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:
Computed tomography (CT) scan
Magnetic resonance imaging (MRI)
These are the main tests your healthcare provider may perform if he or she suspects you have laryngeal cancer:
Indirect laryngoscopy. Using a small mirror with a long handle, your healthcare provider looks down your throat. This lets your healthcare provider check to see if your vocal cords move normally. The exam is painless. But your healthcare provider may spray a local anesthetic on your throat to numb it and keep you from gagging. You may have this test in your healthcare provider's office.
Direct laryngoscopy. Your healthcare provider inserts a thin, flexible, lighted tube called a laryngoscope through your nose or mouth. This tube lets the healthcare provider 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 healthcare provider's office, an outpatient clinic, or a hospital. Sometimes, your healthcare provider decides to perform this test in the operating room, using a general anesthesia to put you to sleep during the test. Biopsies might be done during this test. (See below.)
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.
If your healthcare provider 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, your healthcare provider removes a piece of tissue while you are under local or general anesthesia. A healthcare provider called a pathologist then looks at the tissue under a microscope to check for cancer.
It usually takes a few days for biopsy results to come back. A biopsy can sometimes be done in your healthcare provider'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 a swollen lymph gland, also called a lymph node. Your healthcare provider 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 healthcare provider's office or a clinic. That means you can go home the same day.
Your healthcare provider will order tests to check blood counts and make sure your liver and kidneys are working well. Your healthcare provider 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 healthcare 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.
June 09, 2018
Gersten, Todd, MD,Stump-Sutliff, Kim, RN, MSN, AOCNS