Endometrial Cancer

Diagnosis

If a woman has symptoms of endometrial cancer, her doctor asks about her medical history and conducts a physical exam. In addition to checking general signs of health, the doctor usually performs blood and urine tests and one or more of the following procedures:

  • The doctor performs a pelvic exam, checking the vagina, uterus, ovaries, bladder, and rectum. The doctor feels these organs for any lumps or changes in their shape or size. An instrument called a speculum is used to widen the vagina so the doctor can see the upper portion of the vagina and the cervix.

  • The Pap test is often performed during a pelvic exam. The doctor uses a wooden scraper (spatula) or small brush to collect a sample of cells from the cervix and upper vagina. The cells are then sent to a medical laboratory to be checked for abnormal changes. Because endometrial cancer begins inside the uterus, it may not show up on a Pap test, which examines cells from the cervix.

  • A biopsy is necessary to help the doctor make an endometrial cancer diagnosis. A biopsy can usually be done in the doctor's office. In a biopsy, the doctor removes a sample of tissue from the uterine lining.

  • In some cases, a woman may require a dilation and curettage (D&C), which is usually same-day surgery done in a hospital with anesthesia. During a D&C, the opening of the cervix is widened and the doctor scrapes tissue from the lining of the uterus. A pathologist examines the tissue to check for cancer cells, hyperplasia, or other conditions. After a D&C, women may have cramps and vaginal bleeding during healing.

Endometrial Cancer Staging

Once endometrial cancer is diagnosed, the doctor needs to know the stage, or extent, of the disease in order to plan the best treatment. Endometrial cancer staging procedures help the doctor find out whether the cancer has spread and, if so, what parts of the body are affected. For most women, endometrial cancer staging procedures include blood and urine tests and chest x-rays. Doctors may also order a CT scan, MRI, sigmoidoscopy, colonoscopy, ultrasonography, or other x-rays.

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