Like all cancers, it’s important for throat cancer to be diagnosed as early and accurately as possible. This helps increase your chances for being cured while at the same time limiting the effect of cancer treatment on your quality of life, including ability to speak and swallow.
The experts at MD Anderson are among the most skilled and experienced in the nation in diagnosing and treating throat cancer. They use specialized, advanced technology that has pinpoint focus and reliable results, including three-dimensional imaging that provides detailed information.
Throat Cancer Diagnostic Tests
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 and drinking habits, sexual history, and family medical history.
The tests used to diagnose throat cancer and find out if it has spread depend on the type of cancer. Tests also may be used to find out if treatment has damaged other tissues or organs. One or more of the following tests may be used.
Different methods are used to obtain tissue for a biopsy, depending on where the tumor is located. Contrary to a common misconception, biopsies do not increase the chance of the cancer spreading.
- Conventional incisional biopsy: This is the traditional, most frequently used type of biopsy. The doctor surgically removes part of the tissue where cancer is suspected.
- Excisional biopsy: A type of biopsy which removes most or all of the tissue suspected of having cancer. This is frequently done with tonsillectomy in the operating room.
- Fine-needle-aspiration biopsy (FNA): This type of biopsy may be used if you have a lump in your neck that can be felt. A thin needle is inserted into the area, and then cells are withdrawn and examined under a microscope. This is often coupled with an ultrasound in order to verify the placement of the needle.
Endoscopy: 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.
Imaging tests, which may include:
- CT or CAT (computed axial tomography) scans
- PET (positron emission tomography) scans
- MRI (magnetic resonance imaging) scans
- Chest and dental X-rays
Barium swallow: Also called an upper GI (gastrointestinal) series, evaluates the passage from the throat to the stomach and is used to look for abnormal changes in structure and muscle movement. The patient drinks liquid barium, which allows for certain areas of the body to show up more clearly during X-rays. It's called a series because the X-rays in this test will be of the pharynx, esophagus, stomach and duodenum. All X-rays will be taken during a single test.
Modified barium swallow: During this procedure, the patient swallows liquid, pudding, and solid food consistencies with barium in them. By observing the swallow during a real-time form of X-ray called flurorscopy, the speech pathologist and radiologist can evaluate the structures and movements associated with swallowing in order to determine what foods an individual can eat.
Laryngeal videostroboscopy: An evaluation of the overall appearance and movements of the voicebox (larynx) and vocal cords (folds) during sound production (phonation) using a lighted tube placed into the mouth or nose.
Fiberoptic endoscopic examination of swallowing (FEES): A small, flexible endoscope is inserted through the nose, allowing the doctor or speech pathologist to examine swallowing.
(Source: National Cancer Institute)
Staging is the process of defining and describing the primary tumor as well as whether it has metastasized (spread) into the lymph nodes or bloodstream. Staging is a universal language for the physicians treating cancer to discuss the treatment options, and to know which treatments will be most effective. It also helps to define what the overall prognosis will be once the treatment is completed.
The staging system most often used for throat cancer is the TNM staging system, also known as the American Joint Committee on Cancer (AJCC) system.
This system gives three key pieces of information:
- T stands for tumor (how far it has spread within the larynx or pharynx and to nearby tissues).
- N describes whether the cancer has spread to lymph nodes.
- M stands for metastasis (spread of the cancer) to distant organs.
All of this information is combined to arrive at a disease stage. After stage 0 (which is carcinoma in situ or cancer that has not grown beyond the lining layer of cells), stages are labeled using Roman numerals from I through IV (that is, 1 through 4). The smaller the number, the less the cancer has spread. A higher number, for example, stage IV, means a more advanced stage of the disease.