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Tests

Tests to find the cancer

The following tests and procedures may be used to find and diagnose uterine sarcoma.

Physical exam and history

An examination of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. Your doctor will also take a history of your health habits and past illnesses and treatments.

Pelvic exam

An examination of the vagina, cervix, uterus, fallopian tubes, ovaries and rectum. The doctor or nurse inserts one or two lubricated, gloved fingers of one hand into the vagina and the other hand is placed over the lower abdomen to feel the size, shape, and position of the uterus and ovaries. A speculum is also inserted into the vagina and the doctor or nurse looks at the vagina and cervix for signs of disease. A Pap test or Pap smear of the cervix is usually done. The doctor or nurse also inserts a lubricated, gloved finger into the rectum to feel for lumps or abnormal areas.

Pap test (Pap smear)

A procedure to collect cells from the surface of the cervix and vagina. A piece of cotton, a brush, or a small wooden stick is used to gently scrape cells from the cervix and vagina. The cells are viewed under a microscope to find out if they are abnormal. Because uterine sarcoma begins inside the uterus, this cancer may not show up on the Pap test.

Dilation and curettage (D&C)

Surgery to remove samples of tissue or the inner lining of the uterus. The cervix is dilated and a curette (spoon-shaped instrument) is inserted into the uterus to remove tissue. Tissue samples may be taken and checked under a microscope for signs of disease.

Endometrial biopsy

The removal of tissue from the endometrium (inner lining of the uterus) by inserting a thin, flexible tube through the cervix and into the uterus. The tube is used to gently scrape a small amount of tissue from the endometrium and then remove the tissue samples. A pathologist views the tissue under a microscope to look for cancer cells.

Further tests

After uterine sarcoma has been diagnosed, tests are done to find out if cancer cells have spread within the uterus or to other parts of the body. This process is called staging. The results will help you and your doctor decide on the best treatment for you.

Surgery may be used to diagnose, stage, and treat uterine sarcoma at the same time. During this surgery, the doctor removes as much of the cancer as possible.

The following surgical procedures may be used in diagnosis:

Laparotomy

An incision (cut) is made in the wall of the abdomen to check the inside of the abdomen for signs of disease. Sometimes organs are removed or tissue samples are taken and checked under a microscope for signs of disease.

Abdominal and pelvic washings

A saline solution is placed into the abdominal and pelvic body cavities. After a short time, the fluid is removed and viewed under a microscope to check for cancer cells.

The following further tests may be used in the staging process:

Transvaginal ultrasound exam

A procedure used to examine the vagina, uterus, fallopian tubes and bladder. An ultrasound transducer (probe) is inserted into the vagina and used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. The doctor can identify tumours by looking at the sonogram.

CT scan

A computerised tomography (CT) scan is a type of x-ray procedure. It makes a series of detailed pictures of areas inside the body, such as the abdomen and pelvis, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues to show up more clearly.

People who are allergic to iodine may also be allergic to the dye used in a CT scan. If you think you may have such an allergy, tell your doctor before the scan.

A CT scan is usually done at a hospital or radiology clinic. You will be asked to lie on a table while the scanner, which is large and round like a doughnut, moves around you.

This procedure is also called computed tomography, or computerised axial tomography.

Chest x-ray

You may have a chest x-ray to check that your lungs and heart are healthy.

Blood tests

You may have blood tests to assess your general health and to help with making decisions about your treatment. An unusual (higher or lower than normal) amount of a substance in the blood can be a sign of disease in the organ or tissue that makes it.

CA 125 assay

A test that measures the level of CA125 in the blood. CA125 is a substance released by cells into the bloodstream. An increased CA125 level is sometimes a sign of cancer or other condition.

Cystoscopy

A procedure to look inside the bladder and urethra to check for abnormal areas. A cystoscope is inserted through the urethra into the bladder. A cystoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.

Sigmoidoscopy

A procedure to look inside the rectum and sigmoid (lower) colon for polyps, abnormal areas, or cancer. A sigmoidoscope is inserted through the rectum into the sigmoid colon. A sigmoidoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove polyps or tissue samples, which are checked under a microscope for signs of cancer.

Barium enema

A series of x-rays of the lower gastrointestinal tract. A liquid that contains barium (a silver-white metallic compound) is put into the rectum. The barium coats the lower gastrointestinal tract and x-rays are taken. This procedure is also called a lower GI series.