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Diagnosis and Stages


Lt Col Flemings
Providers use a variety of tests to determine if a woman has developed uterine cancer. Those tests include pelvic exams, transvaginal ultrasounds, and of course, biopsies. Once cancer has been diagnosed, the next step is to determine the stage. Dr. Malone, what can you tell us about diagnosis and stages of uterine cancer?

Dr. Malone
Well, Dr. Flemings, during a pelvic exam, the provider examines the woman’s vagina, uterus, ovaries, bladder, and rectum. In order to examine the upper part of the vagina and the cervix, the provider opens the vagina using a device called a speculum. This allows for a visual inspection and provides the opportunity to perform additional tests, such as cultures or a Pap test. During the pelvic exam, the provider will feel the uterus, checking for any lumps or changes in size or shape. Although a Pap test is often conducted as part of a pelvic exam, it is not designed to detect uterine cancer. However, in some cases, a Pap test may reveal signs of a previously undiagnosed uterine cancer.

A transvaginal ultrasound is used to provide an image of the uterus. During a transvaginal ultrasound, the provider inserts a special wand into the vagina. This instrument emits high frequency sound waves that are used to form a picture of the uterus.

A uterine biopsy is used to sample tissue from the uterus for testing. When performing a biopsy, instruments are usually passed through the vagina into the uterus and a sample of tissue is removed from the uterine lining. A pathologist examines the tissue to check for cancer cells, hyperplasia, and other conditions. For a short time during and after the biopsy, some women may have cramps and vaginal bleeding.

These tests, or frequently a combination of these tests, can help your provider determine if uterine cancer is present. With an early diagnosis, your provider can refer you to the proper specialists, and you can move forward with the most effective treatment plan.

If uterine cancer is diagnosed, the provider will then determine the stage of the disease in order to plan the most effective way to treat the specific condition. The tests involved in staging are designed to determine whether the cancer has spread beyond the uterus and, if so, to what parts of the body. A provider may order blood tests, urine tests, and x-rays. Additional tests may include CT scans, an ultrasound test, magnetic resonance imaging – known as MRI – sigmoidoscopy, and colonoscopy.

The most reliable way to stage uterine cancer is to perform a hysterectomy. After the uterus has been removed, signs that the cancer has invaded the muscle of the uterus can be looked for. The surgeon can also check the lymph nodes and other organs in the pelvic area for signs of cancer.

There are four stages of uterine cancer. In Stage I, the cancer is only in the body of the uterus. In Stage II, the cancer has spread from the uterus to the cervix. Stage III cancer means that it has spread outside the uterus, but not outside the pelvis and not to the bladder or rectum. Lymph nodes in the pelvis may contain cancer cells. If the cancer has spread into the bladder, rectum, or other parts of the body outside the pelvis, it is Stage IV.