If any of these tests or procedures show that you have cervical cancer, you may need further tests to find out whether the cancer has spread to other parts of your body. This is called staging. You may have one or more of the tests described below.
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You may have a blood test to check your general health, and how well your kidneys and liver are working.
Various imaging scans can create pictures of the inside of your body and provide different types of information. You may have one or more of the following imaging scans to find out if the cancer has spread to lymph nodes in the pelvis or abdomen, or to other organs in the body.
A CT (computerised tomography) scan uses x-rays to take pictures of the inside of your body and then compiles them into a detailed, three-dimensional picture.
When you make the appointment for the scan, you will be told if there are any special instructions to follow. Before the scan, you may be given a drink or an injection of a dye (called contrast) into one of your veins. The contrast may make you feel hot all over for a few minutes. You may also be asked to insert a tampon into your vagina. The dye and the tampon make the pictures clearer and easier to read.
During the scan, you will need to lie still on a table that moves in and out of the CT scanner, which is large and round like a doughnut. The scan is painless and takes 5–10 minutes.
An MRI (magnetic resonance imaging) scan uses a powerful magnet and radio waves to create detailed cross-sectional pictures of the inside of your body. Let your medical team know if you have a pacemaker or any other metal implant, as some may affect how an MRI works.
Sometimes gel is placed in the vagina before the MRI scan to better show the cervix or vagina. During the scan, you will lie on a treatment table that slides into a large metal cylinder that is open at both ends.
The test is painless but the noisy, narrow machine can make some people feel anxious or claustrophobic. If you think you may become distressed, talk to your medical team before the scan. You may be given medicine to help you relax, and you will usually be offered headphones or earplugs. Most MRI scans take between 30 and 90 minutes.
A PET (positron emission tomography) scan combined with a CT scan is a specialised imaging test. It provides more detailed information about the cancer than a CT scan on its own. Not all women need to have a PET–CT scan.
The imaging centre may give you instructions to follow before and after the scan. Before the scan, you will be injected with a glucose (sugar) solution containing a small amount of radioactive material. Cancer cells show up brighter on the scan because they take up more glucose than normal cells do. The radioactive material will leave your body within a few hours.
You will be asked to lie still for 30–60 minutes while the solution spreads through your body, then you will have the scan. Let your doctor know if you are claustrophobic, as you need to be in a confined space for the scan. It may take a few hours to prepare for a PET–CT scan, but the scan itself usually takes about 30 minutes.
Before having scans, tell the doctor if you have any allergies or have had a reaction to contrast during previous scans. You should also let them know if you have diabetes or kidney disease or are pregnant or breastfeeding.
Another way to check whether the cancer has spread is for the doctor to examine your cervix, vagina, uterus, bladder and rectum. This is done in hospital under general anaesthetic.
If the doctor sees any abnormal areas of tissue during the procedure, they will take a biopsy. The area examined will depend on where the cancer may have spread to and may include:
Pelvic examination – The doctor will put a speculum into your vagina and spread the walls of the vagina apart so they can check the cervix and vagina for cancer.
Uterus – The cervix will be dilated (gently opened) and some of the cells in the lining of the uterus (endometrium) will be removed and sent to a laboratory for examination under a microscope. This is called a dilation and curettage (D&C).
Bladder – A tube with a camera and light on the end (a cystoscope) will be inserted into your urethra (a tube that drains urine from the bladder to the outside of the body). This lets the doctor examine your bladder.
Rectum – The doctor will use a gloved finger to feel for any abnormal growths inside your rectum. To examine your rectum more closely, the doctor may insert an instrument called a sigmoidoscope, which is a tube with an attached camera.
You will most likely be able to go home from hospital on the same day after one of these examinations under anaesthetic. You may have some light bleeding and cramping for a few days afterwards. Your doctor will talk to you about the side effects you may have.
Podcast: Tests and Cancer
Dr Pearly Khaw, Lead Radiation Oncologist, Gynae-Tumour Stream, Peter MacCallum Cancer Centre, VIC; Dr Deborah Neesham, Gynaecological Oncologist, The Royal Women’s Hospital and Frances Perry House, VIC; Kate Barber, 13 11 20 Consultant, VIC; Dr Alison Davis, Medical Oncologist, Canberra Hospital, ACT; Krystle Drewitt, Consumer; Shannon Philp, Nurse Practitioner, Gynaecological Oncology, Chris O’Brien Lifehouse and The University of Sydney Susan Wakil School of Nursing and Midwifery, NSW; Dr Robyn Sayer, Gynaecological Oncologist Cancer Surgeon, Chris O’Brien Lifehouse, NSW; Megan Smith, Senior Research Fellow, Cancer Council NSW; Melissa Whalen, Consumer.
We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title.
View the Cancer Council NSW editorial policy.
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