Diagnosing Oral Cancers

Last modified on July 25th, 2018

Diagnosing Oral Cancers

We have a number of methods at our disposal in order for quick and accurate diagnosis.


If you have symptoms that may indicate cancer, your dentist or doctor will examine the inside of your cheeks and lips, the floor and roof of the mouth, the tongue and the lymph nodes in your neck. He or she will ask questions about your health and past illnesses and dental problems.

Flexible Nasoendoscopy(FNE)

If your symptoms suggest the possibility of a lesion in the back of the nose / throat / larynx then an FNE is usually performed. This straightforward test is usually well tolerated, and involves placing a small camera inside the nose which enables the surgeon to view the back of the throat. This can be done in-clinic.

If your doctor suspects you may have oral cancer, one or more of the following tests may be used to find out if you have cancer and if it has spread.


Incisional biopsy

A simple procedure where a small sample of tissue is taken from the area of concern either under local anaesthesia or sometimes under a short general anaesthetic depending on the circumstances.

Fine-needle-aspiration biopsy(FNA)

This involves placing a needle in to a neck lump – usually under ultrasound guidance to collect a sample of cells. These cells are then looked at under the microscope by a pathologist to reach a diagnosis.

Imaging tests

Mouth cancers can spread and invade local structures such as the jaws, and are most likely to spread to the lymph glands in the neck. It’s relatively rare for mouth cancers to spread elsewhere in the body but they can occasionally spread to the lungs.

This is why scans are also performed of the neck and chest in addition to scans of the tumour itself. These are called staging scans because they enable us to understand how advanced the tumour is and helps inform treatment options.

CT scan with contrast

This is a type of x-ray which gives lots of useful detail, and is usually the imaging of choice for the chest and neck to look for signs of spread or metastasis.

MRI (Magnetic Resonance Imaging) scans

These can give a high level of detail particularly of the primary tumour.

OPT – Dental x-rays

It’s important that your teeth are assessed prior to treatment. If your require radiotherapy then the jaws are at risk of infection. Any dental issues are best addressed prior to treatment.

PET Scan

This is a special type of scan which combines a CT scan with imaging of biological activity. This works on the premise that tumours are more metabolically active than normal tissue. These scans are typically used in the context of recurrent disease or to investigate an “unknown primary”, ie to find a tumour when the metastasis has already been proven.

US Scan (Ultrasound)

This is a scan performed by one of our specialist head and neck radiologists and is particularly good at examining lumps in the head, neck, and face. Our radiologists can often diagnose lumps from their appearance and certain characteristic features on the scan.

Sometimes this is confirmed with a biopsy which takes a sample of cells from the lump for analysis by a pathologist.