Diagnosing Endometrial Cancer
If you have symptoms that suggest endometrial cancer, you should make an appointment with your gynecologist. They will try to find out what’s causing the problems since there are several conditions that could have similar symptoms.
Endometrial cancer begins inside the uterus, so it does not usually show up in Pap test results. Because of this, a sample of endometrial tissue is taken during a short procedure and checked under a microscope to look for cancer cells. One of the following procedures may be used to get that sample of tissue from the endometrium (inner lining of the uterus):
- Endometrial biopsy: This is the most common way of determining if there is cancer present in the lining of the uterus. The procedure is done in the doctor’s office and doesn’t require either an outpatient or inpatient hospital procedure. You’re awake for the entire process.
The doctor inserts a thin, flexible tube through the cervix and into the uterus. The tube is used to gently scrape a small amount of tissue from the endometrium and then remove the tissue samples. In most cases, this process is highly accurate.
- Hysteroscopy: A procedure to look inside the uterus for abnormal areas such as a tumor. A hysteroscope is inserted through the vagina and cervix into the uterus that’s filled with saline. A hysteroscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer. Most patients are awake for this procedure that’s typically done with local anesthesia.
- Dilatation and curettage: A procedure where the cervix is dilated and a curette (spoon-shaped instrument) is inserted into the uterus to remove tissue. This procedure is also called a D&C. This might be done if the biopsy wasn’t clear or more tissue needs to be tested. This is typically done in an outpatient setting with anesthesia.
Other tests and procedures used to diagnose endometrial cancer include the following:
- Physical exam and health history: An exam of the body, including the pelvic area, to check general signs of good health or signs of disease, such as lumps or anything else that seems unusual. A note of the patient’s health habits and past illnesses and treatments will also be documented.
- CA-125 blood test: This blood test can tell your doctor if there are high levels of CA-125 in the bloodstream, typically indicating the presence of endometrial or ovarian cancer. However, not all patients have a lot of CA-125 in the bloodstream, so a low number doesn’t necessarily rule out cancer.
- Transvaginal ultrasound exam: An internal exam used to look at the vagina, uterus, fallopian tubes, and bladder. An ultrasound transducer (probe) is inserted into the vagina and bounces high-energy sound waves (ultrasound) off internal tissues or organs and makes echoes. The echoes form an image of body tissues called a sonogram. The doctor can identify any abnormalities or tumors from the sonogram.