Diagnosis & Evaluation
MEDICAL HISTORY AND EXAMINATION
A Surgeon needs to obtain a detailed history of the presenting complaints as well as personal and family history. The doctor will then do a detailed examination of the oral cavity, nose, throat and neck.
Areas that cannot be visualized from the oral cavity can be visualized with a small tube with camera called a flexible endoscope. This can usually be done in the office under local anesthesia and allows a direct view of areas that would normally not be visualized. Occasionally the endoscopy cannot be done in the office and needs to be done in the operating theater under general anesthesia.
Imaging tests such as an ultrasound, CT scan or MRI are commonly employed to visualize the head and neck region. The type of imaging test ordered depends on the location and size of the lesion and at times a combination of the tests may be used. A PET scan is also commonly employed in advanced stage lesion.
A small piece of tissue is necessary to complete the diagnosis and this is obtained by doing a biopsy. The biopsy can be obtained using a needle or forceps or scalpel. The biopsy is taken under local anesthesia or general anesthesia depending upon the location of the suspected lesion.
Once the diagnosis has been made with all the steps, the clinical stage can be ascertained. The TNM (Tumour, Node and Metastases) staging is most commonly used for H&N cancers. The staging helps decide the course of treatment and prognosis of the patient.