Endometrial Cancer

Tests and procedures used to diagnose endometrial cancer include:

• Examining the pelvis. A pelvic exam checks the reproductive organs. It’s often done during a regular checkup, but it might be needed if you have symptoms of endometrial cancer.

  During the exam, a health care professional carefully inspects the outer genitals. Two fingers of one hand are inserted into the vagina and the other hand presses on the abdomen to feel the uterus and ovaries. A device called a speculum is inserted into the vagina. The device opens the vaginal canal so the health professional can look for signs of cancer or other problems.

• Imaging tests. Imaging tests make pictures of the inside of the body. They can tell your health care team about your cancer’s location and size. One imaging test might be a transvaginal ultrasound. In this procedure, a wandlike device called a transducer is inserted into the vagina. The transducer uses sound waves to create a video image of the uterus. The image shows the thickness and texture of the endometrium. Ultrasound can help your health care team look for signs of cancer and rule out other causes for your symptoms. Other imaging tests such as MRI and CT scans also may be suggested.
• Using a scope to examine your endometrium, called a hysteroscopy. During a hysteroscopy, a health care professional inserts a thin, flexible, lighted tube through the vagina and cervix into the uterus. This tube is called a hysteroscope. A lens on the hysteroscope allows the health professional to examine the inside of the uterus and the endometrium.
• Removing a sample of tissue for testing, called a biopsy. In an endometrial biopsy, a sample of tissue is removed from the lining of the uterus. Endometrial biopsy often is done in a health care professional’s office. The sample is sent to a lab for testing to see if it is cancer. Other special tests give more details about the cancer cells. Your health care team uses this information to make a treatment plan.
• Performing surgery to remove tissue for testing. If enough tissue can’t be obtained during a biopsy or if the biopsy results are unclear, you’ll likely need to undergo a procedure called dilation and curettage, also called D&C. During D&C, tissue is scraped from the lining of the uterus and examined under a microscope for cancer cells.

If endometrial cancer is found, you’ll likely be referred to a doctor who specializes in treating cancers involving the reproductive system, called a gynecologic oncologist.

Staging endometrial cancer

Once your cancer has been diagnosed, your health care team works to determine the extent of your cancer, called the stage. Tests used to determine your cancer’s stage may include a chest X-ray, a CT scan, blood tests and positron emission tomography, also called a PET scan. Your cancer’s stage may not be known until after you have surgery to treat your cancer.

Your health care team uses information from these tests and procedures to assign your cancer a stage. The stages of endometrial cancer are indicated using numbers ranging from 1 to 4. The lowest stage means that the cancer hasn’t grown beyond the uterus. By stage 4, the cancer has grown to involve nearby organs, such as the bladder, or has spread to distant areas of the body.