Diagnosis
If you have any of the symptoms above you should contact your doctor. Your doctor will conduct a physical exam including a pelvic exam and ask you about your medical history, general health, lifestyle, and family history. If your doctor is concerned about your symptoms they may order one or more of the following tests:
Pelvic Exam
Your doctor will feel inside your vagina and rectum with gloved, lubricated fingers to check for any growths or abnormalities on your ovaries or nearby organs. A rectal exam is important since it allows the doctor to feel deep in the pelvis for any growths which might not be felt on the vaginal exam.
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Endometrial biopsy
Your doctor will insert a thin, flexible tube into your uterus and remove a small sample of endometrial tissue. A biopsy is the only way to be certain if cancer is present. This test is very accurate in diagnosing post-menopausal women and can be done in your doctor’s office.
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D&C (dilation and curettage)
Your doctor may perform this procedure if results from the endometrial biopsy are inconclusive or to confirm diagnosis. Your doctor will use metal instruments to enlarge (dilate) the opening of the cervix and then use a tool called a curette to scrape a tissue sample from the endometrium. This is often done in an outpatient surgery setting. This may be performed at the time of hysteroscopy (described below).
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Hysteroscopy
Your doctor will insert a thin, lighted telescope into the uterus and use it to examine the uterus and opening of the fallopian tubes. Your doctor will remove a sample of any abnormal tissue and have it sent to the lab for evaluation.
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Transvaginal ultrasound
Your doctor will insert a wand-shaped scanner with an ultrasound device into your vagina. Ultrasounds bounce sound waves off of your internal organs in order to create echoes that form a picture. A transvaginal ultrasound can create images of the uterus and other pelvic organs and can show if the endometrium is thicker than expected. If the findings are concerning, your doctor may follow this with a biopsy using the above techniques.
Complete Blood Count (CBC)
A CBC measures the levels of the different types of cells in your blood. Women with heavy vaginal bleeding from any cause may have low levels of red blood cells (anemia).
Additional Tests
If you are diagnosed with endometrial cancer, your cancer doctor may order one of the following tests to get a better idea of where the cancer is located.
Chest X-Ray
X-rays use electromagnetic radiation to produce images of the inside of your body. Your doctor may order a chest X-ray to see whether the cancer has spread to your lungs.
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Computed Tomography (CT) Scan
A computed tomography (CT) scan uses X-rays to produce an image of your body. A special dye may be injected into your veins and you may be asked to drink a special fluid in order to make the internal organs stand out. A CT scan reveals the presence of tumors and whether or not the cancer has spread to other parts of your body.
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Magnetic Resonance Imaging (MRI) Scan
Magnetic resonance imaging (MRI) uses radio waves and a strong magnet to create clear and detailed images of body parts. Radio waves are absorbed by your body and then released in a certain pattern, which is translated by a computer in order to show "slices" of your body.
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Positron Emission Tomography (PET) Scan
For a PET scan, the doctor injects a radioactive substance into your bloodstream. This substance collects in malignant (cancerous) cells in your body. The doctor then uses a PET scanner to detect these areas of radioactivity and to find the exact location of the cancer in your body. This study can be paired with a CT scan to completely localize the cancer.
The Society for Gynecologic Oncology recommends consideration of Lynch Syndrome screening of all women with endometrial cancer. This could impact risk of other cancers and future treatment.
