Cystoscopy, ureteroscopy, lymphangiogram, and cone biopsy may be helpful to detect the spread of vaginal cancer.

A biopsy may be done to find out if cancer has spread to the cervix^[1]. A sample of tissue is cut from the cervix and viewed under a microscope. A biopsy that removes only a small amount of tissue is usually done in the doctor’s office. A woman may need to go to a hospital for a cone biopsy (removal of a larger, cone-shaped piece of tissue from the cervix and cervical canal). A biopsy of the vulva may also be done to see if cancer has spread there.

A procedure to look inside the bladder and urethra to check for abnormal areas. A cystoscope is inserted through the urethra into the bladder. A cystoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer. Cystourethroscopy permits visualization of the urethral tumor and allows biopsies to be performed to remove samples for histologic examination.^[2].

A procedure to look inside the ureters to check for abnormal areas. A ureteroscope is inserted through the bladder and into the ureters. A ureteroscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease. A ureteroscopy and cystoscopy may be done during the same procedure^[3].

A procedure used to x-ray the lymph system. A dye is injected into the lymph vessels in the feet. The dye travels upward through the lymph nodes and lymph vessels and x-rays are taken to see if there are any blockages. This test helps find out whether cancer has spread to the lymph nodes^[4].