If cancer is found, other lab tests may also be done on the biopsy samples to help better classify the cancer. Tests for certain proteins on tumor cells: If the cancer has spread metastasized or come back, doctors will probably look for certain proteins on the cancer cells. For example, cancer cells might be tested for the PD-L1 protein, which, if found, might predict if the cancer is more likely to respond to treatment with certain immunotherapy drugs. Imaging tests use x-rays, magnetic fields, or radioactive substances to create pictures of the inside of your body.
Imaging tests are not used to diagnose laryngeal or hypopharyngeal cancers, but they're done for a number of reasons after a cancer diagnosis, such as:. This test can help your doctor determine the size of the tumor, see if it's growing into nearby tissues, and find out if it has spread to lymph nodes in your neck. It might also be done to look for the spread of cancer to your lungs or other organs. But MRI scans use radio waves and strong magnets instead of x-rays.
A contrast material called gadolinium may be injected into your vein before the scan to get clear pictures. An MRI scan can be done to look for spread of the cancer in the neck and other areas of the body, too. A chest x-ray might be done to see if the cancer has spread to the lungs, but more often a CT scan of the lungs is done since it tends to give more detailed pictures. For a PET scan , a slightly radioactive form of sugar known as fluorodeoxyglucose or FDG is injected into the blood and collects mainly in cancer cells.
A PET scan may be used to look for possible areas of cancer spread, especially if the main cancer is more advanced. This test can also be used to help tell if a suspicious area seen on another imaging test is cancer or not. This lets the doctor compare areas of higher radioactivity on the PET scan with a more detailed picture on the CT scan.
For a bone scan , a small amount of low-level radioactive material is injected into the blood and collects mainly in abnormal areas of bone. A bone scan can help show if a cancer has spread to the bones. This test might be done if someone is having a problem with swallowing.
For this test, you drink a chalky liquid called barium to coat the walls of the throat and esophagus swallowing tube. A series of x-rays of the throat and esophagus is taken as you swallow to help show problems.
Other tests may be done as part of a workup in people diagnosed with laryngeal or hypopharyngeal cancer. Cancer Research UK has more information about the stages and grades of laryngeal cancer. Page last reviewed: 21 October Next review due: 21 October The main tests that may be carried out in hospital are described below. Nasendoscopy A nasendoscopy is a procedure used to get a clear view of your larynx. Laryngoscopy If it was not possible to get a good view of your larynx during a nasendoscopy, or a possible problem is spotted, you may have a further test called a laryngoscopy.
Biopsy During a nasendoscopy or laryngoscopy, your doctor may use small instruments to remove a sample of cells from your larynx so it can be examined for signs of cancer. Further testing If the results of the biopsy show you have cancer and there's a risk it may have spread, you'll probably be referred for further testing to assess how widespread the cancer is.
The tests may include: a CT scan — a series of X-rays are taken to build up a more detailed three-dimensional picture of your larynx and the surrounding tissue a MRI scan — a strong magnetic field and radio waves are used to produce a more detailed image of your larynx and the surrounding tissue a PET-CT scan — a CT scan is used to take pictures of the inside of your body after you have been injected with a mildly radioactive substance that helps to show cancerous areas more clearly an ultrasound scan — high-frequency sound waves are used to check for signs of cancer in the lymph nodes glands found throughout the body near the larynx Staging and grading After these tests have been completed, your doctor should be able to tell you the extent of the cancer.
The T stage is given as a number from 1 to 4 — small tumours confined to one part of the larynx are described as T1 tumours and large tumours that have grown into tissues outside the larynx are described as T4.
The N stage is given as a number from 0 to 3 — N0 means the lymph nodes are not affected, whereas stages N2 to N3 mean that 1 or more lymph nodes are affected.
Your doctor may be able to preserve your ability to speak and breathe normally. For larger, more-extensive tumors, it may be necessary to remove your entire voice box. Your windpipe is then attached to a hole stoma in your throat to allow you to breathe tracheotomy. If your entire larynx is removed, you have several options for restoring your speech. You can work with a speech pathologist to learn to speak without your voice box.
