Ovarian Cancer Overview

+ -Text Size

Early Detection, Diagnosis, and Staging TOPICS

How is ovarian cancer found?

If you are having symptoms that could be caused by ovarian cancer, you should see your doctor. Your doctor will ask questions and examine you and may also order some tests. If ovarian cancer is suspected, you should be referred to a gynecologic oncologist. This is a doctor that specializes in treating cancers of the female reproductive system, including cancer of the ovaries.

These are some of the tests that could be done to find out if you have ovarian cancer or to find out more about the cancer:

Imaging tests

These tests can show if there is a mass (tumor) in the pelvis, but they cannot tell if it is cancer.

Ultrasound

This is often the first test done to see if there is a problem with the ovaries. This test uses sound waves to make a picture on a video screen. A small probe is placed in the woman’s vagina or on the skin over her belly (abdomen). Because tumors and normal tissue reflect sound waves differently, this test may be useful in finding tumors and in telling if a mass is solid or a fluid-filled cyst.

CT scans (computed tomography)

A CT scan is a type of x-ray that gives a detailed picture of the inside of your body. It takes a series of pictures of the body from many angles. A computer then combines the pictures.

A CT scanner has been described as a large donut, with a narrow table in the middle “hole”. You will need to lie still on the table while the scan is being done. CT scans take longer than regular x-rays, and you might feel a bit confined by the ring while the pictures are being taken.

Also, a contrast dye may be put into your vein or you may be asked to drink a contrast fluid. The contrast dye or fluid helps better outline structures in your body. The dye can cause some flushing (redness and warm feeling that may last hours to days). A few people are allergic to the dye and get hives. Rarely, more serious problems like trouble breathing and low blood pressure can happen. Medicine can be given to prevent and treat allergic reactions. But be sure to tell the doctor if you have ever had a reaction to any dye used for x-rays.

CT scans do not show small ovarian tumors well, but they can show larger tumors, and may be able to tell if the tumor is growing into nearby structures. A CT scan may also find enlarged lymph nodes, signs of cancer spread to liver or other organs, or signs that an ovarian tumor is affecting your kidneys or bladder. CT scans also can be used to guide a needle into a tumor to remove a sample of tissue (see biopsy under “Other tests" below). This is rarely used to take a sample from an ovarian tumor but is used more often to check out an area of possible cancer spread.

Chest x-rays

X-rays may be taken to see if the cancer has spread to the lungs.

PET (Positron emission tomography) scans

PET scans use a form of radioactive sugar (glucose) to look for the cancer. Cancer uses sugar at a higher rate than normal tissues. This means that the radioactivity will tend to collect in the cancer, which can be seen on the scan. This test is sometimes useful finding ovarian cancer that has spread. But it is expensive and is not always covered by insurance when it is used to look for ovarian cancer.

Blood tests

If ovarian cancer is suspected, the doctor may check your blood to see if it has high levels of certain proteins called tumor markers. Levels of these proteins can go up if cancer is present. Still, tumor marker levels can’t tell for certain if you have cancer – you can have a normal level and still have cancer, and a high level can be caused by things besides cancer. The most common tumor marker used for ovarian cancer is CA-125.

Your doctor may also check to make sure you have the right number of the different kinds of blood cells. Blood tests are also often done to check your kidney and liver functions,.

Biopsy

The only way to tell for sure that something is cancer is by removing a sample of tissue to see if cancer cells are present. This is called a biopsy. For many kinds of cancer, this is done before surgery to remove the tumor. For ovarian cancer, though, this could spread the cancer, and so the biopsy is usually done during surgery to remove the cancer.

If you have fluid built up in the abdomen (called ascites), the doctor can remove it and check it for cancer cells before surgery (this doesn’t spread the cancer).

For women who are too sick to have a big operation, a biopsy can be done during an operation that uses a laparoscope (see below) or rarely with a needle placed right into the tumor through the skin of the belly (abdomen).

Other tests

Laparoscopy

This test lets the doctor take pictures of the ovaries and other pelvic organs. A thin, lighted tube (a laparoscope) is placed through a small cut (incision) into the lower belly (abdomen). This lets the doctor see organs in order to figure out if the tumor has spread and if so, how far. This can help the doctor plan surgery or other treatments. Also, doctors can use small instruments through the cut to do a biopsy.

Colonoscopy

This test is a way for the doctor to see the inside of the large intestine (colon). After you have taken laxatives to clean out your intestines, the doctor puts a tube into the rectum and into the colon. Through this, the doctor can see inside and spot any cancer. Because it can be uncomfortable, you will be given drugs to make you sleep through the test. This test is most often used to look for colorectal cancer.

MRI (magnetic resonance imaging)

Like CT scans, MRIs show a cross-sectional picture of the body. But an MRI uses radio waves and strong magnets instead of x-rays. MRI scans are very helpful in looking at the brain and spinal cord. These scans take longer than CT scans, often up to 30 minutes or more. These are not often used to look for ovarian cancer but may be used to check the brain or spinal cord.


Last Medical Review: 08/08/2014
Last Revised: 11/17/2014