Your GP or dentist will refer you to hospital for specialist advice, tests and treatment. You are likely to see an oral and maxillofacial surgeon (who is qualified as a dentist and a doctor) or an ear, nose and throat (ENT) specialist.

At the hospital, the specialist will ask you about your current symptoms as well as your medical history, and will want to know if you are taking any medicines. The doctor will then examine your mouth, throat and neck.

In order to examine your throat and neck, the doctor may use a small mirror held at the back of your mouth. The doctor may also pass a nasendoscope (a very thin flexible tube with a light at the end) into your nose to get a better view of the back of the mouth and throat.

These tests can be uncomfortable for you, but will only last a few minutes. You may be given a lozenge to suck, which contains a local anaesthetic that numbs the mouth for a few minutes. Alternatively, the area may be sprayed with an anaesthetic spray, which numbs the back of your throat. If you do have a local anaesthetic, you shouldn't eat or drink anything for about an hour afterwards, until your throat has lost the numb feeling. Otherwise there is a risk of things going into your windpipe when you swallow. You could also scald your mouth or throat with hot drinks.

The doctor can only make a definite diagnosis by taking a sample of cells from the abnormal area to examine under a microscope. This procedure is called a biopsy.

Sometimes the biopsy can be taken in the clinic. The affected area is first numbed with some local anaesthetic. A small piece of the suspected cancer is then removed using a very fine needle or a special pair of tweezers (biopsy forceps). However, it is more likely that a biopsy will be taken while you are asleep under a general anaesthetic. This allows the specialist to examine the mouth and throat area closely and take biopsies from any other suspicious areas. Usually this is done during a day visit, but you may need to spend a night in hospital.

By looking at the sample of cells under the microscope, the doctors will be able to tell if cancer cells are present. They will also be able to find out the type of cancer; for example, whether it has begun in the cells lining the mouth and throat (squamous cells).

This is a quick, simple procedure that is done in the outpatient clinic. Using a fine needle and syringe, the doctor takes a sample of cells from a lump and sends it to the laboratory to see if any cancer cells are present. An FNAC may be quite uncomfortable and the area may be bruised for a week or so afterwards.

This is a new test that is still being evaluated in research. It is sometimes used for people with pre-cancerous conditions who need to have regular biopsies. Instead of having biopsies, a small amount of blue dye is painted onto the abnormal area, which is then looked at very closely using a microscope. Microcytoscopy should not be painful although it may be a little uncomfortable.