By Dr. Minu Pandey Shah , Gynaecology
Uterine cancers can be very difficult to suspect given the symptoms are similar to any pelvic problem. However, once the doctor suspects that a woman could be suffering from uterine cancer. The following is a list of tests, starting from the most non-invasive, which is a physical exam and covering the entire gamut of tests including blood and urine samples and biopsy and soft tissue scanning (MRI and PET scans).
- Physical exam: When uterine cancer is suspected, the doctor will do a bimanual exam with two fingers of one hand inside the patient’s vagina and another hand on the abdomen. This can help identify nodules or masses in the rectum, vagina, cervix, or uterus.
- Pap smear: An instrument called speculum is used instead of the fingers and can be useful in detecting uterine cancer, though it is more commonly used for cervical cancer.
- Blood and urine tests: These could check for things like blood in the urine, hormonal levels, etc., which could be an indicator of overall health and suspected problems.
- Transvaginal ultrasound: A sound probe is inserted into the vagina and images are taken of the internal pelvic organs, which can help identify any abnormality.
- Hysteroscopy: A device similar to a telescope, known as a hysteroscope, is inserted through the vagina to examine the internal uterine organs. This may be combined with biopsy where a small portion of the suspected uterine area is scraped or sucked out through a pipe and sent for laboratory testing.
- Endometrial biopsy: In most cases, though scanning can help identify the location, size, and shape of the tumour, a biopsy is required to confirm it is indeed a tumour and then further analysis on the type of tumour. A small piece of the uterine tissue is removed through a probe and sent for laboratory testing. This can be done as an isolated procedure or as a part of dilatation and curettage. This is when the uterine wall is literally scraped to clear off remnants and debris from a miscarriage or abnormal growth of the uterus.
- CT or computed tomography: This helps obtain 3-dimensional images which can be used to measure the size of the tumour. Sometimes, a contrast medium (a special dye) may also be used either as an injection or as a drink which can help improve the detailing in the images.
- MRI scan: This soft tissue scanning technique is useful in producing detailed images which can measure the tumour’s location, size, shape, etc.
- PET scan: This uses a radioactive substance, which is absorbed more in cancerous areas. This can also help in confirming if cancer has spread to other parts of the body, which is highly likely in advanced tumours.