What tests might your gynecologic oncologist perform to determine treatment?
The first step is to confirm the diagnosis of cervical cancer and to establish the stage of your cancer. The diagnosis of cervical cancer requires a biopsy from the cervix for the pathologist to review under the microscope. This biopsy might be done in the office or in the operating room. Your doctor will review which option is best for you. The stage of cervical cancer is a standardized way to describe the extent of the cancer in the body and to establish whether the cancer has spread outside the cervix elsewhere in the body. The stage of a cervical cancer is based on a thorough pelvic and rectal exam in addition to some radiologic studies and possibly other diagnostic tests. Your gynecologic oncologist will recommend treatment based on the stage of the cancer, your overall health status, and, if appropriate, your desires about preserving fertility.
Further tests may be necessary to either establish the stage of the. During your consultation, your gynecologic oncologist may order additional testing. Common tests and procedures performed during the workup of cervical cancer are as follows:
- Rectovaginal exam. This is a relatively simple type of pelvic exam done in the office performed by examining the vaginal area and the rectal area at the same time. This allows your doctor to better determine if the cervical cancer extends past the cervix.
- CT or CAT scan, also called computed tomography, computerized tomography, or computerized axial tomography. To do a CT scan, a dye must be swallowed or injected into a vein. The dye helps certain organs to show up better in x-ray images.
- MRI (magnetic resonance imaging) scan, sometimes called an NMRI (nuclear magnetic resonance imaging scan). This procedure uses a magnet, radio waves, and a computer to make pictures of areas inside the body.
- PET (positron emission tomography scan). In this procedure, radioactive glucose is injected into a vein. The PET scanner takes pictures of places where glucose is being used up in the body at a greater rate. Cancer cells look brighter in PET scan images because cancer cells are more active and use more glucose than normal cells do.
- Chest X-ray, to determine if cancer has spread into your chest or lungs.
- Blood tests evaluating your blood count, kidney function, and related issues.
- Cystoscopy. An outpatient procedure that uses a very small lighted camera to look inside the bladder. Your doctor might recommend this test if there is any concern that the cancer involves the bladder or has caused a blockage of urine going from the kidney to the bladder. Biopsies can be taken using the cystoscope.
- Proctoscopy. This is another outpatient procedure that uses a small lighted camera to look inside the anal and rectal canal. Your doctor might recommend this test if the clinical exam raises concern about growth of the cancer from the cervix into the rectal area.
- Exam under anesthesia. This is an outpatient procedure that may be recommended by your doctor to perform a more thorough examination with the assistance of intravenous sedation by an anesthesiologist. This may be recommended to you if the office exam is too painful for you and your doctor needs to perform a better exam to determine the stage. This is often done with cystoscopy, proctoscopy, and tumor biopsies at the same time.