Diagnosis

If a woman has symptoms that suggest uterine cancer, her doctor may check general signs of health and may order blood and urine tests. The doctor also may perform one or more of the exams or tests described on the next pages.

Pelvic exam A woman has a pelvic exam to check the vagina, uterus, bladder, and rectum. The doctor feels these organs for any lumps or changes in their shape or size. To see the upper part of the vagina and the cervix, the doctor inserts an instrument called a speculum into the vagina.

Pap test The doctor collects cells from the cervix and upper vagina. A medical laboratory checks for abnormal cells. Although the Pap test can detect cancer of the cervix, cells from inside the uterus usually do not show up on a Pap test. This is why the doctor collects samples of cells from inside the uterus in a procedure called a biopsy.

ultrasound The doctor inserts an instrument into the vagina. The instrument aims high-frequency sound waves at the uterus. The pattern of the echoes they produce creates a picture. If the looks too thick, the doctor can do a biopsy.

Biopsy The doctor removes a sample of tissue from the uterine lining. This usually can be done in the doctor's office. In some cases, however, a woman may need to have a dilation and curettage (D&). A D& is usually done as same-day surgery with anesthesia in a hospital. A pathologist examines the tissue to check for cancer cells and other conditions. For a short time after the biopsy, some women have cramps and vaginal bleeding.

Staging

If uterine cancer is diagnosed, the doctor needs to know the stage, or extent, of the disease to plan the best treatment. Staging is a careful attempt to find out whether the cancer has spread, and if so, to what parts of the body.

The doctor may order blood and urine tests and chest x-rays. The woman also may have other x-rays, CT scans, an ultrasound test, magnetic resonance imaging or .

In most cases, the most reliable way to stage this disease is to remove the uterus (hysterectomy). (The description of surgery in the "Methods of Treatment" section has more information.) After the uterus has been removed, the surgeon can look for obvious signs that the cancer has invaded the muscle of the uterus. The surgeon also can check the lymph nodes and other organs in the pelvic area for signs of cancer. A pathologist uses a microscope to examine the uterus and other tissues removed by the surgeon.

These are the main features of each stage of the disease

Stage I -- The cancer is only in the body of the uterus. It is not in the cervix.

Stage II -- The cancer has spread from the body of the uterus to the cervix.

Stage III -- The cancer has spread outside the uterus, but not outside the pelvis (and not to the bladder or rectum). Lymph nodes in the pelvis may contain cancer cells.

Stage IV -- The cancer has spread into the bladder or rectum. Or it has spread beyond the pelvis to other body parts.