Being diagnosed with womb cancer

If your GP thinks you may have womb cancer, they will do some of the following tests or refer you to a specialist at the hospital for them:

  • Blood and urine tests – these check your general health and how well your kidneys and liver are working.
  • An internal vaginal examination (sometimes called an internal pelvic examination).
  • Trans-vaginal ultrasound – this uses sound waves to build up a picture of the inside of your womb so your specialist can tell how thick your womb lining is.
  • Biopsy – a sample of cells or tissue is taken from the lining of your womb and checked for cancer cells.
  • Outpatient hysteroscopy – a thin, flexible tube is passed into the womb which gives the specialist a clear picture of the inside of womb and a sample of tissue (biopsy) is taken.
  • Hysteroscopy dilatation and curettage (D&C) – a small operation done under general anesthetic where a tissue sample is taken from the womb lining.

Waiting for your test results can be difficult. It can help to talk about your worries with someone close to you.

How womb cancer is diagnosed

Usually, you begin by seeing your GP, who will ask you about your symptoms.

Your GP may do an internal vaginal examination and press down on your tummy at the same time to feel for anything unusual in your pelvis. This is sometimes called an internal pelvic examination.

You might have a blood test and you may be asked to give a sample of your urine for testing.

Your GP may arrange other tests or refer you directly to a gynaecologist – a doctor who specialises in treating conditions of a woman’s reproductive system.

You will usually be referred urgently (within two weeks) for a clinic appointment if you have:

  • vaginal bleeding after the menopause
  • a lump in the pelvis that your GP can feel
  • ongoing vaginal bleeding in between your periods after a normal pelvic examination.


At the hospital

At the hospital, your specialist will ask about your general health, any other medical problems you have, and whether you have any close relatives with womb or bowel cancer. You may also be introduced to a gynaecology nurse specialist, who will be able to give you information and support.

The gynaecologist will examine you and carry out an internal pelvic examination. You may also have a smear test taken if you haven’t had one recently. After this, they’ll explain any more tests you need to have.


Blood tests

Samples of your blood may be taken to check your general health, the number of blood cells in your blood (blood count) and to see how well your kidneys and liver are working.


Trans-vaginal ultrasound

This uses sound waves to make up a picture of the inside of your womb. It tells your specialist how thick the lining of your womb is. A small probe with a rounded end is placed gently in your vagina. The test can be a little uncomfortable, but shouldn’t be painful. It only takes a few minutes. If it isn’t possible to do the scan through the vagina, it can be done by passing a small device over the tummy (abdomen).


Biopsy

This involves taking a sample of cells or tissue from your womb lining. A doctor called a pathologist will look at the sample under a microscope. If there are cancer cells present, the biopsy results will also usually identify the type of womb cancer it is. Biopsies can be done in several different ways.

Aspiration biopsy

You can have this done at your clinic appointment and you won’t usually need any anaesthetic. Some people may need to have it another time, using a local or general anaesthetic. Your doctor or nurse will gently put an instrument called a speculum into your vagina to keep it open. They carefully pass a fine tube (called a pipelle) through the cervix into your womb.

Then, using gentle suction, they draw some cells from the womb lining into the tube. This might cause you to feel some period-like cramps while it’s being done, but this usually wears off in a few minutes. After the test, you may have light bleeding and some mild period-like discomfort for a couple of days.


Outpatient hysteroscopy

You can have this test in an outpatient clinic. Your doctor or nurse will pass a very thin flexible tube (hysteroscope) with a light on the end through the vagina and cervix into your womb. They may place a speculum in your vagina, and inject a small amount of anaesthetic into the cervix. This helps to open it up a little and allows the hysteroscope into your womb. You may be advised to take some painkillers an hour before the test.

Pictures of the inside of your womb will show up on a screen. Some clear fluid or air is put into the hysteroscope to allow the doctor or nurse to get a better picture. A sample of tissue (biopsy) from the womb lining is taken.

After the test, you’ll have some vaginal bleeding and period-like cramps for a couple of days. You can take mild painkillers to help with this.


Hysteroscopy dilatation and curettage (D&C)

This small operation is done under a general anaesthetic. A hysteroscopy (see above) is usually done at the same time so the surgeon can examine the womb. The surgeon stretches (dilates) the cervix during the operation to open it, and uses a small instrument called a curette to carefully take some tissue from the womb lining. Afterwards, you’ll probably have period-like pains and some vaginal bleeding for a couple of days.

Back to Tests and scans