Newly Diagnosed?
We Can Help Getting the correct diagnosis and the most appropriate treatment from the start is crucial 
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Our doctors perform any of the following tests to help them make a definitive diagnosis of head and neck cancer and to stage the cancer, or determine how far it has progressed.
Diagnosis
Diagnosing a head and neck cancer incorporates one or more of the following tests:
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Physical Examination & History
First, the doctor or nurse will take a complete medical history, noting all symptoms and risk factors. The doctor will then thoroughly examine the head and neck area, feeling for abnormalities and looking at the inside of the mouth and throat. This is the most important part of the exam, and an experienced physician may be able to detect problems that a less experienced one might not.
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Endoscopy
The doctor may use mirrors and lights to examine hard-to-see areas and may also use a flexible lighted tube called an endoscope to examine areas that are less accessible. Doctors sometimes insert this tube through the nose or mouth, using a topical anesthetic (a medication applied directly to the skin) to make the examination more comfortable. Depending on whether they are examining the nasopharynx, pharynx, or larynx, this examination is called a nasopharyngoscopy, pharyngoscopy, or laryngoscopy. Occasionally, the doctor will perform this type of examination while the patient is under general anesthesia so a very thorough inspection can be done; this is called a panendoscopy.
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Imaging Tests
The doctor may suggest any of several other imaging tests, including a computed tomography (CT) scan, a magnetic resonance imaging (MRI) scan, or an ultrasound exam. Doctors at Memorial Sloan-Kettering also use positron emission tomography (PET) scans to help diagnose head and neck cancers. We use PET scans combined with CT to improve our ability to detect the spread of cancer to lymph nodes in the neck and other areas of the body.
Other possible tests include a panorex (a special x-ray of the jaws), a barium swallow, dental x-rays, chest x-rays, and a radionuclide bone scan (a sensitive method of measuring bone activity).
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Biopsy
If a suspicious area is identified, the doctor may do a biopsy. In some cases doctors will simply remove a few cells or small piece of tissue with either a scalpel or special needle in an outpatient setting. In other cases, the biopsy will be done in the hospital while the patient is under general anesthesia.
Staging
After a diagnosis has been made, staging uses information collected from exams and diagnostic tests to describe how advanced the tumor is and if and where it has spread. This information is used to determine the best course of treatment and to establish an estimate of the patient's prognosis. The TNM (Tumor, Node, Metastasis) staging system is most widely used for head and neck cancers. Head and neck physicians at Memorial Sloan-Kettering helped to develop and update this staging system.
