Nasal Cancer: How is Nasal Cancer Diagnosed?

January 6, 2005 (Press Release) -- 1) Physical Examination is done carefully and includes a meticulous description of the tumor, including it's location, size, color, texture, and whether it is "fixed" to underlying tissue or can be moved about. the doctor looks for white patches ("leukoplakia") and reddish patches ("erythroplasia") which may be precancerous areas. A through exam of the neck is always done, noting any enlarged glands which may represent the cancer spreading to lymph nodes. the back of the throat is examined, and a mirror is used to visualize the vocal cords ("indirect laryngoscopy"). The nerves which arise from the brain (12 of the called "cranial nerves") supplying the face, eyes, ears, nose and throat are tested to look for signs of nerve invasion or compression by cancerous lymph nodes. Naturally, it is also appropriate to do a complete exam of the rest of the body to assess general health and look for signs of distant cancer spread.

2) Endoscopic Examination means placing a visualization tube under light local anesthesia into the nose and down the throat. the preferred procedure is a "triple endoscopy", which looks at the nose, esophagus and larynx (voice box). Clear Endoscopic visualization of the larynx is called "direct laryngoscopy". A biopsy is taken of any suspicious area, and sometimes "blind biopsies" are taken of areas most likely to develop cancer (such as the tonsil, nasopharynx, pyriform sinus and bse of the tongue). This is also done since, as mentioned 5% of patients will have a "second primary" when they come to medical attention-- that means another simultaneous cancer. Endoscopy is a very safe procedure, and is the clearest way to actually look at tissues of the aero-digestive tract, and take samples for pathologist evaluation (the endoscope has a cutting scissors at its end to take biopsies).

3) Blood and Urine Tests are standard preoperative ones to assess general health; there are no special blood tests ("tumor markers") yet to detect spread of squamous cell cancer as there are for some other cancers. Routine tests include Complete Blood Count ("CBC") to look for anemia and infection. A Blood Chemistry Panel ("SMA") measures sodium, potassium, calcium, phosphorus, blood sugar, cholesterol and liver and kidney function. If a major surgery is contemplated , blood tests for clotting ability (PT, PTT and bleeding time) are standard. A Urinalysis (UA) to check for protein, blood, or infection completes the lab tests.

4) Imaging Tests are done in the radiology department and standardly include a Chest X-ray to look for signs of infection or lung tumors. Special imaging of the head and neck is obtained; a "panorex" is a series of jaw X-rays which is excellent for detecting spread of cancer to local bone. ...

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