What Tests Help Diagnose Endometrial (Uterine) Cancer?

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When a woman comes to you is concerned about urinary cancer or if I'm concerned because she's having abnormal bleeding, the number one thing that I wanna do is to take a sample of the tissue from the lining of the uterus. Now a lot of people think when they're coming for the annual examine, that the pap smear, is going to determine if they have urinary cancer, but in fact, that's not the case, a pap smear is just to detect cervical cancer.

The only way that I can check the cells in the lining of the uterus is to actually get a sample of those cells, and it's easier than it sounds. Essentially I put a speculum just like a pap smear and I pass a very thin little flexible catheter through the opening of the cervix into the uterine cavity, and then I air sprayed a few cells, there is no cutting, there is no needles, it takes about ten seconds, and while some women do experience a little crampy it's really quite mild and tolerable, I send those cells off to the pathologist, and they are able to tell me.

Are there abnormal cells there, are there pre-cancer cells, or is there actual cancer. Now, sometimes we don't get an adequate amount of cells and we don't get an answer from doing an endometrial biopsy, and then we do a full D&C, and women have heard of D&Cs, but they're not quite sure what it is.

Essentially the D stands for Dilate, we open up the cervix a little bit, and the C stands for Curettage, where we scrape out the lining of the uterus in order to get a larger amount of cells, and at the same time we do a hysteroscopy, where we put a little scope through the cervix so I can actually see what I'm doing and make sure that I'm not missing any areas.

So that's the definitive way to diagnose Endometrial Cancer. A lot of times though we'll start out with an ultrasound just to measure the lining of the uterus to see if it's thick, to see if we even wanna go ahead and do a biopsy.