HOW IS CERVICAL CANCER DIAGNOSED?
Signs and Symptoms of Cervical Cancer
Women with early Cervical Cancers and pre-cancers usually have no symptoms. Symptoms often do not begin until the cancer becomes invasive (it takes a period of 6-13 years) and grows into nearby tissue. The most common symptoms are:
- Abnormal vaginal bleeding, such as bleeding after sex (vaginal intercourse), bleeding after menopause, bleeding and spotting between period, and having (menstrual) periods that are longer or heavier than usual. Bleeding after douching or after a pelvic exam is a common symptom of Cervical Cancer but not pre-cancer.
- An unusual discharge from the vagina – the discharge may contain some blood and may occur between your periods or after menopause.
- Pain during intercourse.
These sings and symptoms can also be caused by conditions other than Cervical Cancer. An infection can cause pain or bleeding. If you have any of these signs or other suspicious symptoms, you should see your health care professional. Ignoring symptoms may allow the cancer to progress to a more advanced stage and lower your chance for effective treatment. Don’t wait for symptoms to appear, early screening greatly improves the chances of successful treatment and prevent early Cervical cell changes from becoming cancerous.
ADVANCED DIAGNOSTIC TESTS FOR CERVICAL CANCER
Many of the diagnostic tests described below are not necessary for every patient. Decisions about using these tests are based on the results of the physical exam and biopsy.
- Medical history and physical exam: Getting a complete personal and family medical history is the first step a doctor will take on consultation. This includes information related to risk factors and symptoms of Cervical Cancer.
- Cystoscopy and examination under anesthesia: It is most often done in women who have large tumors (cancer). In cystoscopy a slender tube with a lens and a light is placed into the bladder and urethra to see if cancer is growing into these areas.
- Proctoscopy and examination under anesthesia: Proctoscopy is a visual inspection of the rectum through a lighted tube to check for spread of Cervical Cancer in the rectum.
IMAGING STUDIES
Certain imaging studies may be done if test results shows that Cervical Cancer is present. These include Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) scans. These studies show whether the cancer has spread beyond the Cervix.
- Chest x-ray: A plain x-ray of the chest will be done to see if the disease has spread to the lungs.
- Computed Tomography (CT): The CT scan is an x-ray procedure that produces detailed cross-sectional images of the body. CT scans can determine if cancer has spread to the lymph nodes in the abdomen, pelvis, livers, lungs or any other part of the body. CT scans takes longer than regular x-rays but faster than other computerized devices. The newest CT scanners take only seconds to complete the study. CT scans are sometimes used to guide a biopsy needle precisely into a suspected metastasis (cancer spread). For this procedure, called a CT guide needle biopsy, the patient remains on the CT scanning table while a radiologist advances a biopsy needle towards the location of mass.
CT scans are repeated until the doctors are confident that the needle is within the mass. A fine needle biopsy sample (tiny fragment of tissue) or a core needle biopsy sample (a thin cylinder of tissue) is removed and examined under a microscope.
- Magnetic Resonance Imaging (MRI): MRI scans use radio waves and strong magnets instead of x-rays to take pictures. The energy from the radio waves is absorbed and then released in a pattern formed by the type of tissue and certain diseases. A computer translates the pattern of radio waves given off by the tissues into a very detailed image of parts of the body. MRI images are particularly useful in examining pelvic tumors. They are also helpful in detecting cancer that has spread to the brain and spinal cord.
- Intravenous urography: Intravenous urography (also known as intervenous pyelogram or IVP) is an x-ray of the urinary system taken after a special dye is injected into the vein. This dye is removed from the blood stream by the kidneys and passes into the ureters and bladder (the ureters are the tubes that connects the kidneys to the bladder). This test is useful in finding abnormalities of the urinary tract, such as changes caused by spread of cervical cancer to the pelvic lymph nodes, which may compress or block the ureter. Patient that already had CT or MRI might not need an IVP.
- Positron Emission Tomography: Positron emission tomography (PET) uses glucose (a form of sugar) that contains a radioactive atom. Cancer cells in the body absorb large amounts of the radioactive sugar and a special camera can detect the radioactivity. This test can detect the spread of cancer in the lymph nodes.
Newer devices combine a CT scan and a PET scan to even better pinpoint the tumor. This test is rarely used for patients with early Cervical Cancer, but may be used if they have more advanced disease.