HomeTopicsDiagnosing Mouth Cancer

Tongue and Mouth Cancer Diagnosis

Early mouth cancer and tongue cancer diagnosis improves both prognosis and survival rates. Mouth cancer diagnosis requires examinations by a medical doctor or dentist, whose expertise in mouth diseases extends beyond teeth and gum care. In any case, diagnosis of oral cavity cancers usually begins with the health professional taking a detailed dental history.

Physical Examination of the Oral Cavity

The doctor or dentist will examine the lips, the inside of the mouth, and the tongue. The inside of the mouth is examined using a bright light. Unusual growths, lesions, and other possible mouth cancer symptoms are noted.

Tongue cancer is the most common form of mouth cancer so all areas of the tongue will be visually examined. Tongue examination requires that the tongue be stuck out. If the tongue cannot be extended sufficiently, the doctor may use a piece of gauze to pull the tongue out further.

As well as examining the tongue and mouth visually, the doctor or dentist will use fingers to feel the floor of the mouth. Portions of the back of the throat may also be felt.

An external examination of the throat may reveal swollen lymph nodes or possibly a hard mass.

Imaging Tools

X-rays of the oral cavity and the throat may be used to look for abnormalities. In some cases, a diagnosis may involve the use of a CAT scan—a series of x-rays of the body that provides images in thin sections.

Biopsy Techniques

Final diagnosis of mouth or tongue cancer usually requires a biopsy. A biopsy is a technique that gathers a sample of suspicious tissue, which is then examined microscopically for signs of cancer. Three different biopsy techniques are used to make a mouth cancer diagnosis.
  • Incisional Biopsy: The biopsy sample is surgically removed.

  • Fine Needle Aspiration: A thin needle is inserted into the mass, and removes a small sample of tissue. Aspiration is used to gather biopsy samples from large masses or lymph nodes.

  • Punch Biopsy: A circular blade cuts a round area of suspicious tissue. The cut area is lifted, and surgically snipped off.

OralCDx®

Less invasive than a biopsy, dentists are increasingly using OralCDx to diagnose oral cavity cancer. OralCDx uses a small brush to gather cells from mouth or tongue lesions. The OralCDx brush firmly "scrubs" the lesion to gather cell samples. Computer analysis of the cells yields a diagnosis. The pressure of the OralCDx brush may cause mild bleeding or abrasions, but the procedure causes no serious complications.

Resources
 
Beers, M. H., & Berkow, R. (ed). Disorders of the oral region [online version]. The Merck Manual of Diagnosis and Therapy, 17th Edition. Merck Research Laboratories, NJ, 1999. Retrieved September 9, 2003, from
www.merck.com/pubs/mmanual/section9/chapter105/105a.htm.

Beers, M. H., & Berkow, R. (ed). Neoplasms of the head and neck [online version]. The Merck Manual of Diagnosis and Therapy, 17th Edition. Merck Research Laboratories, NJ, 1999. Retrieved September 9, 2003, from
www.merck.com/pubs/mmanual/section7/chapter89/89a.htm.

Beers, M. H., & Berkow, R. (ed). Oral examination [online version]. The Merck Manual of Diagnosis and Therapy, 17th Edition. Merck Research Laboratories, NJ, 1999. Retrieved September 9, 2003, from
www.merck.com/pubs/mmanual/section9/chapter104/104a.htm.
 
 
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