Diagnosis of Nasopharyngeal Cancer

Doctors perform many tests to find or diagnose cancer. They also do tests to see if cancer has spread to another part of the body from where it began. If this happens, it is called metastasis. For instance, imaging tests can represent if cancer has spread. Imaging tests show pictures of the body from the inside. Doctors can also do tests to learn which treatments would work best.

A biopsy is the sure short way for the doctor to know if an area of the body has cancer for most types of cancer. In a biopsy, the doctor takes a small tissue sample for testing in a laboratory. The doctor may suggest other tests if a biopsy cannot help diagnose.

The doctor may consider given factors when choosing a diagnostic test:

  • Your signs and symptoms
  • The age and general health status
  • The type of cancer suspected
  • The result of earlier medical tests

Doctors use these tests to diagnose NPC:

  • Physical examination and blood tests – The doctor feels for any lumps on the neck, lips, gums, and cheeks during a physical exam. The doctor will look for abnormalities in the mouth, throat, nose, and tongue, often using light or a mirror to get a clearer view. He or she may do a blood test to check antibodies against the EBV virus simultaneously.
  • Endoscopy – An endoscopy helps the doctor see inside the body with a thin, flexible, lighted tube called an endoscope. The person may be sedated as the tube is inserted through the nose or mouth to examine the head and neck areas. Nasopharyngoscopy is when endoscopy is done to look into the nasopharynx.
  • Biopsy – A biopsy removes a small amount of tissue for examination under a microscope. Other tests suggest that cancer is present, but only a biopsy can make a definite diagnosis. A pathologist then analyzes the sample(s). 

Doctors remove the cells with the help of a thin needle inserted directly into the tumour during fine-needle aspiration. During cytologic examination for signs of cancer, the doctor examines the cells using a microscope. The doctor may perform a biopsy using local anaesthesia or general anaesthesia. It is an injection that numbs the area where a procedure is being done. On the other hand, while general anaesthesia makes a person unconscious during a major procedure, such as surgery.

  • X-ray – An x-ray is a method to form a picture of the structures inside of the body, using a small quantity of radiation. Sometimes, the patient may need a barium swallow before having an x-ray. The barium coats the throat and mouth to enhance the image on the x-ray. A doctor may require an x-ray of the skull and chest to learn more about the extent of NPC.
  • Computed tomography (CT or CAT) scan – A CT scan takes images of the body inside using x-rays taken from different angles. A computer combines photos into a detailed, 3-dimensional image that shows abnormalities or tumours. A doctor uses a CT scan to measure the size of the tumour and recognize enlarged lymph nodes, which may indicate the spread of cancer. Before the scan, a contrast medium dye delivers better detail to the image. The doctor can inject this dye intravenously into the patient or given as a liquid to swallow. 
  • Magnetic resonance imaging (MRI) – An MRI uses magnetic fields, not x-rays, to produce detailed body images, especially soft tissue images such as the tongue’s tonsils and base. An MRI is more sensitive than a CT scan in detecting a tumour of the nasopharynx and any possible spread to nearby tissues or lymph nodes. One can use an MRI to measure a tumour’s size. Doctor gives a contrast medium dye before the scan to create a better picture. He or she gives it either as a pill to swallow or injects into a patient’s vein.
  • Ultrasound – An ultrasound uses sound waves to create a picture of the internal organs.
  • Bone scan – A bone scan uses a radioactive tracer to see the inside of the bones. The doctor injects the tracer into the patient’s vein. It collects in areas of the bone and is detected by a special camera. Healthy bone is visible lighter to the camera, and areas of injury, such as those caused by cancer, stand out in the image.
  • Neurological tests – During these examinations, the doctor tests a person’s nerve function, especially the sense of touch in their face and the motor function of specific nerves in the head and neck area.
  • Hearing test – The doctor may perform a hearing test if it seems that fluid could be in the middle ear.

Positron emission tomography (PET) or PET-CT scan creates images of organs and tissues present inside the body. Doctor injects a small quantity of a radioactive substance into the patient’s body. Cells take up this substance using the most energy. The cancer cells which use energy actively take up the radioactive substance, and the scanner then spots this substance to produce images of the inside of the body. However, the radioactivity in the substance is significantly less harmful to patients. A scanner then detects this radioactive substance to produce images of the inside of the body.