Nasopharyngeal cancer tests

If you are worried about symptoms, you usually begin by seeing your GP. Your doctor will examine you and ask about your general health. You will be asked about your symptoms, including when you get them and whether anything you do makes them better or worse.

Your doctor will examine your throat, ears and mouth. He or she may also feel the lymph nodes (glands) in your neck. After examining you, your doctor may refer you to hospital for tests and X-rays or directly to a specialist. The specialist is usually a head and neck surgeon.

If you see a specialist, he or she will ask about your medical history and symptoms. The specialist will examine you. You may have blood tests and a chest X-ray to check your general health. Your specialist may arrange for you to have tests in the outpatient department. You may need to have a

• Nasendoscopy
• Biopsy
• Panendoscopy
• Fine needle aspiration

Your doctor may be able to examine the back of your throat using a small mirror. This is called indirect laryngoscopy. Often doctors need to get a better look than they can with the mirror. So the specialist may pass a narrow, flexible or rigid telescope (a nasendoscope) up your nose and down your throat.

The nasendoscope allows the specialist to look at all your upper air passages (the inner parts of your nose, throat and larynx – voice box). As this test may be a little uncomfortable your doctor can use an anaesthetic spray to numb your throat first. If the anaesthetic spray is used you won't be able to eat or drink until the numb feeling wears off, so you may choose not to have this.

The results from the tests and your symptoms may suggest you have cancer. But to get a definite diagnosis your doctor will take a sample of tissue (a biopsy) and look at it under a microscope. As nasopharyngeal cancers can be difficult to get to because they are deep inside the head, you may need to have a panendoscopy to reach it.

Your doctor may ask you to come into hospital to have a panendoscopy

• To get a more detailed look at the abnormal area 
• To get a biopsy of the abnormal area.

A panendoscope is a series of connected telescopes. A head and neck specialist uses a panendoscope to look at your upper airways. There is a camera and light at one end, and an eyepiece at the other. The test is usually done under a general anaesthetic. Your doctor will put the panendoscope up your nose and down your throat. He or she will take biopsies of any abnormal looking areas. The tissue will be examined for cancer cells under a microscope in the lab.

Your doctor may also use a fine needle biopsy to see if the cancer has spread to the lymph nodes in your neck. This is sometimes written as FNA. If your doctor can feel a lump in your neck, you may need to have a FNA. Your doctor will use a thin needle to draw out cells and fluid out of the lump. These cells are sent to the lab and examined to see if they are cancerous.