Tests and diagnosis

Your doctor will confirm the diagnosis with a number of tests. You may have some or all of the following tests.
Physical examination

The doctor will feel your abdomen to check for swelling. You may also have a vaginal or cervical examination using an instrument designed to separate the walls of the vagina (a speculum). This is similar to what the doctor does when you have a Pap test.

Transvaginal ultrasound

A pelvic ultrasound uses soundwaves to create a picture of the inside of your uterus and ovaries. A small device called a transducer is put both on the abdomen and gently into your vagina. It makes soundwaves and receives echoes. A computer creates an image based on the echoes produced when soundwaves meet something dense, such as an organ or tumour.

Using the ultrasound, the doctor can see the size of your ovaries and uterus and the thickness of the endometrium. If anything appears unusual, the doctor may suggest you have a biopsy. The ultrasound may be uncomfortable but shouldn′t be painful.

A Pap test (Pap smear) is used to check the cells inside the vagina and cervix. Occasionally, cancer celIs are detected in a Pap test, but this is uncommon. A Pap smear isn′t used to diagnose cancer – if cancer is suspected, you′ll have extra tests.

Hysteroscopy and biopsy

You may have a hysteroscopy and biopsy if your doctor suspects cancer is present. A hysteroscopy is a procedure that allows your doctor to see inside your uterus. A telescope-like device called a hysteroscope is inserted through your vagina into your womb and some tissue is removed (biopsy) and then sent to a laboratory for examination. The tissue sample can be taken in different ways:

• Part of the uterine lining is scraped out. This is called a dilation and curettage (D&C) and is the most common and accurate way to remove tissue for a biopsy.
• A spray of fluid may be used to remove cells or tissue can be snipped out.
• Using a long thin plastic tube (a Pipelle) that′s put into the womb through the vagina and gently sucks out cells. This is called endometrial aspiration.

You may have a biopsy as an outpatient under a local anaesthetic. If you have a D&C, you may need a general anaesthetic and stay in hospital for a few hours. Afterwards, you may have period-like cramps and light bleeding for a few days.

X-rays

You may have a chest x-ray to check that your lungs and heart are healthy. Sometimes x-rays using a dye are taken to test how your kidneys, bladder or bowel are functioning.

Blood tests

You might have blood tests to assess your general health. The test results can help you and your doctor make treatment decisions.

Further tests

If the initial tests show you have cancer, you′ll have scans to see if the cancer has spread. These tests are usually done at a hospital or radiology clinic. Each scan can take about an hour, and most people can go home as soon as the procedure is over. Most cancers of the uterus are found early and don′t require further tests.