Oral Cancer: Tests After Diagnosis

After a diagnosis of oral cancer, you will likely have other tests. These tests help your healthcare providers learn more about your cancer. They can help show if the cancer has grown into nearby areas or spread to other parts of the body. The test results help your healthcare providers work with you to decide the best ways to treat the cancer. If you have any questions about these or other tests, be sure to talk with your healthcare team.

The tests you’ll have may include imaging tests such as: 

• CT scan

• MRI

• Positron emission tomography (PET) scan

• Ultrasound

• Barium swallow

• Panorex films

• Chest X-ray

You can learn more about each of these tests below.

CT scan

This test uses a series of X-rays and a computer to make detailed images of tissues inside the body.  A CT scan is much more detailed than a regular X-ray. Your healthcare provider may request scans of your head and neck area, to look for tumors in the oral cavity, lymph nodes, or elsewhere. Your healthcare provider may also request scans of your entire lower jawbone (mandible).

During the test, you lie still on a table as it slides through the center of the CT scanner. Then the scanner sends a beam of X-rays at your body. A computer uses the data from the X-rays to create many pictures of the inside of your body. These are used together to create a 3-D picture. You may be asked to hold your breath once or more during the scan. You may be asked to drink a contrast dye after the first set of pictures is taken. This dye can help define different areas in your body. The contrast dye will pass out of your body over the next day or so through your bowel movements. If you have dye through an IV in your arm, this may cause a feeling of warmth in your body for a few minutes. In rare cases, it can also cause hives or other allergic reactions. Tell the test technician if you don’t feel well during the test.

MRI

This test uses large magnets and a computer to make detailed images of tissues in your body. An MRI is used to see if cancer has spread to your neck. It can also show the size and extent of any cancer that has spread.

For this test, you lie still on a table as it passes through a narrow, tube-like scanner. Then the scanner directs a beam of radio waves at the area being examined. A computer uses the data from the radio waves to create a 3-D picture of the inside of your body. You may need more than 1 set of images. Each 1 may take 2 to 15 minutes, so that the whole experience may take an hour or more. You may be injected with a dye before getting this scan to help the doctors get an even clearer view of what’s happening inside your body. This test is painless. Ask for earplugs if they aren’t offered because there is a loud thumping noise during the scan. If you are claustrophobic, you may be given a sedative before having this test.

PET scan

A PET scan is used to find cancer cells anywhere in the body. A needle is used to put a radioactive sugar into a vein. The sugar travels through the blood throughout the body and is taken up by the cancer cells. Cancer cells are more active and use more sugar than normal cells usually do. A scanner is then used to get pictures of the parts of the body that contain the radioactive sugar. Some people are sensitive to the radioactive glucose and may have nausea, headache, or vomiting.

Ultrasound

This test uses sound waves to look at internal organs. A wand is moved over the skin to show pictures on a computer screen. Ultrasound may be used to look for enlarged lymph nodes in the neck. This may be a sign that cancer has spread to that area.

Barium swallow

This test is a series of X-rays done while you swallow a liquid that contains barium. This liquid shows up on X-rays. People with oral cancer are at risk for cancers of the digestive tract. So your healthcare provider may request this test to see if there is cancer in your esophagus. This is the tube that connects your mouth to your stomach. It also shows how well you swallow and if the cancer is causing problems with normal swallowing.

Panorex films

This test uses X-rays to take a picture of your upper and lower jawbones. It can show if cancer has spread to these bones. You sit or stand and place your chin on a rest, looking straight ahead. The machine moves around your head, taking the X-ray picture of your jaws.

Chest X-ray

A chest X-ray can help show if cancer has spread to your lungs. For this test, you stand in front of a rectangular target area where the X-ray film is held. You may be asked to hold your arms to the side or over your head. You take a breath and remain still for a few seconds. You may have an X-ray of your chest from the front and from the side.

Working with your healthcare provider

Your healthcare provider will talk with you about which tests you'll have. Get ready for the tests as instructed. Ask questions and talk about any concerns you have.