Oral Cancer: Diagnosis

How is oral cancer diagnosed?

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

• Sores or red or white patches in your mouth

• Abnormal 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. You'll be asked about your health history, your symptoms, risk factors, and family history of disease. A physical exam will be done. It will include looking at your head and neck and checking inside your mouth. Your provider 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 findings, 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's removed from the changed area that might be cancer. A healthcare provider called a pathologist examines this tissue sample to see if it contains cancer cells. Samples may be taken from your mouth and from lymph nodes in your neck. The biopsy may be done in your healthcare provider's office or at a hospital. A biopsy is the only sure way to know if you have cancer and exactly what kind of cancer it is. 

Types of biopsies

These are three main ways to do a biopsy to check for oral cancer:

• Exfoliative cytology. A small tool or brush is used to scrape some cells from the suspicious area and put them on a slide. This can be done in a healthcare provider's office.

• Incisional biopsy. Your healthcare provider may cut out a small piece of the changed tissue. If the suspicious area is easy to reach, medicines can be used to numb your mouth and do this in the office. If the area is deeper in your mouth or throat, this biopsy is done in a hospital. This is the most commonly used type of biopsy to check for oral cancer.

• Fine-needle aspiration (FNA). 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. FNA is not used to get samples from changes in your mouth.

Once the biopsy is done, the samples are sent to a lab for testing. They're also often tested to see if they contain a virus called HPV (human papillomavirus). 

Getting your test results

It often takes several days for the results of your biopsy to come back. When your healthcare provider has the results of your biopsy, they will contact you. Ask how you can expect to find out your biopsy results. Will it be a phone call or do you need to make an appointment?

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 your next steps should be.