Doctors use many tests to diagnose cancer and determine if it has metastasized (spread). Some tests may also determine which treatments may be the most effective. For salivary gland tumors, a fine needle aspiration biopsy (cytology) is the preferred method of examination in making a diagnosis. Incisional biopsy should be avoided in essentially every case (with rare exceptions). Imaging tests may be used to find out whether the cancer has metastasized. Your doctor may consider these factors when choosing a diagnostic test:

—      Age and medical condition

—      The type of cancer

—      Severity of symptoms

—      Results of previous tests

A medical history and physical examination have to be done carefully, identifying potential risk factors. If a facial nerve paralysis is present, specific function tests will be required, and an inspection of the oral cavity, hypopharynx, and larynx will also be done. There are no specific blood or urine tests that can detect a salivary gland tumor, and there are no tumor markers (substances found in higher than normal amounts in the blood, urine, or body tissues of people with certain kinds of cancer) for salivary gland cancer known at this time.

The following tests may be used to diagnose salivary gland cancer:

Fine needle aspiration. Cells are withdrawn using a thin needle inserted directly into the tumor. The cells are examined under a microscope for signs of cancer, and should be examined by a cytologist with expertise in salivary gland cancer.

Endoscopy. A thin, flexible tube with an attached light and view lens is inserted through the mouth or nose to examine the head and neck areas. The examination has different names depending on the area of the body that is examined, such as laryngoscopy (larynx), pharyngoscopy (pharynx), or a nasopharyngoscopy (nasopharynx). It is performed using an anesthetic spray or general anesthesia to make the person more comfortable.

Computed tomography (CT or CAT) scan. A CT scan creates a three-dimensional picture of the inside of the body with an x-ray machine. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors.

Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body, especially images of soft tissue, such as the tonsils and base of the tongue.

Ultrasound. In this test, a video image of the inside of the body is produced using sound waves. Ultrasound is used to check lymph nodes in the neck and to assist in fine needle aspiration biopsy.

Positron emission tomography (PET) scan. In a PET scan, radioactive sugar molecules are injected into the body. Cancer cells absorb sugar more quickly than normal cells, so they light up on the PET scan. PET scans are often used to complement information gathered from CT scan, MRI, and physical examination. PET scanning is especially useful to detect possible cancer in other organs (metastasis, or spreading) or hidden primary tumors.

Additionally, a dentist, in his or her evaluation of the person with salivary gland cancer, may order specific imaging studies for the teeth, including a panorex (a rotating, or panoramic, x-ray) of the mandible (jawbones).

To learn about the terms used in this section, read the PLWC Feature: Cancer Terms to Know: Newly Diagnosed.

To learn more about what to expect during common diagnostic tests, read PLWC: Tests and Procedures.

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