Investigations

www.womb.org.uk - 28-Dec-2004

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These are some important investigations that can be performed during diagnosis and assessment of corpus and cervical cancers.

Smear test (Pap smear)
Endometrial biopsy
Ultrasound
Hysteroscopy
Colposcopy
Examination under anaesthetic
MRI scan
CT scan
Other tests
 

Smear test (Pap smear)

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.

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Endometrial biopsy

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.

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Ultrasound

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.

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Hysteroscopy

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.

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Colposcopy

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.

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Examination under anaesthetic

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).

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MRI scan

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.

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CT scan

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.

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Other tests

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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This site was last updated 28-Dec-2004