women s health issues
Cancer of the Uterus
Diagnosis of Uterine Cancer
Biopsy Sometimes dilation and curettage with hysteroscopy Doctors may suspect endometrial cancer if one of the following is present: Women have typical symptoms, such as vaginal bleeding after menopause or between periods or irregular, heavy, or unusually long periods. A Papanicolaou (Pap) test detects cells from the uterus. If cancer is suspected, doctors take a sample of tissue from the endometrium ( Uterus ) and send it to a laboratory for analysis. An endometrial biopsy accurately detects endometrial cancer more than 90% of the time. Alternatively, an ultrasound device may be inserted through the vagina into the uterus (called transvaginal ultrasonography) to evaluate abnormalities. However, a biopsy is still necessary to make the final diagnosis. If the diagnosis is still uncertain or suggests cancer, doctors scrape tissue from the uterine lining for analysis—a procedure called Dilation and Curettage (D and C). At the same time, doctors usually view the interior of the uterus using a thin, flexible viewing tube inserted through the vagina and cervix into the uterus in a procedure called hysteroscopy. If endometrial cancer is diagnosed, some or all of the following procedures may be done to determine whether it has spread: Blood tests Kidney and liver function tests (using samples of blood or urine) Possibly a chest x-ray If results of the physical examination or other tests suggest that the cancer has spread beyond the uterus, computed tomography (CT) or magnetic resonance imaging (MRI) is done. Staging is based on information obtained from these procedures and during surgery to remove the cancer. Stages are based on how far the cancer has spread and the specific type of endometrial cancer (there are different types, some of which are more likely to spread). Stages range from I (the earliest) to IV (advanced): Stage I: The cancer occurs only in the body of the uterus but not in the lower part (cervix), with possible spread to an ovary for some types of endometrial cancer. Stage II: The cancer has spread into the muscle layer of the uterus or to the cervix. Stage III: The cancer has spread to nearby tissues, the vagina, or lymph nodes. Stage IV: The cancer has spread to the bladder and/or intestines or to distant organs. 