The following tests may be used to find gynecologic cancer:
Biopsy – If abnormal cells are found, a sample of tissue is cut from the cervix and viewed under a microscope to check for signs of cancer. A biopsy that removes only a small amount of tissue is usually done in the doctor’s office.
Colposcopy A procedure to look inside the vagina and cervix for abnormal areas. Allows for a magnified view of the vagina and cervix to inspect for precancerous or cancerous changes and to guide biopsies of the abnormal areas.
Dilatation and curettage (D&C) – Usually done in the operating room, so patients can be under anesthesia. This procedure involves removal of tissue samples from the inner lining of the uterus and cervix.
Endocervical curettage – A narrow instrument is used to collect a small amount of tissue from the cervical canal. This is another type of biopsy.
Endometrial biopsy –Usually done in the doctor’s office. The removal of tissue from the endometrium (inner lining of the uterus) by inserting a thin, flexible tube through the cervix and into the uterus. A pathologist views the tissue under a microscope to look for cancer cells.
Pap smear (Pap test) – A brush or a small wooden stick is used to gently scrape cells from the cervix and vagina. The cells are viewed under a microscope to see if they are abnormal.
Pelvic exam – The doctor inserts one or two lubricated, gloved fingers of one hand into the vagina. The other hand is placed over the lower abdomen to feel the size, shape and position of the uterus and ovaries. The doctor may also use an instrument called a speculum to check for signs of disease. After examining the vagina, a rectal exam may be done to check for spread of cancer.
Scans and Imaging
Chest X-ray – An X-ray of the organs and bones inside the chest. An X-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
CT scan (computed tomography) – An X-ray procedure that creates detailed, highly accurate cross-sectional body images.
MRI scan (magnetic resonance imaging) – An imaging technique that provides detailed images of body structures. It uses a magnetic field instead of the X-rays used in a CT scan.
PET scan (positron emission tomography) – An imaging test used to highlight cancer in different parts of the body. A short-lived radioactive substance is injected prior to the scan. Cancerous tissue absorbs more of the substance, and appears brighter than normal tissue on the PET images. Other non-cancerous tissues, such as areas of inflammation, may also “light up.”
Ultrasound exam – High-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.
Blood chemistry studies – A blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that makes it.
CA 125 assay – Measures the “CA 125” in the blood. CA 125 is a substance released by cells into the bloodstream. An increased CA 125 level is sometimes a sign of cancer or other condition.
Cystoscopy – An instrument called a cystoscope is inserted through the urethra into the bladder to check for abnormal areas. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.
Pretreatment surgical staging – This is occasionally done to find out how far the cancer has spread. Knowing how far the cancer has spread assists with planning the proper treatment of cervical cancer.
Proctoscopy – A proctoscope is inserted through the rectum to check for abnormal areas. A proctoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool that removes tissue and can be checked under a microscope for signs of disease.