Uterine and Endometrial Cancer

Tests 

Every new patient exam at Sylvester starts with a detailed history. That may be followed by the following exams or tests:

• Physical Examination, Including a Pelvic Examination 

  During this exam, the doctor checks the vagina, rectum, and lower abdomen for masses or growths. Since this cancer originates inside the uterus, a Pap test may not be as effective for detection.

• Transvaginal Ultrasound Exam

  This test examines the vagina, uterus, fallopian tubes, and the bladder, using. An ultrasound transducer (probe) which bounces high-energy sound waves off internal tissues or organs. The echoes form a picture of body tissues called a sonogram. The doctor may do a biopsy if the endometrium looks too thick.

• Dilatation and Curettage

  A D&C is a kind of biopsy. During this procedure, samples of tissue are removed from the inner lining of the uterus. The cervix is dilated, and your doctor uses a curette (spoon-shaped instrument) or a thin, flexible tube to remove tissue. It is often performed when larger amounts of tissue samples are needed. It is usually done in the hospital or surgical center under a general or local anesthesia. Tissue for biopsy can also be obtained with an endometrial biopsy, a simple office procedure.

• Endometrial Biopsy

  A biopsy is the best way to confirm a cancer diagnosis. An endometrial tissue sample is collected and is examined to see if there are abnormal or cancerous cells in it. This biopsy is often performed in a doctor's office. It may also be done as part of a D&C.

• Hysteroscopy

  During this procedure, your doctor takes a biopsy of the endometrial tissue, while looking inside the uterus through a thin telescope-like tool. Any growths are removed and examined for cancer cells. Hysteroscopy may be done in your doctor's office with a sedative, or as an outpatient procedure with general anesthesia.

  When the surgeon has the needed tissue, the pathology team will run additional tests on the biopsied tissue to determine if the growth is cancerous or pre-cancerous, how quickly the cancer may grow and spread, and how well certain treatments might work.

• Genomic Tumor Profiling

  Also called somatic DNA testing, this is the driver for precision medicine. It looks at your tumor’s molecular signature to identify characteristics indicating how aggressive it is and what types of treatment will work best.

  If cancer is detected, additional tests might be used to determine the extent, or stage of the cancer:

  • CA 125 assay: This is a blood test that measures the level a substance released by cells into the bloodstream. An increased level of CA 125 is may be a sign of cancer or other condition.

  • Immunohistochemistry (IHC): This screening will be performed on newly diagnosed endometrial cancer patients as part of the pathology evaluation to decide if your endometrial disease may be due to an inherited condition, and if genetic testing is needed. There are red flags for possible hereditary cancers, including having a mother, daughter, or sister who has had a gynecologic cancer. Also, having a family history of breast or colon cancer is also associated with an increased risk of developing endometrial cancer. The hereditary risk for uterine cancer is about five percent. We can help you make decisions about approaches to screening and treatment. If you think you fall into one of these categories, ask your doctor about a referral to the cancer genetics clinic, or call (305) 243-6006 to ask for an appointment in the cancer genetics clinic.

  • Computed Tomography (CT or CAT) Scan: A series of detailed pictures of areas inside the body are taken from different angles. The procedure may be combined with injection or oral intake of a dye to help the organs or tissues show up more clearly to look for other organ involvement.

  • PET (positron emission tomography) scan: A small amount of radioactive glucose (sugar) is injected into a vein. Then, the PET scanner rotates around your body and creates a picture of where your body is holding the sugar. Malignant tumor cells appear brighter in the images because they are more active and use more glucose than normal cells.

  • Magnetic Resonance Imaging (MRI): For this test, experts use a magnet, radio waves, and a computer to make a series of extremely detailed pictures of areas inside the body.