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Diagnosing Head and Neck Cancer: Tests and Staging

To find the cause of symptoms, a doctor:

  • Evaluates a person’s medical history
  • Performs a physical examination
  • Orders diagnostic tests

Exams and Tests

The exams and tests conducted may vary depending on the symptoms. Examination of a sample of tissue (a biopsy) under the microscope is always necessary to confirm a diagnosis of cancer.

Some exams and tests that may be useful are described below:

Physical examination may include visual inspection of the oral and nasal cavities, neck, throat, and tongue using a small mirror and/or lights. The doctor may also feel for lumps on the neck, lips, gums, and cheeks.

Endoscopy is the use of a thin, lighted tube called an endoscope to examine areas inside the body. The type of endoscope the doctor uses depends on the area being examined. For example, a laryngoscope is inserted through the mouth to view the larynx; an esophagoscope is inserted through the mouth to examine the esophagus; and a nasopharyngoscope is inserted through the nose so the doctor can see the nasal cavity and nasopharynx.

Laboratory tests examine samples of blood, urine, or other substances from the body.

X-rays create images of areas inside the head and neck on film.

CT (or CAT) scan is a series of detailed pictures of areas inside the head and neck created by a computer linked to an x-ray machine.

MRI (Magnetic resonance imaging) uses a powerful magnet linked to a computer to create detailed pictures of areas inside the head and neck.

PET scan uses sugar that is modified in a specific way so it is absorbed by cancer calls and appears as dark areas on the scan.

Biopsy is the removal of a piece tissue. A pathologist studies the tissue under a microscope to make a diagnosis. A biopsy is the only sure way to tell whether a person has cancer.


If the diagnosis is cancer, the doctor will want to learn the stage (or extent) of disease. Staging is a careful attempt to find out whether the cancer has spread and, if so, to which parts of the body. Staging may involve an examination under anesthesia (in the operating room), x-rays and other imaging procedures (discussed above), and laboratory tests. Knowing the stage of the disease helps the doctor plan treatment.

Source: National Cancer Institute – Head and Neck Cancer: Questions and Answers

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