Referral

If your GP thinks you have symptoms that could be caused by a gynaecological cancer, they will refer you to a gynaecologist or a gynae-oncologist (a specialist in gynaecological cancers).

Investigations and diagnosis

As part of the pathway for diagnosis and management of gynaecological cancer, patients may be referred for a number of investigations. These investigations allow doctors to make a diagnosis to see the extent of any disease.

Some investigations are used for all types of gynaecological cancer, while others are used only for specific types.

Diagnostic investigations may include:

• Biopsy – a small sample of tissue is removed for examination and the cells are looked at under a microscope
• EUA (examination under anaesthetic) – is performed when a patient cannot be adequately examined without sedation or general anaesthesia
• Laparoscopy – is a minimally invasive surgical procedure which uses a special surgical instrument called a laparoscope to look inside the body
• CT scan – uses X-rays and a computer to create detailed images of the inside of the body
• MRI – a type of scan that uses magnetic fields and radio waves to produce detailed images of the inside of the body
• Ultrasound – is a procedure that uses high-frequency sound waves to create an image of part of the inside of the body. A small ultrasound microphone is inserted in the vagina for a transvaginal ultrasound scan
• X-ray – a test that produces images of the structures inside your body
• PET – a scan used to produce detailed three-dimensional images of the inside of the body
• Colposcopy – an internal examination of the cervix using a small microscope with a light on the end (colposcope)
• LLETZ (cervical) – the area of the cervix where the abnormal cells develop is cut out in a simple, quick procedure
• Cone biopsy (cervical) – a small cone shaped area of your cervix will be removed so that it can be examined under a microscope for pre-cancerous cells
• Hysteroscopy (womb and cervical) – a fine telescope called a hysteroscope is used to examine your womb or cervix and a sample of the lining will be taken

Staging and grading

Your gynaecological cancer specialist needs certain information about the cancer to decide on the most appropriate treatment for you. This includes the stage and grade of the cancer. The stage of a cancer describes its size, position and whether it has spread to beyond the area of the body where it started.

For more information on staging and grading gynaecological cancer, please visit the staging and grading sections of each gynaecological cancer sections on the Macmillan Cancer Support website.

Results

The results of your tests, scans and investigations will be discussed at the regional Gynae- Oncology Multi-Disciplinary Team (MDT) meeting. The MDT is a well established group of specialists comprising of doctors, nurses, radiographers and other healthcare professionals who manage the treatment of gynae cancers. The team will review all aspects of your care and recommend an appropriate treatment plan. A member of the team will discuss this with you.