released into a pattern that allows the cancer to be detected and diagnosed. This technique is also used to establish whether or not the cancer has spread, and to visualize its location within the body.
- Ultrasonography: Ultrasound imaging is a medical technique that uses high-frequency sound waves to create an interior image of the body on a special computer screen. This image is formed from the echoes of the sound waves on the surface of the organs. Abnormal tissue masses and organs reflect sound waves differently. This test involves a device called transducer, that is placed on the upper part of the abdomen, and a computer that translates this sound into an image. Ultrasound imaging is a safe, noninvasive and fast test that can detect tumors.