While there is no simple, reliable way to screen for ovarian cancer in women who do not have any signs or symptoms, there are diagnostic tests to detect ovarian cancer once you begin experiencing symptoms, or if you are a high-risk patient who has not yet demonstrated symptoms.
Tests and Procedures to Diagnose Ovarian Cancer
Your doctor may use one of the following diagnostic tests to determine the cause of your symptoms and to determine if you have ovarian cancer.
- Pelvic exam: An exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum. Your doctor or nurse inserts one or two lubricated, gloved fingers into your vagina while placing the other hand over your lower abdomen to feel the size, shape, and position of your uterus and ovaries. Using a speculum to hold open the vagina, your doctor examines the vagina and cervix for signs of disease. A Pap test (Pap smear) is usually performed in conjunction with the pelvic exam, as is a digital rectal exam, in which your doctor or nurse inserts a lubricated, gloved finger into your rectum to feel for lumps or other abnormalities.
- Ultrasound: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs to create echoes. The echoes form a picture of your body tissues (sonogram). An abdominal ultrasound or a transvaginal ultrasound may be done.
- CA 125 assay: A test that measures the level of CA 125 in the blood. An increased CA 125 level is sometimes a sign of cancer or another condition.
- Barium enema: A series of X-rays of the lower gastrointestinal tract. A liquid that contains barium (a silver-white metallic compound) is put into the rectum. The barium coats the lower gastrointestinal tract and x-rays are taken. This procedure is also called a lower GI series.
- Intravenous pyelogram (IVP): A series of X-rays of the kidneys, ureters, and bladder to find out if your cancer has spread to these organs. A contrast dye is injected into a vein. As the contrast dye moves through the kidneys, ureters, and bladder, X-rays are taken to see if there are any blockages.
- CT scan (CAT scan): A procedure that creates a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an X-ray machine. A dye may be injected into a vein or given orally to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
- Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. The tissue is removed in a procedure called a laparotomy (a surgical incision made in the wall of the abdomen).
To plan the best treatment, your doctor needs to know the grade of the tumor and the extent or stage of the disease. The stage is based on whether the tumor has invaded nearby tissues, whether the cancer has spread, and if so, to what parts of the body. Staging requires sample tissue to look for cancer and to determine if it has spread. Your doctor may order these diagnostic tests to stage your cancer: barium enema, chest X-ray, colonoscopy, or CT scan.
Staging refers to the extent that your cancer has spread. Stages of ovarian cancer are defined as:
- Stage I: Cancer cells are found in one or both ovaries. Cancer cells may be found on the surface of the ovaries or in fluid collected from the abdomen.
- Stage II: Cancer cells have spread from one or both ovaries to other tissues in the pelvis. Cancer cells are found in the fallopian tubes, the uterus, or other tissues in the pelvis. Cancer cells may be found in fluid collected from the abdomen.
- Stage III: Cancer cells have spread to tissues outside the pelvis or to the regional lymph nodes. Cancer cells may be found on the outside of the liver.
- Stage IV: Cancer cells have spread to tissues outside the abdomen and pelvis. Cancer cells may be found inside the liver, in the lungs, or in other organs.
Your treatment options and chance of recovery (prognosis) depend on the following:
- The stage of the cancer
- The type and size of the tumor
- Patient age and general health
- Whether the cancer has just been diagnosed or has recurred (come back)