Diagnosing Head & Neck Cancer

Support Throughout the Diagnostic Process

Our physicians, nurses and support staff are here to advise you, listen to you and calm your fears. Your physicians will explain your diagnosis and compassionately offer suggestions for treatment and care. Their job is to help you.

Also available for counsel, support and guidance are nurse coordinators, oncology social workers and a pastoral team. They’ll help you navigate through the system and provide additional assistance, including:

  • Social support
  • Spiritual guidance
  • Emotional support
  • Practical advice
  • Tips on coping

Call on them. They’re here for you.

There isn’t any way to screen for this cancer. There isn’t any nationally recommended screening program. The only way this cancer really gets picked up is when the patient has a doctor who’s a careful examiner with a high level of suspicion because the patient’s a drinker or a smoker. It may just be a cold, but if they’re a smoker and a drinker and they’re past 50 years old, and the hoarseness has been going on three or four weeks or longer, then it’s probably cancer and it needs to be looked at.

D. Randall Pinkston, MD; Chief – Section of Head & Neck Surgical Oncology

If your head and neck cancer is found early, your prognosis for cure is excellent. Like most cancers, early detection makes all the difference.

Head and neck cancer is often preventable. Avoiding smoking and heavy drinking can reduce your risk of developing cancers of the mouth and throat.

Whether your head and neck cancer is found in early or advanced stages, you’ll receive top-of-the-line, sophisticated cancer care here at Scott & White. Our team of radiologists, pathologists and surgical oncologists are on the leading edge of diagnostic procedures and techniques.

Our head and neck oncologists are renowned not only for their diagnostic expertise and skill, but also for their thoroughness in explaining the:

  • Disease process
  • Diagnostic testing
  • Treatment details
  • Prognosis for cure

Our doctors are just kind. They’re good to their patients. They don’t rush anything. They explain everything carefully. It’s the kind of personalized care we give them.

— Marilyn Cox, Head & Neck Team Coordinator

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Head & Neck Cancer Diagnostic Services

At Scott & White Healthcare, we use the most advanced diagnostic equipment available to detect, identify and evaluate your head and neck cancer tumors.

We offer a number of diagnostic services to locate and assess your tumor or to determine whether your cancer has spread. Your physician may recommend one or more of the following tests.

Physical Exams

  • Physical exam. Your physician will begin with a thorough physical exam and medical history.
  • Indirect laryngoscopy. Your physician may examine your larynx (voice box) by using a small, long-handled mirror in the back of your palate to check for abnormalities. You will first receive a mild local anesthetic.
  • Indirect pharyngoscopy. Your physician may examine your pharynx by using a small, long-handled mirror in the back of your palate to check for abnormalities. You will first receive a mild local anesthetic.
  • Indirect nasopharyngoscopy. Your physician may examine your nasopharynx by using a small, long-handled mirror in the back of your palate to check for abnormalities. You will first receive a mild local anesthetic.
  • Dental exam. Your physician team may recommend an extensive dental exam if your cancer is affecting your teeth or gums. A dentist or oral surgeon can help provide adequate dental care during your cancer treatments.

An oral surgeon may be part of your Integrated Care Team. An oral surgeon will help provide restructuring work to your palate, jaw, gums, or other structures, if necessary.

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Endoscopy

In these procedures, your physician will insert a very small high-definition camera attached to a thin tube (endoscope) into your aero-digestive system to check for abnormalities.

With all endoscopic procedures described below, your physician will remove small samples of tissue (biopsy) if he or she finds abnormal cells. Tissue samples will be sent to the laboratory for evaluation by a pathologist. Results will be sent to your lead physician.

Endoscopy is generally an outpatient procedure.

  • Laryngoscopy. Your physician may examine your larynx (voice box) by placing a very small high-definition camera attached to a thin tube (laryngoscope) behind your palate and checking for abnormalities.
  • Pharyngoscopy. Your physician may examine your pharynx by placing a very small high-definition camera attached to a thin tube (endoscope) behind your palate and checking for abnormalities.
  • Nasopharyngoscopy. Your physician may examine your nasopharynx by placing a very small high-definition camera attached to a thin tube (endoscope) behind your palate to check for abnormalities.
  • Esophagoscopy. Your physician may examine your esophagus (muscular tube through which food passes to your stomach) by placing a very small high-definition camera attached to a thin tube (endoscope) down your esophagus to check for abnormalities.
  • Bronchoscopy. Your physician may examine the inside of your lungs (bronchus) with either a rigid (metal) or flexible bronchoscope (thin tube with a very small high-definition camera on the end). Your physician may insert the bronchoscope through either your mouth or your nose, and then down through your windpipe (trachea) and into your lungs.

Your physician will check for abnormalities.
If a flexible bronchoscope is used, in most cases the procedure will be performed in your physician’s office with local anesthesia. If a rigid bronchoscope is used, general anesthesia will be required and the procedure may be performed in a treatment room.

  • Panendoscopy. Your physician may examine your pharynx, larynx, upper windpipe (trachea) and esophagus (muscular tube through which food passes to your stomach) with either a rigid (metal) or flexible endoscope (thin tube with a very small high-definition camera on the end). Your physician will check for abnormalities. In most cases, this procedure is performed using general anesthesia.

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Biopsy

A biopsy is the best way to confirm the presence of Head & Neck Cancer. Your physician may recommend a biopsy if cancer is suspected based on the results of other diagnostic tests.

  • Incisional biopsy. In this minimally invasive procedure, your surgeon will make a small incision and remove a portion of your tumor for evaluation. The tissue sample will be sent to a pathologist for assessment. Results will be sent to your physician.
  • Excisional biopsy. In this minimally invasive procedure, your surgeon will make a small incision and remove your entire tumor and the tissue surrounding it. A tissue sample will be sent to a pathologist for evaluation. Results will be sent to your physician.
  • Open biopsy. In this surgical procedure, your surgeon will make an incision and remove your tumor. Your surgeon will also check adjacent lymph nodes for cancer spread.
  • Fine needle aspiration. With a fine needle aspiration (FNA) biopsy, your cytopathologist will insert a thin, hollow needle into the affected area to remove a small sample of tissue.

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Imaging Tests

  • Modified barium swallow. For this test, you will drink a solution containing barium, and then X-rays of your digestive tract are taken. This test is used to determine whether your Head & Neck Cancer may have spread to your esophagus. A barium swallow is also known as an upper GI series.
  • Panorex. Your physician may request a panoramic X-ray of your jawbones to evaluate the condition of your bones and teeth prior to your cancer treatment.
  • Ultrasound. Used to determine whether you tumor is solid or fluid filled or whether your cancer has spread.
  • Magnetic resonance imaging (MRI) scan. Exceptional image quality helps to detect small masses or determine whether your cancer has spread.
  • Positron emission tomography (PET) scan. Used to determine malignancy or spread.
  • Chest X-ray. Used to detect presence of a mass in your lungs.
  • Bone scan. Used to determine whether cancer has spread to your bones.

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