Head and Neck Cancer

When you have any of the above symptoms, your primary care doctor will refer you to an Otolaryngologist or Head & Neck Surgeon. Your surgeon will first perform a complete head and neck examination, which will usually include examination of the mouth, flexible fibreoptic endoscopy of the nose, pharynx and larynx and examination of the neck.

Depending on the suspected location and type of tumour, the following investigations may be ordered.

To determine the type of cancer

• Biopsy – removing a small piece of tumour for testing if it can be easily reached
• Fine needle aspiration cytology (FNAC) – using a needle to extract cells for testing, from lymph node or if tumour is deep

To evaluate extent or stage of cancer

• CT or MRI scan of the head and neck region
• CT of lungs and liver
• Bone scan

Miscellaneous tests

• EBV serology – blood test for risk of nasopharyngeal cancer

A diagnostic operation, panendoscopy, may be necessary on top of the above investigations, to accurately determine the extent of the tumour and examine the rest of the areas at risk for a second cancer, which may exist in up to 10% of patients.

This operation involves examining the entire pharynx and larynx (throat), trachea (windpipe) and oesophagus (food passage) with the aid of rigid scopes under general anaesthesia.