If you’re having symptoms that might be caused by cancer in the uterus, your doctor will want to check further. Your doctor is likely to ask you questions about these things.
Your health history
Your reproductive history, such as when you had your first period, how many times you’ve been pregnant, and whether you have gone through menopause
Your family history of cancer
Lifestyle habits, such as what you eat
In addition, your doctor may also do a physical exam. Here are some tests your doctor or a specialized nurse may do to check you.
Your doctor places an instrument called a speculum into your vagina to hold it open. It may feel a little uncomfortable, but it doesn’t hurt. With the vagina open in this way, the doctor can see the top part of your vagina and your cervix. Then your doctor will insert a gloved finger or 2 into your vagina and use the other hand to press on your abdomen. This lets him or her feel your uterus, ovaries, bladder, rectum, and vagina to check for lumps or anything else unusual.
Your doctor can do this test at the same time as the pelvic exam. While your vagina is held open with the speculum, your doctor inserts a small wooden spatula or brush to scrape a sample of cells from the cervix and upper vagina. The doctor sends these cells to a lab to be looked at under a microscope to check for cancer. The Pap test does not check cells from inside the uterus. So it doesn’t help diagnose uterine sarcoma. But it can help your doctor find out if your symptoms might be caused by something other than uterine sarcoma.
A biopsy is one way to find out if you have uterine sarcoma. This is done in a procedure that is similar to getting a Pap smear. It is usually done in your doctor’s office. In most cases, you will not need anesthesia. In some cases, your doctor may suggest a local anesthetic. If you need general anesthesia so that you will be asleep, then the biopsy is done in a hospital or an outpatient surgery center. You put your feet in stirrups. Your doctor uses a tool called a speculum to hold your vagina open. Then he or she inserts a thin tube through your vagina and cervix into your uterus to get a bit of tissue. The tissue is looked at under a microscope and checked for cancer. You may have spotting or bleeding for several days afterward.
A D&C is another kind of biopsy. It is usually done in the hospital or surgical center. Here’s how the procedure is done. You may get an anesthetic so that you are asleep and don’t feel pain. Or you may just be numbed in that area. Your vagina is held open with a tool called a speculum. Then, your cervix is opened wider (dilated) to allow instruments into the uterus. Your doctor inserts a small instrument through your vagina and cervix into your uterus. This tool lets him or her scrape away the endometrium, which is the lining of the uterus. You may notice cramps and bleeding after a D&C. A pathologist looks at the cells under a microscope to see if there is any cancer.
Your doctor makes decisions about your diagnosis based on the results of these tests. Your doctor may decide any of the following.
You probably don’t have cancer.
You need more tests to decide whether or not you have cancer. One type of uterine sarcoma, for example, often does not show up in a biopsy.
You don’t have cancer, but you have changes inside your uterus that might turn into cancer in the future.
You have cancer.
You may need other tests to find out the type of uterine cancer you have--uterine sarcoma or endometrial cancer.
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