Editing Patient Pathways: Endometrial Cancer (section)

== 1. Diagnosis ==

The patient presents with symptoms such as abdominal pain and bleeding. Vulvar cancer shows discomfort in the vulvar area and frequent itching, in some women with vaginal cancer it is possible watery discharge.

'''Consultation with a general practitioner (GP) or gynecologist:''' The patient sees a general practitioner.

'''Medical history and physical examination:''' Detailed medical history of the patient.

'''Initial tests:''' gynecological examination, pap test, HPV testing

'''Referral to a specialist'''

Referral to a radiologist and oncologist

'''Diagnostic evaluation'''

'''Endometrial cancer'''

'''Gynecological examination:''' The doctor performs a physical exam, including a pelvic exam, to evaluate abnormalities in the uterus or other pelvic organs.

'''Transvaginal ultrasound:''' This ultrasound uses high-frequency sound waves to create image of internal structures. It helps to assess the thickness of the endometrium (the lining of the uterus), which can be elevated in case of cancer.

'''Endometrial biopsy:''' Taking a sample of cells from the inner lining of the uterus for analysis under microscope. This is a key test to confirm the diagnosis of endometrial cancer.

'''Hysteroscopy:''' A procedure in which a thin tube with a camera (hysteroscope) is inserted through the vagina and cervix to examine the inside of the uterus and take samples for biopsy.

'''Cervical cancer'''

'''PAPA test (Pap test):''' This test involves taking a sample of cells from the cervix and examining them in the laboratory in order to detect abnormal cells that may indicate cervical cancer or precancerous changes (eg dysplasia).

'''HPV testing:''' Testing for the presence of the human papillomavirus (HPV), which is the main cause cervical cancer. This test can be done alone or in combination with a PAPA test.

'''Colposcopy:''' If the Pap test finds abnormal cells, a colposcopy may be recommended. During this examination, the doctor uses a colposcope (an instrument with magnification) to examine cervix and vagina and may take samples (biopsies) for further analysis.

'''Cervical biopsy:''' Taking a tissue sample from the cervix for analysis to confirm the presence of cancer or other abnormal cells.

'''Vaginal cancer'''

'''Gynecological examination:''' As with other types of cancer, the first step is a physical exam and assessment symptom.

'''Colposcopy:''' Colposcopy is used to examine the vagina and cervix under magnification. If abnormalities are found, biopsies are taken.

'''Vaginal biopsy:''' Taking a tissue sample from the vagina for analysis under a microscope to confirm the presence of cancer.

'''Transvaginal ultrasound:''' This ultrasound can help assess abnormalities in the vagina and surrounding structures.

'''CT scan, MRI, or PET scan:''' These imaging tests can be used to assess the extent disease and determine the spread of cancer to surrounding structures or lymph nodes.

'''Vulvar cancer'''

'''Clinical examination:'''

'''Gynecological examination:''' The doctor performs a physical exam to assess the size, shape, and location tumor and to look for any abnormalities in the area of the vulva, vagina, and cervix.

'''Lymph node palpation:''' Your doctor may feel the lymph nodes in your pelvic and groin area to determine if the cancer has spread to these structures.

'''Colposcopy:''' If abnormalities are found on the vulva, a colposcope (an instrument with magnification) is used to examine the external genitalia and vagina. This exam helps identify abnormal areas that may require further analysis.

'''Biopsy:'''

'''Incisional biopsy:''' Removal of a small portion of the tumor for analysis under a microscope. This procedure allows for histological examination and confirmation of the presence of cancer.

'''Excisional biopsy:''' Removal of the entire tumor and surrounding healthy tissue. This method can serve both therapeutic and diagnostic purposes.

'''Imaging tests:'''

'''CT scan (computed tomography):''' It is used to assess the spread of cancer to the lymph nodes and surrounding structures and for treatment planning.

'''MRI (magnetic resonance imaging):''' Provides detailed images of soft tissues and can help in determining the exact stage of cancer and its spread to surrounding tissues.

'''PET scan (positron emission tomography):''' Used in some cases to detect metastases or spread of disease

'''Lymphangiography:''' In some cases, it is used to visualize the lymph nodes in the groin and pelvis to determine if they are affected by cancer.

'''Laboratory tests:'''

'''Blood and urine:''' Tests may include a complete blood count, liver and kidney function tests, and other specific markers that can help assess overall health.

'''Cytology and histopathology:'''

'''Histopathological analysis:''' The biopsy sample is analyzed under a microscope to confirm the presence of cancer and determine the type and stage of the disease.

'''Urogenital ultrasound:'''

'''Ultrasound:''' rarely used for vulvar cancer, it can help assess the involvement of surrounding structures and in monitoring the disease.

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