Once you have visited your healthcare professional and he/she has determined that you need a confirmation of a suspected area that appears to be either cancerous or precancerous, there are a number and variety of tests and procedures that can be used to properly diagnose oral cancer.

The first part of this diagnosis begins with a preparation of your medical history and a review of any medical records that are available. If you don’t live in a place where these records can easily be requested, steps will need to be taken to obtain copies of these records as soon as possible, either through online resources or physical copies through a postal service. Once these records have been obtained, your healthcare professional will study these records and consult with you one-on-one to get a full and complete understanding (or as much as is possible) of your medical history, lifestyle, and current health condition. You will likely be asked about other family members too, since this information can also help to determine risk factors for certain types of oral cancers. If your mother or father was previously diagnosed with oral cancers, this information is helpful to know because genetics is an important part of any diagnosis.

Next, your healthcare professional will likely conduct a complete physical exam. Even if you have taken a close look in the mirror prior to your visit and already have an idea about whether or not you have oral cancer, this is no substitute for the training and expertise of a professional. Oral cancers may look very similar to ordinary mouth irritations and vice versa. Your healthcare professional will likely closely and carefully examine your lips, mouth, tongue, throat, and teeth/gums to look for any abnormalities or areas of irritation, such as sores, bleeding, inflammation, swelling, or white patches.

Recommended Read: Signs and Symptoms of Oral Cancer

Biopsy

If a suspicious area is found during your exam, your healthcare professional will take the next step, which is likely to remove a sample of your cells for laboratory testing. This procedure is called a biopsy and involves testing the tissue in a lab. This observation typically uses microscopes and confirmation of the development of cells from a prepared slide treated to bring out the characteristics of the cell sample. Unusual or abnormal cells are highlighted in this way.

When obtaining your tissue sample, cells can be removed using different techniques, but are most often are gently cut away using a scalpel, scissors or another surgical tool and placed on a slide or other container used for observation.

Once your sample arrives at the laboratory, the cells are preserved and analyzed as soon as possible. The lab professional studies the sample, looking for cancer cells or precancerous cells that indicate a risk of future problems. A report is prepared and sent back to your healthcare professional. If your sample shows no cancer cells or pre-cancer cells, your healthcare professional will inform you and likely schedule follow-up tests at regular intervals to make sure that your condition remains unchanged.

If your lab sample report shows cancer or pre-cancer cells, your healthcare professional may order a second test. This is to ensure that your sample was given the correct report and analyzed correctly. Even the best labs can make mistakes and when it comes to a proper diagnosis, having two reports to compare together can offer your healthcare provider a better picture of the condition of the area being tested. Some doctors use two different labs for this type of quality assurance.

If your report comes back positive for cancer cells or pre-cancer cells, additional testing begins. These tests can vary dramatically among healthcare professionals. Advancements in oncology occur quickly in the medical field, and some hospitals spend a great deal of time studying the effectiveness of treatments through clinical trials. It is always a good idea to do your own research about where you want your personal healthcare to take place, and if you have a medical history that shows you are at great risk for certain types of cancers, this can be even more important for some people.

Endoscopy

Once mouth cancer is diagnosed, your doctor works to determine the extent, or stage, of your cancer. Mouth cancer staging tests may include using a small camera to inspect your throat. During a procedure called endoscopy, your doctor may pass a small, flexible camera equipped with a light through your nose to examine your throat and voice box. Your doctor looks for signs that cancer has spread beyond your mouth. Endoscopy can be done in the doctor’s office and causes very little discomfort.

Recommended Read: Treatment and Prognosis of Oral Cancer

Imaging

A variety of imaging tests may help determine whether cancer has spread beyond your mouth. Imaging tests may include X-rays, computerized tomography (CT) scans, magnetic resonance imaging (MRI) and positron emission tomography (PET) scans, among others. Not everyone needs each test. Your doctor determines which tests are appropriate based on your condition.

Stages of Cancer

Mouth cancer stages are usually indicated using numbers one through four. A lower stage, such as stage I, indicates a smaller cancer confined to one area. A higher stage, such as stage IV, indicates a larger tumor or that cancer has spread to other areas of the head or neck, or to other areas of the body. Your cancer’s stage helps your doctor determine what treatment options are available for you so that you can make an informed choice.

Here are some brief descriptions of the various stages your doctor may use to evaluate what your diagnosis is:

Stage 1: In this stage, the tumor is under one inch across and has not reached nearby lymph nodes.

Stage 2: In this stage, the tumor typically measures one to two inches and has not reached nearby lymph nodes.

Stage 3: In this stage, either the tumor is over two inches across but has not spread, or it has spread to one nearby lymph node on the same side of the neck as the tumor, and the lymph node (swelling size) is no more than one inch across.

Stage 4: In this stage, the cancer affects tissues around the mouth, lips, and possibly nearby lymph nodes; or testing shows that it has spread to the rest of the body.

Knowing the stage of any cancer is helpful for both healthcare providers and patients. The stage dictates how the cancer is treated as well as the likelihood of recovery. These estimates of recovery are based on statistics, but each person is different and individuals will have unique rates of success at any stage.

All throughout the lives of human beings, cells encounter challenges and dysfunctional cells can develop. In healthy bodies, early dysfunctional cells are identified by the immune system and removed from the body. Cancer is the result in the body when a genetic mutation instructs cells to grow without control. Untreated, oral cancer will start in one part of the mouth, then spread to other parts of the mouth, to the head and neck, and the rest of the body. Mouth cancers typically start in the squamous cells that line the lips and the inside of the mouth. This is called squamous cell carcinoma.

The exact cause of the mutations is unknown, but there is evidence that certain risk factors increase the chance of mouth cancer developing. Even before any cancer is identified in your body, it is reasonable to expect that a healthy lifestyle will minimize your risk for certain types of cancers. This is something that should be discussed on every visit to your healthcare provider, whether you are diagnosed with cancer or not.