How Does My Doctor Find Oral Cancer?

Oral cancers may be found during routine dental or medical exams, or they may be brought to a doctor's attention if they start to cause symptoms. Your doctor or dentist may check for signs of oral cancer during your regular exams. Your doctor may do tests if you have these symptoms that may be caused by oral cancer:

• Unusual sores in your mouth

• Red or white patches

• Unusual swelling in your gums or jaw

• Pain or numbness in the mouth that doesn't go away 

• A lump inside your mouth or in the neck 

• Areas that bleed

• Hoarseness

• Weight loss

If you have signs or symptoms that might suggest oral cancer, your doctor will ask some questions. You’ll probably talk about these issues:

• How long and how severe your symptoms have been

• Current tobacco and alcohol use

• History of tobacco use

• History of alcohol use

• Medical history

• Family history of cancer

In addition to asking you questions, your doctor may also do a physical exam. This involves looking at your head and neck and checking inside your mouth. The doctor may also view the back of your mouth and throat with small mirrors or with a flexible, lighted tube called a laryngoscope or a pharyngoscope.

Based on the results of these tests, your doctor decides whether to do a biopsy to look for cancer.

Using biopsies to diagnose oral cancer

A biopsy is a small sample of tissue that your doctor takes from a suspicious area. A specialized doctor, called a pathologist, examines this sample under a microscope to see if it is cancerous. Samples may be taken from your mouth and from lymph nodes in your neck. The biopsy may be done in the doctor's office or at the hospital.

These are three ways to take a biopsy to check for oral cancer:

• Exfoliative cytology. Your doctor may scrape some cells from the suspicious lesion and put them on a slide. This can be done in a doctor's office.

• Incisional biopsy. Your doctor may cut out a small sample of tissue. If the suspicious area is easy to reach, your doctor can numb your mouth and do this in his office. If the area is deeper in the mouth or throat, this is done in the operating room.

• Fine-needle aspiration. Your doctor may have noticed a lump in your neck. If so, he or she uses a thin, hollow needle to remove a small sample of tissue. This can be done in a doctor's office.

Once the biopsy is completed, the pathologist examines the tissue samples in a lab. He or she looks at the tissue under a microscope to check for cancer cells. It usually takes several days for the results of your biopsy to come back. A biopsy is the only sure way to tell if you have cancer and what kind of cancer it is.