doctor Find a doctor
OR
Breadcrumbs that show current page

Diagnosis

From a patient’s first visit to BMC, he or she receives highly coordinated, multidisciplinary care that is managed by a BMC Oral and Maxillofacial surgeon, a doctor who specializes in treating tumors and cancers of the oral cavity and the head and neck area.

The surgeon will most likely order some testing to confirm the diagnosis of oral cancer. For a suspected or confirmed diagnosis of oral cancer, physicians will use a variety of diagnostic procedures to stage the disease and to determine its severity and spread.

These tests may include: computed tomography (CT), magnetic resonance imaging (MRI) and positron emission tomography (PET). The surgeon may also order a combined PET CT test. All of these tests are important to help the surgeon come up with a diagnosis and a way to stage the patient’s cancer. Staging assesses the degree of local infiltration, involvement of regional lymph nodes and the presence of distant metastases or second primary tumors. The surgeon may also perform a fine needle aspiration (FNA) to make a tissue diagnosis.

Computed Tomography (CT) Scan

CT scans use x-ray equipment and computer processing to produce 2-dimensional images of the body. The patient lies on a table and passes through a machine that looks like a large, squared-off donut. Doctors order CT scans when they want to see a two-dimensional image of the body to look for tumors and examine lymph nodes and bone abnormalities. If contrast dye is used to improve the computer image, the patient may need to avoid eating or drinking for 4 to 6 hours before the test. Patients should tell their provider before the test if they have any allergies or kidney problems.

Magnetic Resonance Imaging (MRI)

This test uses a magnetic field, radiofrequency pulses, and a computer to produce detailed images of body structures in multiple places. You may be asked to drink a contrast solution for better imaging, and you will most likely lie on a moving table as pictures are taken. MRI is a more detailed tool than x-ray and ultrasound and for certain organs or areas of the body, it provides better images than CT. MRI may not be recommended if you have a pacemaker or other metal implant.

Positron Emission Tomography (PET) scan

A PET scan is used to detect cellular reactions to sugar. Abnormal cells tend to react and "light up" on the scan, thus helping physicians diagnose a variety of conditions. For the PET scan, a harmless chemical, called a radiotracer, is injected into your blood stream. Once it has had time to move through your body, you will lie on a table while a scanner follows the radiotracer and sends three-dimensional images to a computer screen. Patients are generally asked to wear comfortable clothing and refrain from eating for 4 hours before the scan. Tell your doctor if you are pregnant or breastfeeding. Patients with diabetes should discuss diet guidelines with their physician for the hours leading up to the scan.

Biopsy

Any suspicious mass of tissue or tumor is subject to a biopsy, or removal of cells from the mass. This is the only technique that can confirm the presence of cancer cells. The doctor will use a general or local anesthetic depending on the location of the mass, and then remove a sample of tissue to send to the lab. The sample is sent to a pathologist, a physician who is an expert at identifying diseased cells in tissue samples. Very often, a few stiches are used to help the area heal, and tenderness is felt for a short period of time.

Fine Needle Aspiration (FNA) Biopsy

FNA uses a thin, hollow needle (thinner than the needles used to draw blood) to draw out fluid or tissue from a lump. Depending on the size and location of the lump, the needle is sometimes directed into the lump simply by feeling it. Other times it may be guided into the lump with the assistance of an ultrasound. FNAs are rarely painful and don’t tend to leave scars. Although FNA is the easiest type of biopsy to have, it doesn’t always provide a clear result.

OR