Further tests for vulval cancer

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. This will probably involve using 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. 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 will put in the speculum first, to open up the vagina. Then they will 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 will 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).

A cystoscopy is an examination of the inside of your bladder. Your doctor may need to do this to see if the vulval cancer has spread to the bladder. There is more about having a cystoscopy in the cancer tests section of CancerHelp UK.

Because it is so nearby, it is possible for vulval cancer to spread into the back passage. To check inside your back passage (rectum), the doctor can use a gloved finger to feel for any growths. Or you may have a proctoscopy. This uses an instrument called a ‘proctoscope’ to examine the rectal wall more closely. If the doctor sees any abnormal areas during this test, he or she will take a sample of the abnormal area (a biopsy) and send it off to the lab to be examined under a microscope. You may have a general anaesthetic for this, although it is possible to have a proctoscopy without anaesthetic.

A CT scan is a computerised X-ray that can take detailed pictures of cross sections of your body. Your doctor may want you to have a CT scan to check for signs of cancer spread to your lymph nodes or other organs. There is information about having a CT scan in the cancer tests section of CancerHelp UK.

You may have an MRI scan to check for signs of cancer spread to lymph nodes or elsewhere in your body. This test uses radio waves and strong magnets (rather than X-rays) to provide a detailed picture of the inside of your body. MRI can be better at showing up the body's soft tissues than a CT scan. There is information about having an MRI scan in the cancer tests section of CancerHelp UK.

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, look on our counselling organisations page. To find out more about counselling, look in the counselling section.