Your doctor or dentist will examine the tongue, roof of the mouth, back of the throat and the insides of the cheeks and lips. The floor of the mouth and the lymph nodes will also be examined.
Should any abnormalities be discovered during the exam, it is typical for a small tissue sample, or biopsy, to be taken. A pathologist will examine the tissue sample under a microscope to check for cancer cells. This biopsy is important, as it is the only sure way to know if the abnormal area is cancerous.
If the biopsy indicates the presence of cancer, the next step is to determine the stage (extent) of the disease, in order for the doctor to plan the most suitable treatment. Staging also provides information about the prognosis(expected outcome) of your cancer. Tumor stage is determined by the size of the primary tumor, how much it has invaded the tissues and whether the cancer has spread to lymph nodes.
Stage 0: Abnormal cells are found in the lining of the lips and oral cavity. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.
Stage I: Cancer has formed and the tumor is two centimeters or smaller. Cancer has not spread to the lymph nodes.
Stage II: The tumor is larger than two centimeters but not larger than four centimeters, and cancer has not spread to the lymph nodes.
Stage III: The tumor may be any size and has spread to a single lymph node that is three centimeters or smaller, on the same side of the neck as the cancer. Or, the tumor is larger than four centimeters.
Stage IVA: The tumor has spread to nearby tissues in the lip and oral cavity. Or, the cancer has spread to one or more lymph nodes on one or both sides of the neck, and the involved lymph nodes are six centimeters or smaller.
Stage IVB: The tumor may be any size and has spread to one or more lymph nodes that are larger than six centimeters. Or, the tumor has spread to the muscles or bones in the oral cavity, or to the base of the skull and/or the carotid artery. Cancer may have spread to one or more lymph nodes on one or both sides of the neck.
Stage IVC: The tumor has spread beyond the lip and oral cavity to other parts of the body. The tumor may be any size and may have spread to the lymph nodes.