Symptoms and diagnosis of mouth, head and neck cancer
The symptoms of mouth, head and neck cancers depend on where the tumour is found. Some common symptoms include:
- A sore or ulcer that does not heal.
- Difficulty or pain on chewing and swallowing.
- Sore throat, difficulty speaking or a hoarse voice.
- Changes in your breathing at rest.
- Unexplained loose tooth.
- A swelling or lump.
- Pain in the face or jaw.
- Earache or ringing in the ear or hearing problems.
- Blocked or bleeding nose.
- White or red patches in the lining of the mouth or on the tongue that do not go away.
Diagnosing mouth, head and neck cancer
First, visit your family doctor (GP) or dentist if you are worried about any symptoms. They can examine you and do some blood tests. If your GP or dentist is still concerned about you, they can refer you to a hospital for more tests. You may be referred to a specialist doctor, such as a maxillofacial surgeon or an ENT (ear, nose and throat) specialist.
The specialist will discuss your symptoms and examine you again. He or she will inspect your mouth, throat, tongue, nose and neck using a small mirror and/or lights. Your neck, lips, gums and cheeks will also be checked for lumps.
The following tests can diagnose mouth, head and neck cancers.
- Fine needle aspiration cytology
An X-ray of the bones of your face and neck allows your doctor to check for cancer. An OPG (orthopantomogram) is a special X-ray of the jaw and teeth.
Nasendoscopy: This test uses a small, thin flexible tube with a light called a nasendoscope to look at your nose and throat. Your throat will be numbed first. Then a tube is passed into your nose while a small mirror is held at the back of your throat. This allows your doctor to have a close look at your throat. The test is little unpleasant but only lasts a few minutes.
A biopsy is a sample of the abnormal cells taken from the affected area. These are then examined under a microscope in the laboratory. Your doctor can do the biopsy during a nasendoscopy using a very small needle. The biopsy will tell your doctor if the sample contains cancer cells and if so what type. In some cases, patients may need a general anaesthetic during a biopsy.
Fine needle aspiration cytology
This test uses a fine needle and syringe to get a sample of cells from a lump. It is then sent to the laboratory to see if any cancer cells are present. The test can be uncomfortable and the area may be bruised for short while afterwards.
The stage of a cancer describes its size and if it has spread to other parts of your body. By knowing the stage of the cancer, it helps your doctors to decide the best treatment for you. Mouth, head and neck cancers are very often divided into four stages:
- Stage 1: This is a small tumour and found in one place only.
- Stages 2/3: The disease has spread to other areas of your mouth, head and neck.
- Stage 4: The disease has spread to other parts of your body further away. These are known as secondaries or metastases.
If the above tests show that you have cancer, you may need other tests. These tests will check if the cancer has spread:
- CT scan
- PET scan
- MRI scan
- Isotope bone scan