Gynecologic oncologists have expertise in the diagnostic evaluation and treatment of patients with cervical carcinoma. They also have surgical expertise in the procedures of radical hysterectomy, pelvic and paraaortic lymphadenectomy, pretreatment surgical staging procedures, and exenterations for patients with recurrent cervical cancer. Gynecologic oncologists work closely with radiation therapists when this is the primary treatment modality. During that time, they function as the patient's primary care oncologist and continue to direct their care after the radiation therapy is finished.
Staging is a careful attempt to find out whether the cancer has spread and, if so, what parts of the body are affected. Blood and urine tests are usually done. The doctor also may do a thorough pelvic exam in the operating room with the patient under anesthesia. During this exam, the doctor may do procedures called cystoscopy and proctosigmoidoscopy.
In cystoscopy, the doctor looks inside the bladder with a thin, lighted instrument. Proctosigmoidoscopy is a procedure in which a lighted instrument is used to check the rectum and the lower part of the large intestine. Because cervical cancer may spread to the bladder, rectum, lymph nodes or lungs, the doctor also may order x-rays or tests to check these areas. For example, the woman may have a series of x-rays of the kidneys and bladder, called an intravenous pyelogram (IVP). The doctor also may check the intestines and rectum using a barium enema. To look for lymph nodes that may be enlarged because they contain cancer cells, the doctor may order a CT or CAT scan, a series of x-rays put together by a computer to make detailed pictures of areas inside the body. Other procedures that may be used to check organs inside the body are ultrasonography and MRI.