Laryngeal Cancer: Diagnosis
How is laryngeal cancer diagnosed?
If your healthcare provider thinks you might have laryngeal cancer, you will need certain exams and tests to be sure. Diagnosing laryngeal cancer starts with your healthcare provider asking you questions. He or she will ask you about your health history, your symptoms, risk factors, and family history of disease. Your healthcare provider will also give you a physical exam. You may also see an ear, nose, and throat specialist, called an otolaryngologist. Or you may see a head and neck surgeon.
What tests might I need?
You may have 1 or more of the following tests:
These are the main tests your doctor may perform if he or she suspects you have laryngeal cancer:
Indirect laryngoscopy. Using a small mirror with a long handle, the doctor looks down your throat. This lets your doctor check to see if your vocal cords move normally. The exam is painless. But your doctor may spray a local anesthetic on your throat to keep you from gagging. You may have this test in the doctor’s office.
Direct laryngoscopy. This test is done by an ear, nose, and throat specialist called an otolaryngologist. Or it may be done by a head and neck surgeon. The doctor inserts a thin, flexible, lighted tube called a laryngoscope through your nose or mouth. This tube lets the doctor see areas that can’t be seen with a simple mirror. You will have a local anesthesia to ease discomfort or a mild sedative to help you relax. You may have this test in the doctor’s office, an outpatient clinic, or a hospital. Sometimes, the doctor decides to perform this test in the operating room, using a general anesthesia to put you to sleep during the test.
This test is like a direct laryngoscopy. But this test checks several parts of the head. These include the nasal cavity, mouth, throat, windpipe or trachea, and food pipe or esophagus. General anesthesia is used to do this test.
This is a series of X-rays taken while you swallow a chalky substance called barium. The barium coats the inside of your throat so that any swallowing changes can be seen on the X-rays.
In this test, an X-ray beam takes a series of pictures of the inside of your body from many angles. These images are then combined by a computer, giving a detailed 3-D picture of your body. The CT scan can be used to check your head and neck and is sometimes used to check the chest, too.
This test uses radio waves, large magnets, and a computer to take detailed pictures of the inside of your body. This test may be used to look for cancer in your neck.
For this test, you lie still on a table as it passes through a tube-like scanner. If you are not comfortable in small spaces, you may be given a sedative before the test. This will help you to relax. The scanner directs a beam of radio waves at the area that’s being checked. You may need more than 1 set of images. Each may take 2 to 15 minutes. This test is painless. It may last an hour or more.
If your doctor finds abnormal areas of tissue, you’ll need a biopsy. The biopsy is the only way to know if you have cancer in your larynx. During a biopsy, the doctor removes a piece of tissue while you are under local or general anesthesia. A doctor called a pathologist then looks at the tissue under a microscope to check for cancer. The tissue that's taken out may also be tested for signs of HPV infection.
It usually takes a few days for biopsy results to come back. A biopsy can sometimes be done in your doctor’s office. Or it may need to be done in the hospital with surgery. In that case, you will have general anesthesia so that you're asleep and don’t feel pain during the procedure.
Fine needle aspiration (FNA)
If you have a lump in your neck, it may be in a lymph gland, also called a lymph node. Your doctor will use a type of biopsy called a fine needle aspiration (FNA) to see if there are cancer cells in your lymph node. This is often done as an outpatient procedure in your doctor’s office or a clinic. That means you can go home the same day.
Your doctor will order tests to check blood counts and make sure your liver and kidneys are working well. Your doctor will also check the levels of certain substances, such as calcium, sodium, potassium, and magnesium.
Getting your test results
When your healthcare provider has the results of your tests, he or she will contact you with the results. Your provider will talk with you about other tests you may need if head and neck cancer is found. Make sure you understand the results and what follow-up you need.
March 21, 2017
Gersten, Todd, MD,Stump-Sutliff, Kim, RN, MSN, AOCNS