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Tests that Help Evaluate Oral Cancer

Your doctor took a sample of cells from your mouth and perhaps your neck in a process called a biopsy in order to know that you have cancer.

Your doctor may request more tests to learn more about your specific type of cancer and its location. These tests provide information that your health care team uses to help decide on the treatment that is likely to be most effective for you. Here are some of the tests you may need to have.

Computed tomography (CT scan)

The CT scan is much more sensitive than a typical X-ray. Your doctor may get scans of your head and neck area, to see if a tumor exists in the oral cavity, lymph nodes, or elsewhere. Your doctor may also get scans of your entire lower jawbone, also called the mandible.

To have the test, you lie still on a table as it gradually slides through the center of the CT scanner. Then the scanner directs a continuous beam of X-rays at your head. A computer uses the data from the X-rays to create many pictures of your jawbone, which can be used together to create a three-dimensional picture.

A CT scan is painless and noninvasive. You may be asked to hold your breath one or more times during the scan. Often, after the first set of pictures is taken, you’ll get an injection of a dye that helps doctors get an even clearer view of what’s happening inside your body. Then technicians take a second set of scans.

Magnetic resonance imaging (MRI)

MRIs are used to determine if cancer has spread from your mouth to your neck. MRIs can also show the size and extent of any cancer that has spread. These pictures can show the difference between normal and diseased tissue.

For this test, you lie still on a table as it passes through a tube-like scanner. Then the scanner directs a continuous beam of radiofrequency radiation at the area being examined. A computer uses the data from the radio waves to create a three-dimensional picture of the inside of your body. You may need more than one set of images. Each one may take two to 15 minutes, so that the whole experience may take an hour or more. You may be injected with a dye before getting this scan to help the doctors get an even clearer view of what’s happening inside your body. This test is painless and noninvasive. Ask for earplugs if they aren’t offered because there is a loud thumping noise during the scan. If you are claustrophobic, you may be given a sedative before having this test.

Positron emission tomography (PET scan)

PET can scan your entire body, so it is more helpful than a series of several different X-rays. The PET scan shows which parts of your body are using glucose (sugar). Glucose use is a sign of active, quickly dividing cells, such as cancer cells. A PET scan may show if cancer has spread to lymph nodes or other parts of the body.

For this test, you get injected with a small amount of radioactive glucose. Then, you lie still on a table that is pushed into the PET scanner, which rotates around you, taking pictures. Some people are sensitive to the radioactive glucose and may have nausea, headache, or vomiting.

Barium swallow

This test is a series of X-rays performed while you swallow a liquid containing barium. This liquid will show up on X-rays. Because people with oral cancer are at risk for cancers of the digestive tract, your doctor may use this test to see if there is cancer in your esophagus. It also shows how well you swallow and whether the cancer is interfering with normal swallowing.

Panorex films

This test uses X-rays to take a picture of your upper and lower jawbones. It can tell whether cancer has spread to these bones. You sit or stand and place your chin on a rest, looking straight ahead. The machine moves around your head, taking the X-ray picture of your jaws.

Chest X-ray

A chest X-ray can help show whether cancer has spread into your lungs. For this test, you stand in front of a rectangular target area where the X-ray film is held. You may be asked to hold your arms to the side or over your head. You take a breath and remain still for a few seconds. You may have an X-ray of your chest from the front and also from the side.

Your doctor will recommend the tests appropriate to your condition. Your age, severity of symptoms, suspected type of cancer, and previous test results all factor into these recommendations. If you have questions about recommended tests, be certain to ask your doctor before agreeing to have them performed. All of your concerns should be addressed before the procedure begins.


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