Laryngeal Cancer: Diagnosis
How is laryngeal cancer diagnosed?
If your healthcare provider thinks you might have laryngeal cancer, you'll need certain exams and tests to be sure. Diagnosing laryngeal 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. You may also see an ear, nose, and throat (ENT) specialist, called an otolaryngologist. Or you may see a head and neck surgeon.
What tests might I need?
You may have 1 or more of these tests:
These are the main tests your healthcare provider may do if laryngeal cancer is suspected:
Indirect laryngoscopy. Using a small mirror with a long handle, your healthcare provider looks down your throat. This lets your provider check to see if your vocal cords move normally. The exam doesn't hurt. But your healthcare provider may spray a local anesthetic on your throat to numb it and keep you from gagging. This test can be done in your healthcare provider's office.
Direct laryngoscopy. Your healthcare provider puts a thin, flexible, lighted tube called a laryngoscope through your nose or mouth. This tube lets your provider see areas that can’t be seen with a simple mirror. Local anesthesia will be used to ease discomfort. Or you might be given a mild sedative to help you relax. You may have this test done in your healthcare provider's office, an outpatient clinic, or a hospital. Sometimes, this test is done in the operating room, using a general anesthesia to put you to sleep during the test. Biopsies might be done during this test. (See below.)
This test is like a direct laryngoscopy. But many different parts of the head are checked for cancer. These include the nose, nasal cavity, mouth, throat, windpipe (trachea), and food pipe (esophagus). General anesthesia is used to do this test. So you're asleep and do not feel pain. If any changes are seen, tissue may be taken out for testing (biopsied).
This is a series of X-rays taken while you swallow a chalky substance called barium. The barium coats the inside of your throat so that any swallowing changes can be seen on the X-rays.
In this test, X-rays come from many angles to take a series of pictures of the inside of your body. These images are then combined by a computer, giving a detailed 3-D picture of your insides. A CT scan can be used to check your head and neck. It's sometimes used to check the chest for signs that cancer has spread to the lungs.
This test uses radio waves, large magnets, and a computer to take detailed pictures of the inside of your body. This test may be used to look for cancer in your neck.
If your healthcare provider finds changed (abnormal) tissue, you’ll need a biopsy. A biopsy is the only way to know if you have cancer in your larynx. During a biopsy, your provider takes out a tiny piece of the abnormal tissue while you are under local or general anesthesia. A healthcare provider called a pathologist then tests the tissue for cancer cells. Some of the tests described above can be used to do a biopsy.
It usually takes a few days for biopsy results to come back. A biopsy can sometimes be done in your healthcare provider's office. Or it may need to be done in the hospital with surgery. In that case, you will have general anesthesia so that you're asleep and don’t feel pain during the procedure.
Fine needle aspiration (FNA)
If you have a lump in your neck, it may be a swollen lymph node, also called a lymph gland. Your healthcare provider might use a type of biopsy called a fine needle aspiration (FNA) to see if there are cancer cells in your lymph node. A thin needle is put through your skin into the swollen node and used to pull out some cells. Your skin may be numbed first. This is often done as an outpatient procedure in your healthcare provider's office or a clinic. That means you can go home the same day.
Your healthcare provider will do tests to check blood counts and make sure your liver and kidneys are working well. The levels of certain substances, such as calcium, sodium, potassium, and magnesium, will also be checked.
Getting your test results
When the results of your tests are ready, your healthcare provider will contact you. Your healthcare provider will talk with you about other tests you may need if cancer is found. Ask questions if you don't understand the results and make sure you know what your next steps should be.