7 Steps To Diagnosing Uterine Cancer

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If you have uterine cancer, an early diagnosis greatly improves your chances of being restored to good health. There is no routine test to screen you for uterine cancer. So give yourself – and care team – the best chance of beating this cancer by seeing your doctor quickly about any abnormal vaginal bleeding or pelvic pain.

Many of the symptoms of uterine cancer can also be caused by less serious conditions.

“Many of the symptoms of uterine cancer can also be caused by less serious conditions,” says gynecologic oncologist Michael S. Guy. “With more than 60,000 women diagnosed each year with uterine cancer, we want to find answers as quickly as possible to the source of the symptoms and then offer treatment.”

The most common type of uterine cancer is endometrial cancer, which starts in the endometrium, the lining of the uterus. Uterine sarcoma is less common and begins in the middle layer of the uterus, the muscular myometrium.

Dr. Guy talks about the symptoms and risk factors of uterine cancer.

Click play to watch the video or read video transcript.

A Proven Path To Detect Uterine Cancer

7 Steps to Diagnosing Uterine Cancer smallIf your risk is high or if you notice some of the signs of uterine cancer, your doctor may recommend several of these steps to make an accurate diagnosis:

1. Medical history and physical exam. Your doctor will examine you to understand your general health and to check for lumps or painful areas. You’ll review your personal medical history and family history. Your health habits can also give your doctor important clues.

2. Pelvic exam. This exam includes a gentle press on your lower abdomen to check the size, position, and shape of your uterus and ovaries. Your health care provider will also insert fingers to check for any unusual lumps or growths in your vagina, cervix, uterus, fallopian tubes, ovaries and rectum.

3. Pap test. A Pap test is usually done during your pelvic exam to scrape off sample cells in your cervix for later study. It does not confirm that you have uterine cancer, but it does help your doctor rule out or confirm conditions of the cervix that may cause symptoms you are having.

4. Ultrasound. This test uses sound waves to create images of your uterus and surrounding organs and tissues. A transducer gliding over your lower abdomen records images generated by sound waves bouncing off your pelvic organs. For a better view of the inside of your uterus, your doctor may recommend a transvaginal ultrasound (TVUS). In this case, the transducer gets close-up images from inside your vagina. Your doctor can look for a mass (tumor) or see if the endometrium is thicker than usual, which can signal endometrial cancer. TVUS may also detect a cancer growing into the muscle layer of the uterus (myometrium) or find abnormalities in the vagina, fallopian tubes, or bladder.

5. CT scan or MRI. These imaging tests can help create pictures of the soft tissue of your uterus and help detect abnormal growths.

6. Biopsy/tissue sampling. If the previous tests uncover an area of concern, your health care provider will remove tissue samples from the inner lining of your uterus so a pathologist can study them under a microscope. These methods are the most accurate way to prove if cancer is present.

With endometrial biopsy, your doctor inserts a thin, flexible tube through your vagina and into your uterus. The tube gently scrapes a small amount of tissue from the endometrium. This test is most often done in your doctor’s office.

Dr. Guy talks about the role of endometrial biopsy in screening for uterine cancer.

Click play to watch the video or read video transcript.

Dilation and curettage (D&C) involves widening the cervix and inserting a spoon-shaped instrument called a curette to remove tissue from different parts of the uterus. This may be done as an in-office or outpatient procedure.

7. Hysteroscopy. This office procedure uses a tiny telescope inserted into your uterus to view the uterine lining. Your uterus is filled with a saline (salt) solution to create better viewing. The test also allows your doctor to remove a sample of abnormal tissue for further study.

More Investigation

If diagnostic tests indicate that you do have cancer, other testing can help determine the stage of the cancer and options for treatment.

Medical researchers continue to look for better ways to find uterine cancer early.

“We don’t currently have a universal screening test for uterine cancer, in the same way that a mammogram helps identify breast cancer,” Dr. Guy says. “Researchers continue to investigate whether Pap smears, transvaginal ultrasound or endometrial sampling could be valuable screening tools in picking up uterine cancers early.”

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