Diagnosis and Investigations
If you have any of the symptoms of womb cancer, you should seek medical advice.
When you see your GP, they may ask you questions about your symptoms and your general health. They may also ask to examine you, which might include a speculum and internal examination (similar to having a smear test).
Your GP may request for you to have blood tests or an ultrasound scan or they may decide to refer you to see a specialist. Your GP might decide that this referral is urgent.
When you see the specialist, they will ask you questions about your symptoms and your medical history. They may also examine you, and arrange for you to have a transvaginal (internal) ultrasound scan.
Transvaginal ultrasound scan
A transvaginal ultrasound scan is a scan performed by a trained sonographer. It uses sound waves to take pictures of your organs and is the same type of scan that is used when women are pregnant. In this case, it is usually performed vaginally, although sometimes an abdominal scan is also needed. The sonographer will gently insert the probe into your vagina. It is not painful but may feel unusual or slightly uncomfortable. The scan takes around 10 minutes to complete.
After you have had the ultrasound scan, the specialist may recommend that you have a hysteroscopy and/or a biopsy of the lining of the womb.
Hysteroscopy
Hysteroscopy is a camera test to look inside the womb. The procedure involves a doctor or nurse passing a hysteroscope, a tiny camera on the end of a thin telescope, through the cervix into the womb. Some fluid is passed through the hysteroscope so that your doctor or nurse can see the lining of your womb more clearly. They may wish to take a biopsy from the lining of the womb during the procedure.
Hysteroscopy can be quite uncomfortable, and some women find it painful. You may wish to take painkillers before the procedure and some doctors are able to offer local anaesthetics or other painkillers during the procedure. A small number of women find the pain is too much and may need to have the procedure performed under sedation or general anaesthetic. Many women experience period-type cramping pains after their procedure and women often report mild vaginal bleeding for up to a week afterwards.
Biopsy
If the doctor thinks you need a biopsy of the lining of the womb, this may be done after or instead of the hysteroscopy procedure. To do this, the doctor or nurse will need to put a speculum (plastic or metal device) into your vagina. They will then pass a thin plastic tube through the cervix into your womb and gently suction out a small sample of cells (biopsy) from the womb lining. This can cause cramping pain during the procedure, but it is quite quick and is normally over in less than a minute.
The doctor or nurse will then send the biopsy off to the laboratory for the cells to be looked at under a microscope. The results are usually back within two weeks.
