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Clinical
Appearance:
Abnormal vaginal bleeding, especially after menopause, is the most common symptom of uterine cancer. Bleeding may start as a watery, blood-streaked flow that gradually contains more blood. Although uterine cancer usually occurs after menopause, it sometimes occurs around the time that menopause begins. Abnormal bleeding should not be considered simply part of menopause; it should always be checked by a
doctor.
A woman should see a doctor if she has any of the following symptoms:
These symptoms can be caused by cancer or other less serious conditions. Most often, they are not cancer, but only a doctor can tell for sure.
Diagnosis
If a woman has symptoms, her doctor asks about her medical history and conducts a physical exam. In addition to checking general signs of health, the doctor usually performs blood and urine tests and one or more of the following procedures:
The doctor performs a pelvic exam, checking the vagina, uterus, ovaries, bladder, and rectum. The doctor feels these organs for any lumps or changes in their shape or size. An instrument called a speculum is used to widen the vagina so the doctor can see the upper portion of the vagina and the cervix.
The Pap test is often performed during a pelvic exam. The doctor uses a wooden scraper (spatula) or small brush to collect a sample of cells from the cervix and upper vagina. The cells are then sent to a medical laboratory to be checked for abnormal changes. Because uterine cancer begins inside the uterus, it may not show up on a Pap test, which examines cells from the cervix.
A biopsy is necessary to help the doctor make a diagnosis. A biopsy can usually be done in the doctor's office. In a biopsy, the doctor removes a sample of tissue from the uterine lining. In some cases, a woman may require a dilation and curettage (D&C), which is usually same-day surgery done in a hospital with anesthesia. During a D&C, the opening of the cervix is widened and the doctor scrapes tissue from the lining of the uterus. A pathologist examines the tissue to check for cancer cells, hyperplasia, or other conditions. After a D&C, women may have cramps and vaginal bleeding during healing.
A woman who needs a biopsy may want to ask the doctor some of the following questions:
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What type of biopsy will I have? Why?
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How long will it take? Will I be awake? Will it
hurt?
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How soon will I know the results?
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If I do have cancer, who will talk with me about treatment? When?
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