Endometrial cancer is the commonest type of uterine cancer. If endometrial cancer is suspected based on signs and symptoms, your doctor will recommend certain tests and procedures.
Medical history and examination: Your doctor will ask questions about current symptoms such as vaginal bleeding or discharge, problems with urinating, pelvic pain and pain during intercourse; family history of uterine cancer or other cancers; menstrual history; and current medications. The doctor will also conduct a pelvic examination as a part of physical examination. During the pelvic exam, a doctor typically checks the uterus, vagina, ovaries, fallopian tubes, bladder, and rectum for any abnormalities in their shape or size. The doctor may insert a speculum (a metal or plastic device) in your vagina to open and spread the walls of your vagina so that the cervix (the mouth of your womb) and vagina are seen.
Ultrasound: This is a painless and non-invasive test. It uses high-frequency sound waves which cannot be heard by human ears to view the organs and structures inside the body. The pattern of the echoes produced when the sound waves are reflected from the internal organs such as uterus, ovaries, and liver creates a picture called a sonogram. The radiologist can differentiate between healthy tissues, fluid-filled cysts, and tumours on this picture. A transvaginal ultrasound may be done to look at the thickness and texture of the endometrium. During this procedure a wand-like device (transducer) is inserted into your vagina to get better pictures of the uterus and other pelvic structures. It can help to diagnose abnormal thickness or growth in your uterine lining.
Hysteroscopy: A special instrument with a small fibre optic camera may be passed through the opening of the cervix to look at the uterus. This permits your doctor to examine the inside of your uterus and endometrium for abnormality.
Biopsy: Your doctor will take sample tissue from the endometrium of the uterus and examine it under a microscope to look for cancer cells in the tissue. Endometrial biopsy may be done along with hysteroscopy. It can be done as an outpatient procedure and does not need any kind of anaesthesia. The tissue sample may be obtained by conducting a procedure called dilation and curettage (D&C). D&C is done under general anaesthesia, and tissue is scraped from the lining of your uterus.
Staging endometrial cancer
If endometrial cancer is confirmed by tests, your doctor will try to determine the extent, or stage of your cancer. Staging of the disease is done using x-rays or other imaging procedures such as CT scan and MRI scan, blood tests and other lab tests. CT scan (computed tomography scan) is a painless and non-invasive test similar to ultrasound, which takes a series of detailed pictures of part of the body that is being examined. CT scan can show the cancerous growth, regional spread of tumour or tumour in other places in the abdomen. This may be done if the site of tumour and extent of the spread is not clear. If needed, an MRI scan (magnetic resonance imaging) may be done. It can detect tumours which are very small in size and may not be seen on a CT scan. Staging is useful to determine the extent of disease (size and spread of cancer) and it helps to decide treatment and predict the prognosis.
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