A smear test is often performed in women
with abnormal vaginal bleeding. However, it is not an
accurate test for cervical cancer and only about 60%
accurate in good hands. About 20% of endometrial cancers
will be detected on a smear test.
An endometrial biopsy is often performed
in the clinic in women with menstrual problems,
menopausal bleeding, discharge, and post-coital
bleeding. This involves the insertion of a small 2mm
wide plastic tube through the cervix into the womb to
collect cells. It only samples a small percentage of the
inside surface of the womb and is about 90 - 95%
accurate at diagnosing endometrial cancer.
An ultrasound scan is often performed in
women with menopausal bleeding. This is normally done
with a probe that passes through the vagina. An
ultrasound scan may also detect leiomyosarcomas although
the eventual diagnosis is not made until they are
removed and analysed in the laboratory.
This is when a telescope is placed
through the cervix and into the womb. Any cancers are
visualised and biopsied. This can be done under general
anaesthetic and sometimes under local amaesthetic.
Colposcopy is the examination of the cervix using a
specially designed microscope. It can be used to detect
early cervix cancers and is normal done in conjunction
with a cervical biopsy. This is done in clinic with the
woman awake in a gynaecological couch.
This is often done to stage cervix
cancers and involved assessing the tissue either side of
the cervix and looking into the bladder (cystoscopy) and
bottom part of the bowel (sigmoidoscopy).
Unless there is a contraindication,
women with cervix and endometrial cancers should have a
Magnetic Resonance Imaging (MRI) scan. This helps assess
the extent of the disease and influences management.
This involves going into a tunnel and is quite
claustrophobic. Open MRI scans exist but often give less
good images.
A Computer assisted Tomogram (CT or CAT)
scan can help assess the lymph glands in endometrial or
cervix cancers. With with sarcomas normally have a CT
scan of the chest, abdomen and pelvis to assess the
spread of the disease.
Blood tests, chest X-rays, and
recordings of the heart are normally performed prior to
major surgery. A test of the kidney called a creatinine
clearance or another called an EDTA clearance is usually
performed before chemotherapy.
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