If an abnormal area has been found in the oral cavity, a biopsy is the only way to know whether it is cancer. Usually, the patient is referred to an oral surgeon or an ear, nose and throat surgeon, who removes part or all of the lump or abnormal-looking area. A pathologist examines the tissue under a microscope to check for cancer cells.
Almost all oral cancers are squamous cell carcinomas. Squamous cells line the oral cavity.
If the pathologist finds oral cancer, the patient’s doctor needs to know the stage, or extent, of the disease in order to plan the best treatment. Staging tests the exam help the doctor find out whether the cancer has spread and what parts of the body are affected.
Staging generally includes dental x-ray and x-rays of the head and chest. The doctor may also want the patient to have a CT (or CAT) scan. A CT scan is a series of x-ray put together by a computer to form detailed pictures of areas inside the body.
Ultrasonography is another way to produce pictures of areas in the body. High-frequency sound waves (ultrasound), which cannot be heard by humans, are bounced off organs and tissue. The pattern of echoes produced by these waves creates a picture called sonogram. Sometimes the doctor asks for MRI (magnetic resonance imaging), a procedure in which pictures are created using a magnet linked to a computer. The doctor also feels the lymph nodes in the neck to check for swelling or other changes. In most cases, the patient will have a complete physical examination before treatment begins.