How is ovarian cancer diagnosed?

If you have symptoms that could be due to ovarian cancer, your healthcare provider will use a combination of the following procedures to determine their cause.
  • Pelvic exam: As part of a pelvic exam, your healthcare provider will feel the ovaries for any abnormal swelling, pain or changes in their shape or position.
  • Ultrasound: This procedure uses sound waves to look at the organs in your abdomen. This may be done through the vagina (transvaginal ultrasound) to get a better look at the
  • internal organs.
  • Blood test: A sample of your blood may be taken to look for a protein in the blood called CA-125. High levels of CA-125 can be a sign of cancer.
  • X-rays: Special pictures are taken of the inside of the body.
  • Computed tomography (CT) scans: These scans are multiple x-rays that are combined to get a more detailed picture of the inside of your body.
  • Magnetic resonance imaging (MRI): Images of the inside of the body are created by a large magnet and radio waves.
If anything abnormal is found during any of the tests, your healthcare provider may recommend a biopsy. A biopsy is when a small sample of tissue is removed and looked at using a microscope to see if cancer cells are present. The biopsy is generally done through a surgical incision made in the wall of the abdomen, called a laparoscopy.

Just because your healthcare provider recommends one or all of these tests does not mean you have cancer. These tests are used to rule out possible reasons for your symptoms, including cancer.

When diagnosing ovarian cancer, the doctor will take a medical history and perform a pelvic exam. The doctor may assess the size of your ovaries with ultrasound, an imaging modality that uses sound waves to create images. Computed tomography (CT), magnetic resonance imaging (MRI), and x-ray imaging may help the doctor get a more detailed look at your organs. Cancer antigen 125, or CA-125, levels may be high in those with ovarian cancer so your doctor may order a blood test. The doctor can also insert a laparoscope into your abdomen in order to more fully assess your ovaries and surrounding organs.

Sharyn N. Lewin, MD
OBGYN (Obstetrics & Gynecology)
If you have a suspicion that you might have Ovarian Cancer or feel you are at high risk for developing ovarian cancer, I suggest that you discuss this with your physician.

You will have a physical exam as well as bi-manual (or pelvic) and recto-vaginal exam to feel your ovaries for lumps and irregularies as well as evaluate the other pelvic and abdominal structures. If you have an abnormal amount of fluid in your abdomen, a sample of fluid may be taken from you abdomen to look at the cells.

A TVUS exam may be performed by inserting an ultrasound device into your vagina to get a better look at the ovaries for surface irregularities and cysts. A CT scan or other xray tests  may be recommended.

A blood test will be ordered to measure CA-125, a tumor marker, which is a blood protein released from ovarian cells. CA-125 is elevated in more than 80 percent of women with advanced ovarian cancers and in 50 percent of those with early-stage cancers. This test is not diagnasotic for Ovarian Cancer but is very helpful to aid in the diagnsosis and follow treatment.

These exams and tests help make the diagnosis but the only way to confirm the presence of ovarian cancer is through a surgical biopsy of the tumor tissue.
Ovarian cancer typically does not cause symptoms in the early stages. Instead, it is often detected once the disease has progressed and a pelvic mass has been discovered. The following tests are often the first step in diagnosing ovarian cancer:
  • Pelvic exam: Your doctor may examine the abdomen and pelvic area for any nodules or bumps, which are explored in greater detail with imaging technology.
  • CA-125 test: Your doctor will perform this blood test to measure the level of a protein called CA-125 in the blood. High amounts of CA-125 may indicate ovarian cancer, as well as less serious conditions, such as endometriosis or inflammation in the abdomen. This test is combined with other screening methods.
CA-125 levels are measured during treatment to monitor how you are responding. If test results show that protein levels in the blood are rising, further testing will be performed and your treatment plan will be changed if needed.
If a gynecologist suspects that a woman has ovarian cancer, tests will be ordered including a pelvic exam, radiological tests and blood tests. A definitive diagnosis only occurs after surgery. The most common preliminary tests are:
  • physical examination
  • recto-vaginal pelvic examination
  • transvaginal ultrasound (TVU) and/or computed tomography (CT) scan
  • blood test for CA-125, a protein in the blood produced by ovarian cancer cells, which is elevated in many women with ovarian cancer
If the results from these tests suggest ovarian cancer might be present, the patient should seek a referral to a gynecologic oncologist before surgery. Research has shown that women treated by gynecologic oncologists live longer than those treated by other physicians.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.