Further tests for vulval cancer
This page tells you about the tests you may need if your biopsy shows you have cancer of the vulva. There is information on
Further tests for vulval cancer
If you have been diagnosed with vulval cancer, you will need more tests to see if the cancer has spread. Your specialist needs to know this before deciding on the best treatment for you.
Your doctor will want to examine you more closely. They may use a speculum and colposcope to see inside your vulva and vagina. The speculum opens up your vagina. A colposcope is a specialised magnifying glass that allows the doctor to look for small abnormalities.
Your doctor will ask you to lie with your feet drawn up and your knees apart. You can also have a pelvic examination under anaesthetic. Then the doctor can also check for signs of cancer spread, for example in the bladder or rectum.
Your doctor may want to look inside your bladder or your back passage (rectum) for signs of cancer spread. Examination of the bladder is called cystoscopy. Doctors examine the rectum either using a gloved finger, or using an instrument called a proctoscope. You usually have this under general anaesthetic.
You can view and print the quick guides for all the pages in the Diagnosing vulval cancer section.
If you have been diagnosed with vulval cancer, your specialist will ask you to come to the hospital for some more tests. These tests will show how far the cancer has grown and if it has spread. Your specialist needs to know this before he or she can decide on the best treatment for you.
If a biopsy shows that you have cancer of the vulva, your doctor will want to examine you more closely. They may feel the lymph nodes in your groin, to see if they are larger than usual.
The doctor may use a speculum and colposcope to see inside your vulva and vagina. A speculum is the metal or plastic instrument that your doctor or nurse uses to spread the walls of the vagina when you have an internal examination or a cervical screening test. A colposcope is like a microscope that helps the doctor to find any abnormality that may be too small to see with the naked eye.
You usually have this examination in the outpatient clinic. But some people have a pelvic examination under anaesthetic.
In the outpatient clinic, your doctor or nurse will ask you to lie on your back on the couch, in the same position as for a smear test. That is, with your feet drawn up and your knees apart. As with a smear, if you cannot get into that position for any reason, the doctor may be able to examine you while you are lying on your side with your knees drawn up.
Your doctor may put in the speculum first, to open up the vagina. Then they may look through a type of specialised magnifying glass, called a colposcope. This enlarges the view of the vulval skin. So any changes will show up more clearly. It doesn't go inside your vagina. The doctor looks through it from outside.
The doctor may examine the inside of your vagina and your cervix with the colposcope, which can take a few minutes to do properly. You may find it uncomfortable to be in one position during the examination. But colposcopy itself is not usually painful.
You may also have a pelvic examination under anaesthetic. During this examination, the doctor can do further tests to check for any signs of cancer spread, such as a bladder examination (cystoscopy) and rectal examination (proctoscopy).
It is possible for large tumours to spread into the bladder or back passage (rectum), although this isn't very common. The doctor may want to do further tests to check your bladder and rectum.
An examination of the inside of your bladder is called a cystoscopy. Read more about having a cystoscopy.
The specialist may put a gloved finger inside your back passage (rectum), to feel for abnormalities. Some people may need to have further tests to look inside the rectum.
To do a more detailed rectal examination, a doctor uses an instrument called a proctoscope. This shows up the rectal wall very clearly. If the doctor sees any abnormal areas during this test, they will take a small sample of the abnormal area (a biopsy). A pathologist then examines the biopsy sample under a microscope. You can have this test done without an anaesthetic, but often the rectal examination and biopsy is done during the examination under anaesthetic.
X-rays use low doses of radiation to take pictures of different parts of your body. You may have a chest X-ray to check that the cancer has not spread to your lungs.
Your doctor will ask you to come back to the hospital when your test results have come through. This is bound to take a little time, even if only a week or so. You may feel very anxious during this time. While you are waiting for results, it may help to talk to a close friend or relative about how you feel. If you would like to talk to someone outside your own friends and family, you may find counselling helpful.
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