The patient's primary care doctor or dentist usually examines the patient first.
The clinical examinations should include:
- thorough inspection of the mucosa of the mouth and pharynx
- thorough palpation of the neck for enlarged lymph nodes
- biopsy of suspect mucosal lesions
For suspected malignancy, the patient should be immediately referred to an otolaryngologist/clinic.
At Oslo University Hospital, the following examinations are performed according to the UICC certainty level C2 (4).
- Clinical examination
- Chest CT
- CT/MRI of primary tumor area and neck. These examinations give objective measurements for primary tumor and metastases, and are necessary to determine the extent of surgery and modeling of the radiation field.
- Endoscopy and palpation evaluations under anesthesia (non-obligatory.
- Fine needle cytology of regional nodes or tumor covered by mucosa, possibly with ultrasound.
Possible additional examinations:
- Blood tests to evaluate T4, TSH, liver and kidney function
- Chest CT in patients with suspected lung metastases/lung tumor
- Broncho- or esophagoscopy for suspected lung metastases/lung tumor (not obligatory)
- If needed, the patient is evaluated by a lung specialist, cardiologist or other specialists for operability.
- Examination by an oral surgeon/maxillofacial surgeon
The staging form is completed and the patient is evaluated by an interdisciplinary team including a head/neck surgeon, oncologist, pathologist, radiologist, dentist, speech pathologist and cancer nurse.
Evaluation for recurrence is the same as for a primary tumor.