Head and Neck Cancer Screenings and Diagnosis

We have the best chance to treat oral cancer early in the disease. Our screenings help us detect cancer as early as possible. If our head and neck cancer doctors think you may have oral cancer, we’ll perform additional tests to confirm the diagnosis.

The first step in oral cancer diagnosis is a physical exam. Your doctor will look for abnormal areas, bumps, or sores inside your mouth, as well as on your head, face, and neck.

Screening and diagnostic tests

You also may need one or more of the following tests:

• Biopsy -- We may need to take a small sample of tissue from the gums or tongue so our pathologists can determine if the cells there are cancerous.
• Imaging -- Your doctor may order a computed tomography (CT) scan, a magnetic resonance imaging (MRI) scan, or X-rays to see inside your body.
• Laryngoscopy -- We’ll examine your throat and larynx (voice box) using small mirrors or a tube with a light and camera.
• Positron emission tomography (PET) scan or bone scan -- These tests use a mild radioactive substance to check the function of your cells and tissues, and it shows us if the cancer has spread.

Oral cancer staging

If we detect oral cancer, we’ll identify the disease stage. The stage of the cancer refers to its size and if it has spread. Cancer staging helps doctors choose the best treatment options possible.

Doctors classify oral cancer in one of the following stages:

• Stage 0: The tumor is only in the outer layers of the oral tissue and hasn’t spread. Doctors also call this stage carcinoma in situ.
• Stage I: The tumor is about 2 centimeters (0.75 inch) or smaller, and it has not spread to other locations outside the oral cavity (mouth and throat).
• Stage II: The tumor is larger than 2 centimeters (0.75 inch) but smaller than 4 centimeters (1.5 inches). The tumor has not spread outside the oral cavity.
• Stage III: Either the tumor is larger than 4 centimeters (1.5 inches) and hasn’t spread, or it is smaller but has spread to one lymph node.
• Stage IV: The cancer has spread deeper into the tissues, has spread into nearby parts of the body, or has spread into the lymph nodes. Doctors use several subcategories (IVA, IVB, or IVC) to describe specifically the tumor’s location and size.

Tumors that develop in the nasal cavity (nose) or the sinuses may be benign (noncancerous) or cancerous. If they’re cancerous, they could be the result of one or more of many different types of cancer. This can make the diagnostic and treatment process for these cancers challenging.

Our head and neck cancer specialists provide accurate, thorough diagnoses for these difficult cancer cases. The first step in the process is a physical examination of the nose and face. Your doctor will look for lumps, swollen lymph nodes, or other unusual features. The doctor may also use a small mirror to look inside the nose.

Screening and diagnostic tests

You also may need one or more of the following tests:

• Biopsy -- We’ll take cells from the tumor so our pathologists can determine if they’re cancerous.
• Imaging -- Your doctor may order a computed tomography (CT) scan, a magnetic resonance imaging (MRI) scan, or X-rays to see inside your nose or sinuses.
• Nasoscopy -- Your doctor may use a thin, tube-like instrument called a nasoscope to view inside the nose and remove a tissue sample for examination.
• Positron emission tomography (PET) scan or bone scan -- These tests use a mild radioactive substance to check the function of your cells and tissues and let us know if the nasal or sinus cancer has spread.

Nasal and sinus cancer staging

If we detect nasal or sinus cancer, we’ll identify which stage the disease is in. The stage of the cancer refers to its size and if it has spread. Cancer staging helps doctors choose the best treatment options possible.

Doctors classify nasal and sinus cancers in one of the following stages:

• Stage 0: The nasal or sinus cancer hasn’t spread yet. Doctors also call this carcinoma in situ.
• Stage I: Nasal or sinus cancer has formed in one area and may have spread into nearby bone.
• Stage II: The nasal or sinus tumor is in two areas and may have spread into nearby bone.
• Stage III: A stage III nasal or sinus tumor has spread either into nearby bone or other organs, or to one or more lymph nodes on the same side of the neck.
• Stage IV: The nasal or sinus cancer has spread to more lymph nodes and to other parts of the head or elsewhere in the body. Doctors classify stage IV tumors as IVA, IVB, or IVC, depending on the size and where cancer cells are located.

