If endometrial cancer is diagnosed, you will be referred to a gynecologic oncologist. This is the doctor who will lead your cancer treatment including surgery to remove the uterus. The gynecologic oncologist will also do an evaluation during surgery to determine if the cancer has spread to other areas of the body.
When the oncologist removes the uterus, tissue samples from the pelvis and abdomen are usually removed and checked to see how deeply the tumor has grown. Also, the other tissue samples are checked for cancer cells.
Other tests may be required by the gynecologic oncologist to stage endometrial cancer. One or more of the following tests may be requested:
- Lab tests: A Pap test can show whether cancer cells have spread to the cervix, and blood tests can show how well the liver and kidneys are working. Also, your doctor may order a blood test for a substance known as CA-125. Cancer may cause a high level of CA-125.
- Chest X-ray: An X-ray of the chest can show a tumor in the lung.
- PET scan: Combined with a CT Scan, this type of scan will find other malignant tumor cells in the body. This is done by giving the patient a small amount of radioactive glucose (sugar) so that cancerous cells in the body will “light up” and be visible on the scan, even if they aren’t visible to the human eye.
- MRI: A large machine with a strong magnet linked to a computer is used to make detailed pictures of your uterus and lymph nodes.
- Lymph node dissection: A surgical procedure where lymph nodes are removed from the pelvic area and a sample of tissue is checked under a microscope for signs of cancer. This will let your oncologist know if it’s likely that the cancer cells have spread through the lymph fluid throughout the body. It’s often performed at the same time as surgery to remove the uterus, but can be done separately.
These are the stages of uterine cancer. You may also be given a substage which indicates how far the cancer has spread within that stage.
- Stage I: The tumor has grown through the inner lining of the uterus to the endometrium. It may have invaded the myometrium.
- Stage II: The tumor has invaded the cervix.
- Stage III: The tumor has grown through the uterus to reach nearby tissues, such as the vagina or a lymph node.
- Stage IV: The tumor has invaded the bladder or intestine, or cancer cells have spread to parts of the body far away from the uterus, such as the liver, lungs or bones.
When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary (original) tumor. For example, if uterine cancer spreads to the ovaries the cancer cells on the ovaries are actually uterine cancer cells and would be treated as such. Doctors sometimes call the new tumor “distant” disease.