Surgery to remove part of the throat pharyngectomy. Smaller throat cancers may require removing only small parts of your throat during surgery. Parts that are removed may be reconstructed in order to allow you to swallow food normally.
Surgery to remove more of your throat usually includes removal of your voice box as well. Your doctor may be able to reconstruct your throat to allow you to swallow food. Surgery carries a risk of bleeding and infection. Other possible complications, such as difficulty speaking or swallowing, will depend on the specific procedure you undergo.
Chemotherapy is often used along with radiation therapy in treating throat cancers. Certain chemotherapy drugs make cancer cells more sensitive to radiation therapy. But combining chemotherapy and radiation therapy increases the side effects of both treatments. Discuss with your doctor the side effects you're likely to experience and whether combined treatments will offer benefits that outweigh those effects.
Targeted drugs treat throat cancer by taking advantage of specific defects in cancer cells that fuel the cells' growth.
As an example, the drug cetuximab Erbitux is one targeted therapy approved for treating throat cancer in certain situations. Cetuximab stops the action of a protein that's found in many types of healthy cells, but is more prevalent in certain types of throat cancer cells. Other targeted drugs are available and more are being studied in clinical trials.
Targeted drugs can be used alone or in combination with chemotherapy or radiation therapy. Immunotherapy uses your immune system to fight cancer.
Your body's disease-fighting immune system may not attack your cancer because the cancer cells produce proteins that help them hide from the immune system cells. Immunotherapy works by interfering with that process. Immunotherapy treatments are generally reserved for people with advanced throat cancer that's not responding to standard treatments.
Treatment for throat cancer often causes complications that may require working with specialists to regain the ability to swallow, eat solid foods and talk. During and after throat cancer treatment, your doctor may have you seek help for:. Your doctor can discuss the potential side effects and complications of your treatments with you. Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness.
Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care. Palliative care can be used while undergoing other aggressive treatments, such as surgery, chemotherapy or radiation therapy.
When palliative care is used along with all of the other appropriate treatments, people with cancer may feel better and live longer. Palliative care is provided by a team of doctors, nurses and other specially trained professionals. Palliative care teams aim to improve the quality of life for people with cancer and their families.
This form of care is offered alongside curative or other treatments you may be receiving. There is a problem with information submitted for this request. Subscribe for free and receive an in-depth guide to coping with cancer, plus helpful advice on how to get a second opinion. You can unsubscribe at any time. Error Select a topic. Error Email field is required. Error Include a valid email address.
Incisional biopsy: In this procedure, a small piece of tissue is cut from an abnormal-looking area. Because the larynx is deep inside the neck, removing samples involves a complex procedure. Biopsies in this region are usually performed in an operating room, with general anesthesia administered to prevent pain. Fine needle aspiration FNA : A very thin needle attached to a syringe is used to extract aspirate cells from a tumor or lump.
Various imaging tests may be performed to help formulate a throat cancer diagnosis, including:. CT scan : A CT scan may provide information about the size, shape and position of any tumors, and may also help identify enlarged lymph nodes that may contain cancer cells.
Barium swallow : A barium swallow test may show irregularities in the different parts of the throat, and may often detect small, early tumors. MRIs provide a very detailed view, and may help determine whether or not the cancer has spread, either to other areas in the neck or other regions of the body.
X-ray : An X-ray of the chest may be taken to check if the cancer has spread to the lungs. Cancer will not be present in the lungs unless it has advanced. Other diagnostic procedures for throat cancer evaluations often involve some type of scope used to inspect the deeper areas of the throat. For example:. Panendoscopy: This is a diagnostic test used to examine the upper digestive system, including the larynx, esophagus, stomach and first part of the small intestine. In this exam, an individual is given general anesthesia in an operating room so that the entire region of the body can be closely inspected for cancer.
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