The diagnosis phase of tongue cancer can be difficult and overwhelming. During this phase, further testing will be necessary to confirm a diagnosis and determine the best course of treatment. Patients can expect their doctor to have a discussion with them about the risks, benefits, and alternatives to each of the following approaches.
Physical Exam
Because the tongue is readily accessible in the mouth, doctors may rely on a physical examination to establish an initial suspected diagnosis. More tests will follow, as described below.
Imaging
Imaging scans, also known as radiologic studies, provide the doctor with an inside view of the body. Imaging of the head and neck will be required to determine the extent as well as the behavior of a growth, and may be required prior to treatment of a tumor in the tongue. The most common initial imaging tests used are CT and MRI scans. A more advanced imaging study called a PET/CT will likely also be performed to evaluate if the cancer has spread to other sites in the body as well as to determine if lymph nodes in the neck are likely to harbor cancer cells.
Biopsy
A biopsy is the removal of a small piece of tissue to examine under a microscope to see if it is cancerous. A biopsy of a suspicious area in the mouth (or mass in the neck) is usually needed prior to treatment. There are a few different ways to perform this biopsy, but the most common and easiest approach is an incisional or punch biopsy. In some cases, a fine needle aspiration (FNA) biopsy of any suspicious lymph nodes in the neck may also be helpful.
