What to Expect at Your Doctor’s Visit?
Step 1: History
First, your head and neck specialist will take a thorough history of your health and address any specific concerns you may have.
Your doctor might ask questions such as:
- How long has the problem been there?
- Is it getting worse, better or staying the same?
- Does it come and go?
- Have you tried anything to make it better?
- Is it painful?
- Do you have numbness or tingling anywhere in your face or mouth?
- Do you have any lumps or bumps in your neck?
- Are you losing weight?
- Do you have any other medical conditions?
- Have you had any surgeries in the past?
- What medications do you take? And do you have any allergies?
- Have you ever been exposed to radiation in the head and neck?
- What do you (or did you) do for a living?
- Do you have a family history of cancer?
Step 2: Physical Exam
Next, your doctor will examine you. Typically, if you’re seeing a specialist in head and neck disorders, you will get a thorough physical examination focused on the area of concern.
You should also expect the doctor to:
- Feel your neck to carefully check for any lumps or bumps
- Look inside your ears
- Look inside the front of your nose
- Check your cranial nerves by asking you to move your face, stick your tongue out, lift your shoulders, follow his or her fingers around with your eyes, do some simple hearing tests and test your sense of touch all over your face
Your doctor might even put a camera in through your nose using a fibreoptic scope to take a look at the back of your throat.
Step 3: Reviewing Tests
After getting your history and performing a physical exam, your doctor will review any imaging, laboratory work and pathology results you may have already had. Be sure to bring all of these with you to your appointment. Bring actual discs of any scans you’ve had, as well as any reports of those scans. If you are seeing a head and neck cancer specialist after a lesion was removed by a non-cancer specialist, you need a thorough review of the pathology to discuss whether additional treatment is necessary. Try to obtain the actual glass slides that were prepared by the pathologist with the specimen taken during your biopsy procedure so your doctor can conduct a complete review. You might need more tissue removed or further treatment.
Step 4: Recommendations
Finally, your doctor will make recommendations about your next steps. This will likely include reviewing some of the studies you’ve already had done or ordering more tests. Once your doctor has all the necessary information, you should be given a preliminary stage and discuss treatment plans.
If the tumour is very large and is putting your breathing at risk, your doctor might recommend you undergo a tracheotomy, which is a breathing tube placed into the front part of your neck directly into your windpipe.
Also, if you are just not able to get enough nutrition by mouth because of the tumour, your doctor might recommend that you receive a feeding tube. This will help make sure you are in good shape to undergo the treatment that you will need to beat the cancer. If you have lost weight, your doctor may give you a choice of getting enough nutrition by mouth by increasing the number of calories in your diet or by undergoing placement of a feeding tube. There are a variety of nutritional supplements that you can eat or drink that can help to achieve that goal. You may want to meet with a nutrition expert early during your treatment. Note that for esophageal cancers, your doctor will probably recommend a special type of feeding tube called a J-tube (or jejunal feeding tube). This is different from a G-tube (gastric tube). This is important because if surgical resection is a possible treatment for your cancer, sometimes your stomach is used as a new esophagus, and it is better if the stomach doesn’t have a feeding tube in it. The J-tube is placed in the jejunum, which is the organ further down the GI tract from the stomach.