A biopsy (usually a fine needle aspiration or a core needle biopsy) is needed to determine the type of head and neck cancer. The biopsy can be taken from the neck lymph node under ultrasound guidance. Often a head and neck surgeon will directly exam your nose and throat with a scope to identify any masses. The surgeon can also do a biopsy. For cancers that arise in the oropharynx, p16 staining is often requested.