Diagnosis of throat cancer
Your doctor can use one or a combination of many techniques to tell if you have throat cancer. They are:
● Imaging tests
This is an exclusive scope with a light attached to it which your doctor will slide down your throat. This will enable your doctor to carefully examine and analyze your throat to determine if you have throat cancer. Your doctor will be able to explore the pictures of your throat on a particular screen. A tiny camera which is attached to the endoscope will take these pictures.
Your doctor will likely draw blood a few days before your endoscopy to determine if you have blood clots or are prone to developing them. Be sure to tell your doctor about any medicines you take that keep your blood from clotting. These include:
● Arthritis medications
Your doctor may ask you to skip a few doses for a few days if the endoscopy interferes with how these medicines work. You can only sip water 8 hours before the test. You are supposed not to eat anything just like fasting for 8 hours before your endoscopy. This is to keep your throat and esophageal passageway bright and clean.
How an endoscopy is done?
Endoscopies tend to be done in outpatient settings. A trained doctor or (usually) nurse will do the endoscopy. You’ll be wearing a hospital gown and have the upper part of your chest bare. You’ll stay in the clinic for less than half an hour. This theoretically means that you could do the endoscopy on your lunch break and still have time to eat. You will likely be given a sedative or local anesthesia to lessen the discomfort of the endoscopy.
You’ll be asked to lie down and receive the local anesthesia or sedation as an injection. Once you are sleepy, the doctor or nurse will slide the endoscope down your throat into the pipe where food and drinks pass down to go to your stomach. It has an ultrasound probe which emits sound waves. These waves appear as images called ultrasound images on an ultrasound machine. The doctor or nurse will have an excellent view and understanding of the state of your food pipe, stomach, and other relevant and surrounding areas. They are also capable of seeing any swollen lymph nodes you may have. Note that this is a sign of throat cancer. The tube will be slid out of your throat once the procedure is finished.
What happens after the endoscopy?
You are supposed to day rest from work or your regular activities to rest after the endoscopy. Don’t eat or drink anything until the anesthesia or sedation wears off completely. Doing so could cause damage to your mouth and food pipe. Since you can’t drive for at least 24 hours after the endoscopy, have someone else take you to the doctor’s place and bring you back to the home. Also, don’t drink alcohol for at least 24 hours after the endoscopy to avoid throat irritation. You will need someone to look after you in your recovery period.
When to expect the results?
You should have the effects no later than two weeks after the endoscopy.
Potential risks and side effects
Though an endoscopy is generally safe, some people have experienced the following side effects. Some are serious, while others are minor:
● Sore throat
● Small tear(s)
● Fluid in your lungs
● Shortness of breath
Your throat may be mildly or severely sore for up to a full day after the endoscopy. Be sure to call your doctor if the pain is intense or lasts for a few days.
Since the endoscope will introduce large quantities of air into your food pipe, you may feel slight to moderate bloating for a few days after the procedure.
You may experience internal bleeding from the site where the endoscope was inserted and located. This is very rare and tends to stop on its own. However, a few people have needed a blood transfusion afterwards.
This is very rare, but you may be experiencing small cracks in your food pipe and in the areas where the endoscope was near or examined. Since this can be life-threatening, call your doctor immediately if you experience this. You will need to be hospitalized, be given antibiotics through an IV drip, and you may even need reconstructive surgery in this instance.
Fluid in your lungs
You may aspirate fluid into your lungs from your mouth during the endoscopy. This is extremely rare but call your doctor immediately if you have trouble breathing or feel fluid in your lungs. Not doing so could overwhelm your heart and put you down the path of early heart failure.
Shortness of breath
You may be allergic to the sedative and anesthesia. This could cause you to have trouble breathing normally. Consult your doctor immediately in this case. It could save your life. Remember that this is extremely rare because you will be given extra oxygen and have your oxygen levels regularly checked during the endoscopy.
Keep in mind that this and other diagnostic tests to detect throat cancer will depend on the following factors:
● The type of cancer you and the doctor think you have
● The signs and symptoms you have been experiencing
● Your age and overall physical health
● The results of any previous medical tests you may have had
Your doctor will perform any of the following tests on you to determine if you have a throat (laryngeal or hypopharyngeal).
● Physical exam
● Imaging your tumors’ molecules
● CAT scan
● PET-CT scan
● Bone scan
● x-ray/swallowing barium
The doctor will feel your neck and mouth areas for any lumps. He or she will then use a mirror to examine your nose, mouth, throat, and tongue for anything abnormal. You may even have to submit to a urine and blood test to help your doctor better determine if you have throat cancer.
Your doctor has three options when performing this diagnosis
● Indirect laryngoscopy
● Fiber optic laryngoscopy
● Direct laryngoscopy
You will be given local anesthesia in a spray form so that you don’t feel any pain or discomfort during the procedure. This also helps to keep you from gagging, which can interfere with the diagnostic process and even be life-threatening. Your doctor will insert a small mirror with a long handle which will allow him or her to examine your vocal folds and cords.
