The road to a gynecologic (GYN) cancer diagnosis can feel confusing, frustrating, and sometimes overwhelming. To help take some of the mystery out of the process, Gynecologic Oncology Physician Assistant Carly Maher discusses what you can expect throughout the diagnostic process. Understanding each step can help you feel more informed and prepared as you navigate your care.
Common Symptoms of GYN Cancer
Unusual bleeding or discharge, especially after menopause, is the most common symptom of GYN cancer. Other symptoms include:
- Vaginal discharge with different odors and colors
- Itching, burning, or changes in skin texture or color
- Bloating or swelling in your belly
- Pelvic pain or pressure
- Abdominal or back pain
- Feeling full quickly or having trouble eating
- Unintentional weight loss or gain
- Bathroom habit changes (like going more often or feeling constipated)
Not all women with GYN cancer will have the same symptoms. Additionally, symptoms can be difficult to recognize because they may be related to other conditions. However, you know your body better than anyone; trust yourself and don’t ignore something that feels different or concerning. Schedule an appointment with either your primary care provider or your gynecologist to get evaluated as soon as possible, especially if symptoms last more than two weeks.
Diagnostic Tests
Once you bring your concerns to your doctor, your gynecologist will first do a pelvic exam to look for any abnormalities, such as lumps, bumps, or unusual tissue changes. From here, it’s common to also need imaging studies, such as a pelvic ultrasound. This could include an abdominal ultrasound, which is performed over the lower abdomen, and a transvaginal ultrasound, which uses a small ultrasound probe inserted into the vagina. These ultrasounds provide detailed views of the uterus and ovaries to help identify any masses or other abnormalities.
If the ultrasound reveals abnormalities, you might need additional imaging. Other options include:
- MRI: This shows a tumor’s size, location, and depth of its invasion into your soft tissue.
- CT scan: This helps determine whether the cancer has spread to other parts of your body by getting a more comprehensive view of your chest, abdomen, and pelvis.
- PET scan: This shows a similar image to a CT scan, but it also highlights areas of increased metabolic activity. Because cancer cells grow and divide more rapidly than normal cells, they absorb more of the imaging tracer and appear as “hot spots” on the scan.
Imaging tests and blood work may suggest that cancer is present, but the only way to fully confirm a cancer diagnosis is with a biopsy.
Biopsies
Hearing the word “biopsy” can be intimidating, but it’s an important step in getting clear answers. During a biopsy, a small tissue sample is collected and sent to a pathology lab. Here, a pathologist prepares the tissue, examines it under a microscope, and performs specialized tests.
After the examination, they prepare a pathology report that becomes available within one to two weeks, although timing may vary depending on the complexity of the testing and the lab’s workload. The report identifies whether the tissue is normal, precancerous, or cancerous, which helps your care team diagnose your condition and determine the best treatment.
Diagnosis and Treatment
Once a diagnosis has been made, you’ll meet with an oncologist to talk through next steps. For many patients, this means surgery. However, if the cancer has spread to other areas, you might need a minimally invasive procedure called a diagnostic laparoscopy first. This procedure uses a tiny camera to look inside your abdomen through small incisions to get a better idea of where exactly the cancer is located. It also helps determine whether chemotherapy or radiation before surgery is necessary.
If you need chemotherapy before surgery, you’ll typically receive about three cycles of treatment, followed by additional imaging. These scans help your care team monitor your progress to determine the best time for surgery. Chemotherapy can shrink tumors, making them easier to remove during surgery.
Ovarian cancer and endometrial cancer often require a more extensive procedure called debulking surgery, which removes as much visible cancer as possible. Removing more of the cancer can improve the effectiveness of other treatments, such as chemotherapy, and gives patients the best chance for a successful outcome.
Moving Forward with Confidence
Receiving a cancer diagnosis is never easy, but understanding the diagnostic process can help reduce some of the uncertainty along the way. If something doesn’t feel right, listen to your instincts and talk with a healthcare provider you trust; no question or symptom is too small. Throughout your journey, you’ll have a team of specialists working together to guide your care, answer your questions, and recommend the treatment plan that’s right for you. With the support of your care team and loved ones, you don’t have to face the diagnostic journey alone.