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Screening for Head and Neck Cancer

There is no simple screening procedure to diagnose these cancers early. They are difficult to diagnose and require complex procedures.

Because the cancers are not common, and the tests require specialized doctors, neither the American Cancer Society nor any other group recommends screening for these cancers.

Talk to your doctor if you have any of these symptoms (as described in the "Symptoms" section). Many of these signs and symptoms may be caused by other cancers or by less serious, benign (non-cancerous) problems.

For a complete evaluation, a person may need to be referred to an ear, nose, and throat (ENT) specialist. These doctors are also known as otolaryngologists or as head and neck surgeons.

The specialist will also examine the larynx and hypopharynx (known as laryngoscopy). It can be done in 2 ways:

Direct (flexible) laryngoscopy:
For this exam, the doctor inserts a fiber-opticlaryngoscope - a thin, flexible, lighted tube - through the mouth or nose to look at the larynx and nearby areas.

Indirect laryngoscopy:
In this exam, the doctor uses special small mirrors to view the larynx and nearby areas.

Both types of exams can be done in the doctor's office. For either type of exam, the doctor may spray the back of your throat with numbing medicine to help make the exam easier.

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

  • Medical history and physical examination:
    The first step in any medical evaluation is for your doctor to gather information about your symptoms, risk factors, family history, and other medical conditions . A thorough physical exam can help uncover any signs of possible cancer or other diseases. In particular, your doctor will pay close attention to your head and neck, looking for abnormal areas in your mouth or throat, as well as enlarged lymph nodes in your neck.
  • Panendoscopy:
    Panendoscopy is a procedure that combines laryngoscopy, esophagoscopy, and (at times) bronchoscopy. This lets the doctor thoroughly examine the entire area around the larynx and hypopharynx, including the esophagus and trachea (windpipe).
  • Laboratory tests examine samples of blood, urine, or other substances from the body. Other types of tests may be done as part of a workup if a patient has been diagnosed with laryngeal or hypopharyngeal cancer. These tests are not used to diagnose the cancer, but they may be done to see if a person is healthy enough for other treatments, such as surgery or chemotherapy.
  • Chest x-ray:
    A chest x-ray may be done to see if laryngeal or hypopharyngeal cancer has spread to the lungs.
  • 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.
  • Magnetic resonance imaging (or MRI) uses a powerful magnet linked to a computer to create detailed pictures of areas inside the head and neck. MRI scans use radio waves and strong magnets instead of x-rays.
  • PET scan uses sugar that is modified in a specific way so it is absorbed by cancer cells and appears as dark areas on the scan.
  • Biopsy is the removal of 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. The doctor may order an Endoscopic biopsy or a Fine needle aspiration (FNA) biopsy.

Source: American Cancer Society: Laryngeal and Hypopharyngeal Cancer [PDF].

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