Diagnosing Lip & Oral Cavity Cancers

If you have symptoms that suggest oral cancer, your doctor or dentist will perform a physical exam of the lips and oral cavity to check your mouth and throat for red or white patches, lumps, swelling, or other problems. A physical exam includes looking carefully at the roof of your mouth, back of your throat, and insides of your cheeks and lips. The floor of your mouth and lymph nodes in your neck will also be checked.

If your doctor finds something that is concerning, they might do a biopsy, which is the removal of a small piece of tissue to look for cancer cells. Usually, a biopsy is done with local anesthesia. A biopsy is the only sure way to know if the abnormal area is cancerous.

If your biopsy comes back positive for cancerous cells, your doctor may elect to have one or more tests done to further diagnose and stage the disease. A few of those methods that are also used in the lip and oral cancer diagnosis and staging process are:

• X-rays: An X-ray of your entire mouth can show whether cancer has spread to the jaw. Images of your chest and lungs can show whether cancer has spread to these areas.
  • Barium swallow: Involves the patient drinking a liquid that contains barium (a metallic compound), which coats and outlines the esophagus, allowing it to show-up in x-rays, and then series x-rays are taken.
• CT scan: An X-ray machine linked to a computer takes a series of detailed pictures of your body. You may receive an injection of dye to help the tissues show more clearly. Tumors in your mouth, throat, neck, lungs, or elsewhere in the body can show up on the CT scan.
• MRI: A powerful magnet linked to a computer is used to make detailed pictures of your body. An MRI can show whether oral cancer has spread.
• Endoscopy: The doctor uses a thin, lighted tube (endoscope) to check your throat, windpipe, and lungs. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of cancer.
• PET scan: You receive an injection of a small amount of radioactive sugar. The radioactive sugar gives off signals that the PET scanner picks up. The PET scanner makes a picture of the places in your body where the sugar is being taken up. Cancer cells show up brighter in the picture because they take up sugar faster than normal cells do. A PET scan shows whether oral cancer may have spread.
• Exfoliative cytology: A piece of cotton, a brush, or a small wooden stick is used to gently scrape cells from the lips, tongue, mouth, or throat. The cells are viewed under a microscope to find out if they are abnormal.
• Bone scan: A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones with cancer and is detected by a scanner.