Seeing a specialist
After investigating your symptoms, your doctor may choose to refer you to a specialist for further tests. If you are experiencing pain in your throat or mouth when being examined, it is likely you will be referred to an Ear, Nose and Throat specialist at your local hospital.
The tests they conduct will then help them determine what is causing your symptoms. The type of tests you can expect may vary depending on what the suspected cause is.
If you have signs of a lump in your neck, you may be referred to a hospital with a Neck Lump Clinic, where tests are carried out and results are usually available same-day.
NASENDOSCOPY or LARYNGOSCOPY
In order to see the tissue inside your throat more clearly, the doctor may check for abnormalities using a nasendoscopy. A narrow, flexible telescope is gently inserted through your nose and down into the throat for a close look at the throat tissue. This may sound unusual, and may be slightly uncomfortable, but will only take a few minutes. This is commonly done as an outpatient appointment.
A local aneathetic lozenge or spray may be applied to the back of the throat to make it more comfortable – if so, avoid eating or drinking until the effects wear off (usually after about an hour), as food swallowed with a numb throat could go into your windpipe.
ULTRASOUND NECK SCAN
This painless test uses sound waves to detect abnormal shapes and growths inside your neck. A little gel is applied to the surface of your neck before the ultrasound device is passed over your skin. The doctor can then see a picture of your neck and lymphnodes.
One of the most common and important tests for diagnosing cancer is for your doctor to take a biopsy – a sample of cells from the area of concern. The sample can then be examined under a microscope and cancer cells may be detected.
The more common forms of biopsy are below. Occasionally doctors may opt to carry out a biopsy under general aneathetic in order to obtain larger tissue samples or take tissue from any other areas of concern. This can usually be done as day surgery, with most patients able to go home the same day.
While an incision biopsy may sound like a less pleasant procedure than FNA (see below), the sample is taken under local aneasthetic. The doctor handling your incision biopsy will use a scalpel to take a thin slice of tissue from the area of concern. The tissue sample will then be tested. Depending on the size of the sample taken, you may be given stitches to help the area heal properly.
If the tissue is taken from inside your mouth or throat, your doctors may recommend that you avoid hot food and drinks while the tissue heals (usually just a few days). Bruising and soreness are common and no cause for concern.
FINE NEEDLE ASPIRATION (FNA)
This test is used more commonly for patients with suspicious neck lumps, but may also be used to take samples from other areas. A fine needle is used to take a sample of cells from the area of concern, while an ultrasound may be used to help the doctor guide the needle more accurately. This can be a little uncomfortable, but can be done as an outpatient.