Uterine cancer: symptoms and diagnosis
Abnormal bleeding must always be followed up with a thorough investigation that includes taking a sample of the lining of the uterus. A Pap test checks for cancer of the cervix. It does not investigate or protect against cancer of the uterus and is an unreliable guide to the presence or absence of cancer of the uterus.
What are the symptoms of cancer of the uterus?
Unusual bleeding or a watery, bloody discharge from the vagina is the most common symptom. Occasionally, this discharge can be smelly. Other symptoms may include a feeling of bloatedness and discomfort in the abdomen.
In women who have not gone through menopause, the unusual bleeding and discharge can happen between periods, or lead to erratic and/or heavy periods. Bleeding or discharge in women who are past menopause (12 months since last bleeding) is not normal and should always be checked. While the most common explanation is due to vaginal dryness associated with menopause, the only way to be sure whether cancer is present or not is to take a sample of the lining of the uterus for testing in a laboratory.
What tests are available for cancer of the uterus?
If cancer of the uterus is suspected or has been diagnosed you will need to be referred to a gynaecological-oncologist. Your specialist will arrange a number of tests and examinations for you.
Physical examination
A physical examination will include an internal pelvic examination where the doctor checks for a mass or lump in the uterus and lower abdomen. Some women may also need to have procedures that check on the health of the bladder and bowel as part of their pre-operative assessment.
Dilatation and curettage (D&C)/Hysteroscopy
A D&C or endometrial sampling are essential to making a correct diagnosis and this may be combined with a hysteroscopy, a procedure for looking closely at the uterus. These simple procedures may be carried out while you are under a light general anaesthetic and you should only be required to spend a few hours in hospital or at a specialist day procedure centre.
Doctors can look inside the uterus by stretching the cervix opening and inserting a device like a telescope (a hysteroscope). There are several different ways of taking biopsy tissue samples from inside the uterus—by snipping out some tissue or by a spray of fluid to dislodge cells. Some of the womb lining may be removed using a suction device in a method called endometrial aspiration.
X-ray studies
Routine chest X-rays may be taken and a CT scan of the pelvis is often done. Sometimes special X-rays using dye or barium are taken to test how well your kidneys, bladder or bowel are working.
Blood tests
Blood tests may also be taken to assess your general state of health and to help you with making decisions about your treatment.
Once a diagnosis of cancer of the uterus is confirmed, treatment will be recommended by your doctor. It is important that you let your doctor know how you feel about your treatment options and that you understand enough about your illness and the treatment before you have surgery or other treatment.
Last Reviewed: 19 April 2001
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