How cancer of the uterus is diagnosed

Physical examination

Your doctor will feel your abdomen to check for swelling.

Your doctor may also look at your vagina and cervix using a speculum (a bit like having a cervical smear).

Transvaginal ultrasound

In this test, sound waves are used to create a picture of internal organs.

A small device called a ‘transducer’ is put into your vagina. Using the ultrasound, the doctor can look at the size of your ovaries and uterus and the thickness of the endometrium. If there is anything unusual, your doctor will suggest that you have a biopsy.

Biopsy

In a biopsy, a sample of the endometrium is taken to be looked at under a microscope. This is usually done in the doctor’s rooms using a small sampling instrument called a pipelle.

Another method of biopsy is called hysteroscopy.

‘After the shock, I thought, well, I’m not going to let a few rogue cells beat me. My family said I was a “tough old bird” and I would get through.’ Sue

Your doctor will look inside your uterus by stretching the cervix opening and inserting a device called a hysteroscope.

There are different ways of taking tissue samples from the inside of the uterus:

  • Tissue can be snipped out, or a spray of fluid may be used to dislodge cells.

  • Tissue can be removed using a suction device. This method is called endometrial aspiration.

  • Sometimes most of the uterus lining is scraped out. This is called a D&C (dilatation and curettage).

Afterwards, you may have period-like cramps and light bleeding, which can last for a few days.

X-rays

You may have a chest X-ray.

Scans (CT, MRI and PET)

CT Scan – this is a type of X-ray that gives a cross-sectional picture of organs and other structures (including any tumours) in your body. This is the usual way of looking for cancer which has spread outside the uterus.

Magnetic Resonance Imaging (MRI) – this test uses magnetism to build up pictures of the organs in your abdomen. The MRI machine is a long cylinder (tube), and when scanning is taking place it is noisy.

Positron Emission Tomography (PET) – you will be given a small amount of low dose radioactive glucose which is ‘picked up’ by rapidly dividing cells. The position of radioactive glucose can be seen on the scan.

The scans take less than an hour. Most people are able to go home as soon as their scan is over.

Blood tests

You may have blood tests to check your general health and to help with making decisions about your treatment. You may have a CA125 blood test. CA125 is a tumour marker which is a chemical produced by cancer cells, which can get into the blood stream. Some women with cancer of the uterus have raised levels of CA125, but not all.

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