Doctors in the United States diagnose about 16,000 people each year with throat cancer. It’s most common among people who smoke, but it’s becoming more common among younger people who aren’t vaccinated against human papillomavirus (HPV).

Our head and neck cancer specialists use advanced tests to detect throat cancer tumors early. Once we know what we’re facing, we’ll design a personalized treatment plan for you.

The first step in the process is a physical examination. Your doctor will look for bumps, sores, or other abnormal areas on your neck and throat.

Screening and diagnostic tests

You also may need one or more of the following tests:

• Barium esophagram -- In this specialized X-ray test, you’ll drink a liquid that contains barium (a silver-white metallic element) to coat the esophagus before your doctor takes X-rays.
• Biopsy -- We may need to take cells from the tumor so our pathologists can determine if they’re cancerous.
• Imaging -- Your doctor may order a computed tomography (CT) scan, a magnetic resonance imaging (MRI) scan, or X-rays to view the inside of your throat.
• Laryngoscopy -- We’ll examine your throat and larynx (voice box) using small mirrors or a tube with a light and camera.
• Panendoscopy -- We’ll use a long, flexible tube with a light and camera called an endoscope to examine the larynx, esophagus (the tube that carries food to the stomach), trachea (windpipe), and bronchial tubes (breathing passages in the lungs). If we see something we suspect to be a tumor, we can estimate its size and if it might have spread, and we can take a biopsy.
• Positron emission tomography (PET) scan or bone scan -- These tests use a mild radioactive substance to check the function of your cells and tissues and let us know if the throat cancer has spread.

Throat cancer staging

If we detect throat cancer, we’ll identify the disease stage. The cancer’s stage refers to its size and if it has spread. Cancer staging helps doctors choose the best treatment options possible.

Doctors classify throat cancer in one of the following stages:

• Stage 0: Doctors identify cancer in the throat’s lining, but it hasn’t spread. This also is called carcinoma in situ.
• Stage I: Cancer has formed in one area of the throat, but it hasn’t spread. If it has spread deeper, the tumor is 2 centimeters (about 0.5 inch) or smaller.
• Stage II: The tumor may be larger than 2 centimeters (about 0.5 inch) and hasn’t spread to the larynx. Alternatively, a cancer may be Stage II if we find it in more than one area of the throat.
• Stage III: A stage III tumor has spread either into nearby lymph nodes or into the larynx or esophagus.
• Stage IV: Cancer has spread to other parts of the body. Doctors classify Stage IV tumors as IVA, IVB, or IVC, depending on their size and where cancer cells are located.

Doctors in the United States diagnose more than 62,500 people per year with thyroid cancer. Advanced diagnostic techniques mean doctors can find the disease earlier and more often.

Our doctors diagnose thyroid cancer accurately and quickly. The process starts with a physical examination. Your doctor will look for swelling, lumps, or other abnormal areas on your neck or throat.

Screening and diagnostic tests

You also may need one or more of the following tests:

• Laryngoscopy -- We’ll examine your throat and larynx (voice box) using small mirrors or a tube with a light and camera.
• Biopsy -- We may need to take cells from the tumor so our pathologists can determine if they’re cancerous.
• Blood tests -- We may take a small blood sample to measure the amount of calcium, hormones, and other substances in your blood.
• Imaging -- Your doctor may order a computed tomography (CT) scan, a magnetic resonance imaging (MRI) scan, or X-rays to view the inside of your throat.
• Radioiodine scan -- In this test, you’ll swallow or have an injection of a small amount of radioactive iodine, and we’ll use a special camera to see where thyroid cells pick up the iodine. This helps us see if a lump is cancerous or if the cancer has spread.
• Positron emission tomography (PET) scan -- These tests use a mild radioactive substance to check the function of your cells and tissues and let us know if the thyroid cancer has spread.

Thyroid cancer types and staging

If we detect thyroid cancer, we’ll identify which type and the state of the disease. The cancer stage refers to its size and if it has spread. Thyroid cancer typing and staging helps doctors choose the best treatment options.

