Cervical Cancer: Tests After Diagnosis

What tests might I have after being diagnosed?

After a diagnosis of cervical cancer, you will likely have some tests. These tests help your healthcare providers learn more about your cancer. They can help show if the cancer has grown into nearby areas or spread to other parts of the body. The test results help your healthcare providers decide the best ways to treat the cancer. If you have any questions about these or other tests, be sure to talk with your healthcare team.

The tests you may have can include:

• Pelvic exam under anesthesia

• Chest X-ray

• CT scan

• MRI scan

• Intravenous pyelogram (IVP)

• PET scan

These tests help show how big the cancer is and whether the cancer has spread. (The number used as the cancer stage is based on this information.)

Pelvic exam under general anesthesia

To look more closely at your cervix to learn the stage of the cancer, your doctor may do a pelvic exam while you are under general anesthesia. This means you will be asleep while it is happening. These tests may also be done while you’re asleep:

• Cystoscopy. During this test, the doctor looks at the inside of the bladder with a special tool called a cystoscope. The doctor inserts this thin, flexible tool in through the urethra and up into the bladder. This lets the doctor see if the cancer has spread to the urethra or bladder.

• Proctoscopy. For this test, the doctor uses a special tool called a sigmoidoscope. The doctor inserts this thin, flexible tool into your anus into the lower end of your large intestine. This allows the doctor to see if the cancer has spread to the rectum and the bottom part of the large intestine.

Chest X-ray

A chest X-ray is done to see if there are any changes in your lungs. This may show that the cervical cancer has spread. An X-ray uses a small amount of radiation to make an image of organs and bones inside the body. The test can spot enlarged lymph nodes in your chest area. This test takes a few minutes, and causes no pain.

CT scan

This test helps your doctor see where the cervical cancer is located and if it has spread to other parts of your body. It is helpful for finding cervical cancer that has spread to the liver, lungs, or other parts of the body.

A CT scan uses a series of X-rays and a computer to create detailed images of the inside of the body. During the test, you lie still on a table as it slowly slides through the center of the ring-shaped CT scanner. The scanner directs a beam of X-rays at your body. A CT scan is painless. You may be asked to hold your breath one or more times during the scan. You may need to drink a contrast medium or receive it by an IV (intravenous) injection.

You may be asked not to eat until a second set of pictures is taken in a few hours. The dye allows your doctor to better see lymph nodes and other tissues. The substance will slowly pass through your system and exit through your bowel movements or urine. Some people have a temporary warm feeling (flushing) just after the injection. Tell your doctor if you have ever had a reaction to contrast material in the past, such as hives or trouble breathing. Tell your doctor if you have these reactions during the test.

MRI

This test is very helpful in looking at pelvic tumors and for checking for cancer spread to your brain and spinal cord. MRI may also be used if the results of an X-ray or CT scan aren’t clear. MRIs use radio waves, magnets, and a computer to make detailed images of the inside of the body.

For this test, you lie still on a table as it passes through a tube-like scanner. If you are not comfortable in small spaces, you may be given a sedative before the test. The scanner directs a beam of radio waves at the area to examine. You may need more than one set of images. Each one may take 2 to 15 minutes. This test is painless. It may last an hour or more. The machine is loud during the test. You can ask for earplugs or headphones with music.

Intravenous pyelogram (IVP)

An IVP is an X-ray of the kidneys, the bladder, and the tubes (ureters) that carry urine from the kidneys to the bladder. You may not need this test if you have a CT scan or MRI.

PET scan

A PET scan can examine your entire body. For this test, you either swallow or are injected with a mildly radioactive substance, usually a form of glucose. The PET scan will show where in your body the glucose is being used the most. This helps find active cells that are dividing quickly, such as cancer.

You’ll lie still on a table that is pushed into the PET scanner. It will rotate around you and take pictures. Other than the injection, a PET scan is painless and noninvasive. Some people are sensitive to the substance, and may have nausea, a headache, or vomiting. Some newer machines can do PET and CT scans at the same time, so areas that show up on the PET scan can be compared to the more detailed image of the CT scan.

Working with your healthcare provider

The gynecologic oncologist will decide which of these tests is best for you and will talk with you about which tests you’ll have. Make sure to prepare for the tests as instructed. Ask questions and talk about any concerns you have.