How womb cancer is diagnosed

At your GP Back to top

If they suspect a cancer they may ask about your family history of cancer. The GP may arrange for samples of blood to be taken and may ask you to give a sample of urine.

They may also do an internal pelvic examination to check your womb, ovaries, vagina, bladder and back passage (rectum) for any abnormal lumps or changes in size and shape. You will be asked to lie on your back on a couch with your feet drawn up and your knees apart. Your GP will put one or two gloved fingers into your vagina and press down on your abdomen with the other hand. Your GP can also look inside the vagina using a speculum to spread the walls of the vagina. If you would prefer, you can be examined by a female doctor.

Your GP can also arrange for any other tests that may be necessary. They may need to refer you to hospital or a clinic for these, and for specialist gynaecological advice and treatment.

The symptoms of womb cancer can be vague and it can sometimes be difficult for GPs to decide whether symptoms are caused by a suspected cancer or by a less serious condition. To help GPs the National Institute for Health and Clinical Excellence (NICE)| has produced referral guidelines.

The guidelines state that your GP should refer you for an urgent appointment if you have any of the following symptoms:

• a lump in your pelvis that the GP doesn’t think is caused by fibroids
• vaginal bleeding in post-menopausal women who are not taking HRT
• vaginal bleeding in post-menopausal women that continues for six weeks after stopping HRT
• vaginal bleeding in post-menopausal women taking tamoxifen
• persistent bleeding between periods in women who have had a normal pelvic examination.

An urgent referral means that you should be seen at the hospital within two weeks.

At the hospital Back to top

At the hospital the specialist will ask you about your general health, any previous medical problems, and whether you have any family history of bowel cancer. The specialist will examine you, and will probably repeat the internal pelvic examination.

You may have one or more of the tests described here:

Trans-vaginal ultrasound Back to top

This uses sound waves to make up a picture of the inside of your womb. It will be done in the hospital scanning department. A small device that produces sound waves is gently put into your vagina. The sound waves are then converted into a picture by a computer. This may be uncomfortable but should not be painful and only takes a few minutes. If it’s not possible to do the scan through the vagina it can be done by passing the device over the tummy (abdomen).

Hysteroscopy Back to top

A thin, flexible tube with a light at the end (a hysteroscope) is passed through your vagina into your womb. This allows doctors to look inside the womb and take tissue samples (see biopsy, below). You may have this test as an outpatient under a local anaesthetic. But sometimes a general anaesthetic is needed so you may have to stay in hospital overnight.

After a hysteroscopy you may have some bleeding and period-type pains for a day or so, which can be controlled with painkillers.

Biopsy Back to top

A small sample of cells (biopsy) may be taken from the lining of your womb by a gynaecologist or specialist nurse. This can be carried out in the outpatients department and you will not need an anaesthetic. A fine tube is passed into the womb, and gentle suction is used to remove a sample of the lining. The sample is sent to the laboratory for examination under a microscope.

Hysteroscopy dilatation and curettage (D&C) Back to top

Under a general anaesthetic you may have a procedure called a hysteroscopy dilatation and curettage. A hysteroscopy is performed (as above) and the cervix is stretched so that the gynaecologist can insert an instrument to remove samples of tissue from the inner lining of the womb. These samples can then be examined under a microscope.

After a D&C, most women have period-type pains for a day or so. These can be controlled with painkillers.