Papillary and follicular thyroid cancer in patients younger than 45

There are two stages of this type of thyroid cancer. In Stage I, the tumor may be any size. It may have spread from the thyroid to nearby tissues or lymph nodes, but it hasn’t spread elsewhere in the body.

In Stage II, the tumor has spread beyond the thyroid to other areas of the body. It may have spread to the lymph nodes.

Papillary and follicular thyroid cancer in patients 45 and older

There are four stages of this type of thyroid cancer:

• Stage I: Cancer has formed in the thyroid, and the tumor is 2 centimeters (about 0.75 inch) or smaller.
• Stage II: The tumor is still only in the thyroid. It may be larger than 2 centimeters (about 0.75 inch), but it is smaller than 4 centimeters (about 1.5 inches).
• Stage III: The tumor is larger than 4 centimeters (about 1.5 inches). It has spread into nearby tissues or nearby lymph nodes.
• Stage IV: Cancer has spread to other parts of the body. Doctors classify stage IV tumors as IVA, IVB, or IVC, depending on their size and where cancer cells are located.

Medullary thyroid cancer (MTC)

There are five stages of this type of thyroid cancer:

• Stage 0: No tumor has formed. Doctors can identify stage 0 MTC with screening tests.
• Stage I: Cancer has formed in the thyroid, and the tumor is 2 centimeters (about 0.75 inch) or smaller.
• Stage II: The tumor is only in the thyroid and is 2 centimeters (about 0.75 inch) or smaller, or it has spread outside the thyroid to nearby tissues but not to lymph nodes.
• Stage III: The tumor has spread into lymph nodes and may have spread to nearby tissues.
• Stage IV: Cancer has spread to other parts of the body. Doctors classify stage IV tumors as IVA, IVB, or IVC, depending on their size and where cancer cells are located.

Anaplastic thyroid cancer

Doctors always classify anaplastic thyroid cancer tumors as stage IV. The cancer usually has spread outside the thyroid by the time it’s diagnosed. Doctors classify these tumors as Stage IVA, IVB, or IVC, depending on their size and where the cancer cells are located.

Salivary gland cancer is relatively rare. Less than 1 percent of all cancers diagnosed in the United States each year are salivary gland cancer. If you may have this type of cancer, it’s important to work with doctors who have experience diagnosing and treating it.

Our team of head and neck cancer specialists has the expertise and advanced diagnostic technology to test for and treat even the rarest types of cancers, including salivary gland cancer.

The first step in the diagnostic process is a physical examination. Your doctor will look for bumps, sores, or other abnormal areas inside your mouth, as well as on your face, head, or neck.

Screening and diagnostic tests

You also may need one or more of the following tests:

• Biopsy -- We may need to take cells from the tumor so our pathologists can determine if they’re cancerous.
• Imaging -- Your doctor may order a computed tomography (CT) scan, a magnetic resonance imaging (MRI) scan, or X-rays to view the inside of your mouth and throat.
• Positron emission tomography (PET) scan or bone scan -- These tests use a mild radioactive substance to check the function of your cells and tissues and lets us know if the cancer has spread.

Salivary gland cancer staging

If we detect salivary gland cancer, we’ll identify the cancer’s stage. The stage refers to the cancer’s size and if it has spread. Cancer staging helps doctors choose the best treatment options.

Doctors classify salivary gland cancer in one of the following stages:

• Stage I: The tumor is no larger than 2 centimeters (0.75inch) and has not spread into nearby tissues, lymph nodes, or elsewhere in the body.
• Stage II: The tumor is larger than 2 centimeters (0.75 inch) but smaller than 4 centimeters (1.5 inches). The tumor has not spread to other parts of the body.
• Stage III: Either the tumor is larger than 4 centimeters (1.5 inches) and has not spread, or it is smaller but has spread to nearby tissues or to one lymph node.
• Stage IV: This stage indicates that the cancer has spread deeper into the tissues, has spread into nearby parts of the body, or has spread into the lymph nodes. Physicians use several subcategories (IVA, IVB, or IVC) to specify the tumor’s location and size.