Oral Cancer: Diagnosis 

How is oral cancer diagnosed?

Oral cancer is often found during routine dental or medical exams. Your healthcare provider may check for signs of oral cancer during your regular exams. And you should tell your healthcare provider if you have any symptoms, such as: 

• Sores or red or white patches in your mouth

• Unusual swelling in your gums or jaw

• Pain or numbness in your jaw, lip, or mouth that doesn't go away 

• A lump inside your mouth or on your neck 

• Bleeding in your mouth

• Loose teeth

• Trouble swallowing

• Earache that doesn't get better

If your healthcare provider thinks you might have oral cancer, you will need certain exams and tests to be sure. Diagnosing oral 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. This involves looking at your head and neck and checking inside your mouth. He or she may also look at the back of your mouth and throat with small mirrors or with a thin, flexible, lighted tube. This tube is called a laryngoscope or a pharyngoscope.

Based on the results, your healthcare provider may decide you need a biopsy to check for cancer.

What is a biopsy?

A biopsy is a tiny piece of tissue that your healthcare provider takes from the suspicious area. A doctor called a pathologist examines this tissue sample under a microscope to see if it is cancer. Samples may be taken from your mouth and from lymph nodes in your neck. The biopsy may be done in the healthcare provider's office or at a hospital. A biopsy is the only sure way to tell if you have cancer and what kind of cancer it is. 

Types of biopsies

These are 3 main ways to take a biopsy to check for oral cancer:

• Exfoliative cytology. Your healthcare provider may scrape some cells from the suspicious area and put them on a slide. This can be done in a doctor's office.

• Incisional biopsy. Your healthcare provider may cut out a small sample of tissue. If the suspicious area is easy to reach, he or she can numb your mouth and do this in the office. If the area is deeper in your mouth or throat, this is done in a hospital. This is the most common biopsy done to test for oral cancer.

• Fine-needle aspiration. If you have a suspicious lump in your neck, your healthcare provider may use a thin, hollow needle to remove a small sample of tissue. This can be done in the office.

Once the biopsy is done, a pathologist looks at the tissue under a microscope to check for cancer cells. The samples are also usually tested to see if they contain a virus called HPV. 

Getting your test results

It usually takes several days for the results of your biopsy to come back. When your healthcare provider has the results of your biopsy, he or she will contact you with the results. Your provider will talk with you about other tests you may need if oral cancer is found. Make sure you understand the results and what follow-up you need.