Before you begin treatment, your care team will need to diagnose which type of mouth cancer you have. This is a key first step in developing the best treatment plan for you.
To start, your care team will take a complete medical history. They will want to know about any risk factors you may have, including your history of tobacco use and alcohol consumption.
If you have an ulcer or other possible signs of cancer, your doctor will ask you questions, such as when it developed and whether it has changed in size or appearance.
At Memorial Sloan Kettering, sophisticated pathology and imaging tests provide your care team with a great deal of information. The radiologists and pathologists who perform these tests not only focus on oncology but specialize in head and neck cancer. This training gives our team the expertise to ensure that you get the right diagnosis and to personalize your care as much as possible.
Throughout the course of your treatment, we’ll continue to use some of these tests to track the size of your tumor and assess your response.
Oral Tissue Biopsy
An oral tissue biopsy is the first step in diagnosing mouth cancer. During the biopsy, your surgeon removes a small amount of abnormal tissue from the area where mouth cancer is suspected. The tissue sample is then sent to a pathologist, who examines it under a microscope and works with the other members of your care team to make a diagnosis.
If surgery is part of your treatment, your pathologist will examine a sample of the tumor your surgeon removed to confirm the diagnosis.
At MSK, we have a team of pathologists whose sole focus is diagnosing cancers of the head and neck. This specialization allows them to make the most precise diagnosis possible. A more precise diagnosis can improve the effectiveness of your treatment or spare you from treatment that won’t work against your disease.
Diagnostic Imaging for Mouth Cancer
As part of making a diagnosis, a radiologist will take special x-rays of your mouth, such as CT scans, MRIs, or Panorex. (A Panorex is an x-ray that shows the full upper and lower jaw, plus the sinuses.)
These imaging tests provide more details about the tissue. If cancer is found, the scans can show how deep the cancer is and if it has spread.
At MSK, our radiologists use the most advanced imaging technologies to safely detect and monitor cancer. Their deep knowledge of mouth cancer allows them to choose the imaging approach that’s best for you and to define the precise extent of your tumor.
Genomic Testing for Advanced Mouth Cancer
Genomic testing is also called tumor sequencing or molecular profiling. It involves looking at the cells obtained from a biopsy to see if there are any genetic mutations (changes in your genes) that could be linked to the type of cancer you have.
For people with advanced disease, our experts use a testing approach called MSK-IMPACT™. This test, developed by MSK experts, screens for mutations in more than 450 genes at once.
Based on which mutations we find, we may have a drug that has been approved for the changes in your specific tumor. Or you may be able to join a clinical trial that is testing a new drug.
Genetic information about your tumor can also help us predict the chances that your cancer will return after treatment.
Almost all of these genetic changes are found only in cancer cells, not in normal cells, which means they cannot be passed on to your children.