Ovarian Cancer Overview

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Early Detection, Diagnosis, and Staging TOPICS

How is ovarian cancer found?

Signs and symptoms of ovarian cancer

  • Swelling of the stomach (abdomen) or bloating caused by a build-up of fluid or a tumor
  • Pelvic or belly (abdominal) pain
  • Feeling full quickly or trouble eating
  • Having to urinate often or feeling like you have to go right away

Most of these symptoms can also be caused by problems other than cancer. While these symptoms can be more severe when they are caused by ovarian cancer, that isn’t always true. What is most important is that they are a change from how a woman usually feels. If you have symptoms that you can’t explain nearly every day for more than a few weeks, talk to your doctor right away.

Women are more likely to have symptoms if the disease has spread beyond the ovaries. Also, some types of ovarian cancer can quickly spread to the surface of nearby organs. Still, dealing with symptoms right away can improve the odds of finding the cancer early and treating it with success.

Other symptoms of ovarian cancer can include those listed below. But, again, most of these symptoms are more likely to be caused by something other than ovarian cancer.

  • Tiredness
  • Upset stomach
  • Back pain
  • Pain during sex
  • Constipation
  • Menstrual changes
  • Abdominal swelling with weight loss

Physical exam

Your doctor will first ask you some questions and examine you to look for signs of ovarian cancer. These signs include finding an enlarged ovary (on a pelvic exam) and signs of fluid in the abdomen (which is called ascites).

Seeing a specialist

If there is any reason to suspect ovarian cancer, the doctor will take steps to find out if the disease is really present. One of the first steps will be for you to meet with a doctor who has special training in treating women with this type of cancer (a gynecologic oncologist). Treatment by a gynecologic oncologist helps you get the best kind of surgery for your cancer. And it has been shown to help patients with ovarian cancer live longer. Women who might have ovarian cancer should see this type of doctor before surgery.

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 studies

These tests can show if there is a mass 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 whether 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 can also be used to guide a needle into a tumor in order 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 more often used to check out an area of possible cancer spread.

Barium enema x-rays

These can be done to see whether the cancer has spread to the large intestine (colon) or rectum. A chalky substance (called barium sulfate) will be put into the rectum and colon. The barium outlines the colon and rectum on x-rays. But this test is rarely used now in women with ovarian cancer. Colonoscopy (see below) may be done instead.

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.

Chest x-rays

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

PET (Positron emission tomography)

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 to find 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.

Other tests

Laparoscopy

This test lets the doctor take pictures of the ovaries and other pelvic organs. A thin, lighted tube is placed through a small cut (incision) into the lower belly (abdomen). This allows the doctor to see the organs in order to figure out whether 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 (see below).

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.

Biopsy

The only way to tell for sure if a growth in the pelvis is cancer is by removing a sample of tissue or fluid to see if cancer cells are present. This is called a biopsy and is often done at the time of surgery. It can also be done during a laparoscopy or rarely with a needle placed right into the tumor through the skin of the belly (abdomen). The sample is sent to the lab where it is looked at under the microscope.

Blood tests

These tests are done to make sure you have the right number of the different kinds of blood cells. The tests also measure your kidney and liver functions, and look for a protein named CA-125. CA-125 is a protein in the blood that may be higher than normal in some women with ovarian cancer. Other substances in the blood can point to different types of ovarian tumors. These substances are called tumor markers.


Last Medical Review: 04/22/2013
Last Revised: 02/06/2014