Tests to find the cancer
Your doctor will confirm the diagnosis with a number of tests. You may have some or all of the following tests:
Your doctor will feel your abdomen to check for swelling. You may also have a vaginal or cervical examination using a medical tool designed to separate the walls of the vagina (called a speculum). This is similar to having a Pap test, where a doctor removes and examines cells from your cervix.
This test uses sound waves to create a picture of internal organs. A small device called a transducer is put into your vagina. It makes sound waves and receives echoes. A computer creates a picture based on the echoes produced when sound waves meet something dense, such as an organ or tumour.
Using the ultrasound, the doctor can look at the size of your ovaries and uterus and the thickness of the endometrium. If anything appears unusual, the doctor will suggest you have a biopsy.
Hysteroscopy and biopsy
You may have a hysteroscopy and biopsy if your doctor suspects that cancer could be present.
A hysteroscopy is a procedure that allows your doctor to see inside your uterus by stretching and opening the cervix and inserting a telescope-like device called a hysteroscope. At the end of the procedure, the doctor will remove some tissue to be sent to the laboratory for examination under a microscope. This is called a biopsy.
There are different ways of taking tissue samples (biopsies) from the inside of the uterus:
- Tissue can be snipped out, or a spray of fluid may be used to discharge cells.
- Tissue can be removed using a suction device. This method is called endometrial aspiration.
Sometimes most of the uterine lining is scraped out. This is called a dilation and curettage (D&C). A dilation and curettage is the most common and accurate way to remove tissue for a biopsy. These procedures are usually done in a few hours in hospital or at a day procedure clinic. You will probably have a light general anaesthetic. There are risks involved with taking any anaesthetic, so you should ask your doctor about these risks before the procedure.
Afterwards, you may have period-like cramps and light bleeding that can last for a few days.
Even after a diagnosis is made, further tests are often needed to determine the size and position of the cancer, and whether it has spread. This process is called staging.
The results will help you and your doctor decide on the best treatment for you.
You may have a chest x-ray to check that your lungs and heart are healthy. Sometimes special x-rays using dye or barium are taken to test your kidneys, bladder or bowel.
CT, MRI and PET scans
Computerised tomography (CT) or magnetic resonance imaging (MRI) scans allow doctors to see pictures of the organs and other structures (including tumours) in your body. They are usually done at a hospital or radiology clinic.
For a CT scan, you will be asked not to eat or drink anything before the scan, except for a liquid dye. The dye makes your organs appear white on the scans, so anything unusual will show more clearly. You will be asked to lie on a table while the scanner, which is large and round like a doughnut, moves around you.
An MRI scan uses a powerful magnet linked to a computer to take detailed pictures of areas inside the body. The pictures are taken while you lie on a table that slides into a metal cylinder.
Like a CT scan, an MRI scan is painless. However, some people find that lying in the MRI scan cylinder is noisy and claustrophobic. You can usually take someone into the room with you for company. If you feel uncomfortable, let your doctor or nurse know. They can give you medication to make you feel more relaxed.
You might also have a positron emission tomography (PET) scan. In this test, you will be injected with glucose solution containing a small amount of radioactive material. The PET scan detects increased quantities of radioactive glucose in areas of the body where there are cancer cells, because cancer cells can not eliminate this glucose in the way that normal cells do.
These scans usually take less than a few hours, and most people are able to go home as soon as their scan is over.
People who are allergic to iodine may also be allergic to the dye used in a CT or MRI scan. If you think you are allergic, tell your doctor before the scan.
You may also have blood tests to assess your general health. The test results may help you to make treatment decisions.