Tests That Help Evaluate Uterine Cancer

Before your diagnosis, your doctor took a biopsy from your uterus to help find out if you had uterine cancer. It’s likely that your doctor has suggested that you have your uterus removed. If so, samples taken from your uterus after it is removed help your doctor decide whether you need more treatment.

In addition, your doctor may request tests to learn more about your type of uterine cancer, its location, and whether it has spread. Here are some of the tests you may have.

Transvaginal Ultrasound

High-frequency sound waves bounce off internal body parts to create an image of your pelvic area. These images help your doctor see if there are growths in the lining of your uterus. They also help your doctor measure the thickness of the lining. Here’s how it’s done. On the examining table, with your legs in the exam stirrups, your doctor inserts a thin, long probe into your vagina (about the size of a Pap smear speculum). It’s covered with a condom and lubricated. The doctor moves the probe around, and sound waves echo off the organs. A computer creates an image of your pelvic area based on these echoes. You may feel some pressure or mild discomfort. If your uterus has not yet been removed, your doctor may use a catheter to put saline into the uterus. This helps create a clearer image. The images provide information on the uterine size, the thickness of the lining surface of the uterus (endometrium), and if there is any enlargement of the ovaries.

Chest X-ray

A chest X-ray is commonly performed for patients who are scheduled for surgery. It may be used to evaluate for heart or lung problems. And it can show if the cancer has spread to your lungs. The procedure is quick and painless.

Magnetic Resonance Imaging (MRI)

MRIs use radio waves and magnetic fields to create images of your body. In some cases, it is important to know about the depth the cancer extends into the uterine wall, if there is spread to the cervix (tip of the uterus), or if there is spread to the lymph nodes before surgery is performed. Doctors also can use MRI scans to help decide whether or not a tumor is cancerous (for example, evaluating a suspected fibroid). Your doctor will explain why an MRI is needed or why it isn’t. For this test, you lie still on a table as it passes through a tubelike scanner. Then the scanner rotates around you. As it moves, it directs a continuous beam of magnetic waves at the area being examined. A computer uses the data from the magnetic waves to create a three-dimensional picture of the inside of your body. You may need more than one set of images. Each one may take 2 to 15 minutes, so the whole scan may take an hour or more. This test is painless and noninvasive. Ask for earplugs if they aren’t offered. There is a loud thumping noise during the scan. If you’re claustrophobic, you may be given a sedative before having this test.

CT Scan

In some cases, a CT scan can help determine if cancer has spread outside of the uterus. It may also be used to help follow patients after their initial treatment to make sure the cancer has not come back (recurred). During a CT scan, X-rays scan the abdomen and pelvis, typically taking about 30 minute. These special X-rays are more sensitive than a typical X-ray. To have the test, you will need to drink a solution (oral contrast) that passes through your intestines, and in most cases, receive an injection of a medicine (IV contrast dye) that helps with evaluating normal from not normal tissues. You lie still on a table as it gradually slides through the center of the CT scanner. Then the scanner rotates around you, directing beams of X-rays at your abdomen and pelvis. A computer uses the data from the X-rays to create many pictures of your abdomen and pelvis, which can be used together to create a three-dimensional picture. A CT scan is painless and noninvasive. You may be asked to hold your breath one or more times during the scan. Some patients experience nausea or diarrhea after the oral contrast solution. Some patients have an allergy to the injection contrast (iodine allergy), and the contrast can cause some patients kidney injury with its use. Your doctor and the radiologist will determine and explain what is recommended and why.

Blood Tests

Blood tests may be done several times throughout your diagnosis and treatment. Some blood tests help your doctor decide if you’re healthy enough for surgery. There is no specific blood test which checks for endometrial cancer. For some patients, a CA125 blood test, a tumor marker commonly used for patients with ovarian cancer, is used to help follow how you are doing after your cancer is treated.

Other tests are infrequently ordered, but include

Cystoscopy

This test checks to see if cancer has spread to your urethra or bladder. Here’s how it’s done. You have this done in a hospital or an outpatient surgery center. You may be given a local anesthetic to numb the area. Or you may be given a general anesthesia so that you fall asleep and don’t feel anything. You lie flat on your back. Your doctor uses a thin tube with a light, called a cystoscope. The cystoscope may also have a camera in it. He or she inserts the tube up through your urethra and into your bladder. Water is also inserted through the cystoscope. You may feel uncomfortable. And you may feel a strong need to urinate. If needed, the doctor can take a tissue sample to check for cancer. The whole test takes between 5 and 20 minutes. You will need a ride home after the test. You may feel a burning sensation when you urinate for a few days after the test.

An intravenous pyelogram (IVP) is an X-ray of your urinary tract, including your bladder, ureters, and kidneys. First, you’re injected with iodine, which acts as a contrast dye. Then, X-rays are taken over timed intervals to show the flow through the urinary tract. The test may take up to an hour. This shows if cancer has spread to that area.

Positron Emission Tomography (PET)

PET can show for some cancer types where cancerous cells occur throughout the body. A special glucose (sugar) dye injected into your vein helps highlight these cells. Researchers are studying whether PET can help determine which tumors are cancerous and which are not. At the present time, for endometrial cancer, PET scanning is not routinely recommended as it has not demonstrated that it is effective.