If a woman has symptoms of ovarian cancer that are persistent and unusual for her, there are a number of tests that doctors may use to find out whether the symptoms are due to ovarian cancer.The only definite way to make sure of the diagnosis of epithelial ovarian cancer is with an operation and a biopsy of the tumour.
This means that treatment for ovarian cancer begins at the time of this diagnostic operation. It’s important that women understand as much about the operation as possible before having surgery.
Tests used to investigate changes that may be due to ovarian cancer include:
Find out more about:
- Receiving a diagnosis of ovarian cancer
- Questions to ask about a diagnosis of epithelial ovarian cancer
Physical examination
A physical examination for ovarian cancer involves checking for any lumps or masses by feeling the abdomen and doing an internal examination.
If the doctor thinks a woman’s symptoms should be investigated further, she will be referred for imaging and a blood test.
Imaging
Various methods are used to provide images of the ovaries that can be seen on a screen. These images can show possible signs of ovarian cancer in and around the ovaries.
Imaging tests to look for ovarian cancer usually involve ultrasound. The ultrasound is usually done internally ( transvaginal ultrasound) by inserting a small probe into the vagina. An ultrasound is used to check for cysts, tumours or other changes that might or might not be ovarian cancer. Ultrasound results cannot be used to give a definite diagnosis of ovarian cancer.
Imaging of the chest and abdomen (tummy) may also be done to look for spread of the cancer. This usually involves ultrasound or computed tomography (CT) scans. Magnetic resonance imaging (MRI) scans or X-rays may sometimes be used.
Blood tests
If a transvaginal ultrasound shows a cyst or tumour on the ovary, a CA125 blood test might be used to find out whether ovarian cancer may be present.
CA125 is a protein found in the blood. CA125 can be produced by ovarian cancer cells. Increased levels of CA125 may indicate that ovarian cancer is present.
There are many other causes for raised CA125 levels such as ovulation, menstruation, endometriosis, fibroids or benign ovarian cysts. Illnesses such as liver or kidney disease can also cause an increase in CA125 levels. For these reasons, a CA125 test alone cannot be used to diagnose ovarian cancer.
A CA125 test is more helpful in diagnosing ovarian cancer in post-menopausal women than in pre-menopausal women. About half of all women with early-stage ovarian cancer have normal CA125 levels.
If your CA125 blood test results are normal but your symptoms persist or get worse, go back to your doctor.
Paracentesis
If there’s a build-up of fluid in the abdomen, a fluid sample can be taken by paracentesis (through a needle passed through the skin). The fluid is checked under a microscope for cancer cells.
Biopsy
The only way to definitely find out whether a woman has ovarian cancer is with an operation and a biopsy of the tumour or cyst.
If the other test results show that a woman might have ovarian cancer, she should be referred to a gynaecological oncologist who will be responsible for her surgical care. Research shows survival for women with ovarian cancer is improved when their surgical care is directed by a gynaecological oncologist.
Treatment for ovarian cancer begins with this surgery. It’s therefore important that women find out as much as they can about the operation before having it.
