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Cervical Cancer: Tests After Diagnosis

When you learn that you have cervical cancer, you may be overwhelmed, scared, or angry. That’s understandable. Acknowledge how you are feeling. Whatever emotions you have are OK.

Once you feel ready to move forward, the next step will likely be more tests. These tests will help you and your healthcare team find out everything you can about your cancer before deciding which treatment plan will work best for you.

What tests might I have after being diagnosed?

The tests you may have include:

  • Pelvic exam

  • Cystoscopy

  • Proctoscopy

  • Imaging tests, including chest X-ray, CT scan, MRI, intravenous pyelogram (IVP), PET scan, or ultrasound

  • Blood tests

The main reason you would get one or more of these tests is to figure out the stage of your cancer. The stage is one of the most important things to know when deciding how to treat cancer. This is because staging reflects:

  • How large the cancer is

  • If it has grown into nearby areas

  • How far it has spread throughout your body

Exams

Your healthcare provider may do a pelvic exam while you are under general anesthesia in order to look more closely at your cervix. Your healthcare team will give you medicine to make sure you aren’t awake and don’t feel any pain during your exam. These two tests can also be done under general anesthesia:

Cystoscopy

During this test, your healthcare provider uses a tool called a cystoscope to see if cancer has spread to your bladder or urethra (the tube that allows urine to flow from your bladder out of your body). The scope is long and thin with a tiny light and lens on the end. Your healthcare provider guides the cystoscope through your urethra and up into your bladder. During the procedure, your provider may take tissue samples to send to the lab for further testing.

Proctoscopy

This may also be called a sigmoidoscopy. For this test, your healthcare provider uses a tool called a sigmoidoscope to see if cancer has spread to your rectum or large intestine. The thin, tube-like scope has a tiny light and lens on the end. The sigmoidoscope goes into your anus, through your rectum, and up into the lower end of your large intestine. Your provider can use the scope to take a sample of any abnormal tissue and send it to a lab for testing.

Imaging studies

There are a variety of imaging tests. (They’re listed below.) These tests will get images of your cervix and other parts of your body.

Just like when you get your photo taken, you need to stay still while an imaging machine snaps pictures so that important details will show up more clearly. You may even be asked to hold your breath a few times during a test. This helps to create a more precise image.

Some imaging tests use a contrast agent or dye. This substance helps abnormal areas inside your body show up more easily on the scan. You may drink the contrast. Or it may be injected into your bloodstream. You may have a brief warm feeling rush through your body just after a dye injection. The dye will slowly move through your body and leave when you go to the bathroom, either when you poop or pee.

Before you get any tests done with contrast material, tell your healthcare team if you have ever had a reaction to it in the past, including:

  • Itching

  • Hives

  • Trouble breathing

  • Swelling

  • Feeling nauseous or vomiting

If you have any allergic reactions, alert your healthcare provider right away so you can be treated.

Types of imaging tests

You may need one or more of the following imaging tests:

Chest X-ray

A chest X-ray uses a small amount of radiation to create an image of your organs and bones. It can show if there are signs of cancer in your lungs or surrounding tissue. Any changes to normal tissue that appear on the X-ray (like enlarged lymph nodes) may mean that the cervical cancer has spread.

CT scan

A CT scan uses radiation, a series of X-rays, and a computer to create detailed images of the inside of your body. During the test, you’ll lie still on a narrow table. It slowly slides through the center of a ring-shaped scanner. The scanner rotates around you and directs beams of X-rays at your body.

The computer combines the series of pictures taken to make a 3-D image of your body, including your bones, organs, tissues, and any possible tumors or abnormal areas. This test can help your healthcare team see exactly where the cervical cancer is and if it has spread to other parts of your body.

MRI

An MRI uses radio waves, powerful magnets, and a computer to create detailed images of the inside of your body. It’s very helpful for looking at pelvic tumors and checking for cancer that has spread to your brain and spinal cord. An MRI may also be used if you need to avoid tests that use radiation.

For this test, you’ll lie still on a table. You’ll pass through a long, tube-like scanner that directs a beam of radio waves at parts of your body. Tell your healthcare provider if being in small spaces makes you uncomfortable or anxious. They may suggest picturing yourself in a peaceful place, like at the beach. You could also possibly get a sedative before the test. An MRI machine can become very loud with clicking and beeping noises. You may receive earplugs or headphones with music and a remote sensor to press if you need help during the test.

IVP

An IVP is an X-ray of your kidneys, bladder, and ureters (the tubes that carry urine from the kidneys to the bladder). During this test, a dye is injected into your veins. A healthcare provider will take X-rays of your kidneys, ureters, and bladder as the dye flows through each of them.

PET scan

For this test, you’ll swallow a mildly radioactive sugar or get it as an injection. Then you’ll lie still on a table. It’ll slide through a ring-shaped scanner that rotates around your body. The PET machine scans your entire body and creates pictures that show where the sugar is being used the most. Cancer cells look brighter on the images because they are more active and dividing more quickly. It’s possible you may get a headache, feel nauseous, or vomit from the radioactive sugar. These are normal reactions.

Some machines can do PET and CT scans at the same time. This means areas highlighted on your PET scan can be combined with images from your CT scan to create a more detailed picture. This is called a PET-CT scan. It can be especially helpful to show if cancer has spread to your lymph nodes.

Ultrasound

Ultrasounds use high frequency sound waves to create images of organs and tissue inside your body. Ultrasounds help detect cancer because they can check blood flow around a tumor.

Blood tests

You may also have blood drawn for tests like a complete blood count (CBC) and blood chemistry studies. These tests can help your healthcare team understand how well your organs are working and detect signs of cancer spread.

Working with your healthcare team

Tell your healthcare provider if you think you may be pregnant before you get any tests. Closely follow instructions to prepare before each test. Ask your healthcare team any questions and bring up any concerns before, during or after diagnostic testing. If you’re getting a second opinion, be sure your new healthcare provider has access to all your test results.

Going through tests after receiving a cervical cancer diagnosis can be a lot. Know that you are not alone. Also remember that these tests are important. They will help your healthcare providers create a plan to treat your cancer.

Medical Reviewers:

  • Donna Freeborn PhD CNM FNP
  • Howard Goodman MD
  • Jessica Gotwals RN BSN MPH