Fiber optic laryngoscopy
If you have this procedure done, you’ll be given local anesthesia. Then your doctor will thread a flexible tube with an attached light to your food pipe through your nose or mouth. This laryngoscopy will give your doctor a better view of your larynx and hypopharynx. It will be easy for him or her to detect any cancerous tumors or lesions.
Since this is a type of minor surgery, you’ll be in an operating room and be given a general anesthetic or sedative. Your doctor will open up your throat and view it with a laryngoscope. Your doctor will likely do a biopsy. A biopsy is a treatment in which your doctor will snip a small section of tissue off of your larynx. He or she will analyze the tissue underneath a microscope to determine if you have throat cancer. Triple endoscopy is a common practice performed by the doctor on patients to determine if they have cancer. If you have this procedure done, you’ll be put under general anesthesia. Your doctor will do a full examination of your ears, nose, throat, trachea, and bronchus.
If you have this procedure done, your doctor will use a fiber optic video to take pictures of your larynx and examine your larynx thoroughly to see if you have throat cancer. This procedure will give your doctor a great view of the folds inside of your vocal chords. If you do have cancerous tumors, a videostroboscopy will give your doctor an excellent look and understanding of their size and location. He or she will also understand how the tumors have affected the functioning of your throat. Since this is akin to looking at your throat using a microscope. It allows your doctor to see the vital details of your throat, which he or she may miss if he or she viewed your throat with his or her naked eye.
As mentioned earlier, a biopsy is a small section of tissue taken from the inside or outside of your throat, which your doctor can analyze thoroughly for the presence of throat cancer. your doctor will snip off small sections of tissue from your throat area to examine it for cancer. This is vital because the doctor can confirm the presence of throat cancer only if he or she analyzes specific tissues from your throat. Different locations of cancer require different types of biopsies to be done. A common biopsy technique is the fine-needle aspiration biopsy. Your doctor will use a very thin syringe to scrape cells off of certain areas of your throat which he or she thinks have cancerous tumors. The doctor who will analyze your biopsies is called a pathologist. Since other methods of diagnosis are often unable to indicate the presence of cancerous tumors and their locations absolutely, many pathologists prefer to biopsy their patients’ throats before using other diagnostic procedures on them. There are two types of biopsies:
Incisional biopsy – a lab technician will remove a small section of tissue from areas which your pathologist thinks have cancer – cancerous areas tend to feel and look unusual. You’ll need to be given general anesthesia and will have a major surgery done on your larynx.
Fine needle aspiration – a lab technician will use a thin needle with a syringe attached to extract cancerous cells.
If you have this type of diagnosis done, your doctor will examine the molecular structure of specific biopsied tissues underneath a microscope for throat cancer. The critical areas your doctor will look for are proteins, genes, and other components which are only associated with cancerous throat tumors.
You’ll be lying down on a table, and you’ll be given an x-ray exam with a particular machine that will take comprehensive pictures of the inside and outside of your head and throat area in search of throat cancer. The images will be interpreted and converted into 3-D images which indicate the presence of anything strange (like precancerous cells) or cancerous tumors. Your doctor can calculate the exact size of your tumors with this exam.
If your cancer is severe enough or is in certain places in your throat, you’ll be given a CAT scan with dye contrasts to help your doctor see the inside and outside of your head and throat clearing. You’ll be given this dye either through an IV or by swallowing a pill or liquid.
Your doctor will use magnetic technology which will use magnetic fields to take images of the insides and outsides of your head and throat. An MRI will produce detailed images of the soft tissues inside and outside of your throat. Good examples are the insides of your cheeks and your tongue. Your doctor can examine the photos and images to calculate the exact size and location of the tumors. If necessary, your doctor will order a contrast medium MRI which uses a special dye to highlight specific areas of the inside and outside areas of your throat. Your doctor will be able to see issues of concern through these images.
If you have this exam done, it will be done with a CAT scan. This scan recreates detailed images of your internal body organs and tissues which your doctor can analyze for the presence of tumors that indicate throat cancer. You’ll be given radioactive dye through an IV drip which will highlight specific areas of your body for further analysis by your pathologist. Since all of your organs and tissues absorb this dye, and cancerous ones even more so, your pathologist will be immediately able to detect the presence and exact location of your throat cancer.
Your pathologist will examine the insides of the bones in your throat with a radioactive tracer. You’ll be given the tracer in the form of a particular radioactive dye through an IV drip. Your bones will absorb large amounts of this dye, and this is even more true with bones that have developed cancerous tumors. If you don’t have throat cancer at all, all of your bones will appear to be grey. However, if you have malignant tumors, they will appear as dark, highlighted images on bone scan pictures. Your pathologist will order a bone scan for you if he or she thinks your throat cancer has metastasized.
You’ll have a special gel put on the outside of your throat, and a special scanner will scan the area. It will produce sound waves which will be interpreted into somewhat crude but detailed images by an individual computer. It is excellent for detecting cancer, metastasized to your liver, or the lymph nodes located in the back of your neck.
Barium swallow and x-ray exam
Your pathologist will have you swallow small amounts of radioactive material called barium. Your pathologist will then scan your throat area with an x-ray machine which is designed to produce more explicit images, especially of problematic areas.
Refer to the laryngoscopy section for information.