Diagnosis of Laryngeal Cancer

Booklet: What You Need to Know about Laryngeal Cancer

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Diagnosis

To find the cause of any of these symptoms, the doctor asks about the patient's medical history and does a complete physical exam. In addition to checking general signs of health, the doctor carefully feels the neck to check for lumps, swelling, tenderness, or other changes. The doctor can also look inside the larynx in two ways:

Indirect laryngoscopy. The doctor looks down the throat with a small, long-handled mirror to check for abnormal areas and to see whether the vocal cords move as they should. This test is painless, but a local anesthetic may be sprayed in the throat to prevent gagging. This exam is done in the doctor's office.
Direct laryngoscopy. The doctor inserts a lighted tube (laryngoscope) through the patient's nose or mouth. As the tube goes down the throat, the doctor can look at areas that cannot be seen with a simple mirror. A local anesthetic eases discomfort and prevents gagging. Patients may also be given a mild sedative to help them relax. Sometimes the doctor uses a general anesthetic to put the person to sleep. This exam may be done in a doctor's office, an outpatient clinic, or a hospital.

If the doctor sees abnormal areas, the patient will need to have a biopsy. A biopsy is the only sure way to know whether cancer is present. For a biopsy, the patient is given a local or general anesthetic, and the doctor removes tissue samples through a laryngoscope. A pathologist then examines the tissue under a microscope to check for cancer cells. If cancer is found, the pathologist can tell what type it is. Almost all cancers of the larynx are squamous cell carcinomas. This type of cancer begins in the flat, scale-like cells that line the epiglottis, vocal cords, and other parts of the larynx.

If the pathologist finds cancer, the patient's doctor needs to know the stage (extent) of the disease to plan the best treatment. To find out the size of the tumor and whether the cancer has spread, the doctor usually orders more tests, such as x-rays, a CT (or CAT) scan, and/or an MRI. During a CT scan, many x-rays are taken. A computer puts them together to create detailed pictures of areas inside the body. An MRI scan produces pictures using a huge magnet linked to a computer.

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