About 20% of ovarian cancers are found at an early stage. Finding the cancer early improves the chances that it can be treated with success. About 9 out of 10 women treated for early ovarian cancer will live longer than 5 years after the cancer is found. Some large studies are in progress to learn how best to find ovarian cancer in its earliest stage.

Ways to find ovarian cancer early

Regular women's health exams: During a pelvic exam the doctor will feel the woman's organs to check their size and shape. But most ovarian tumors are hard to find early because the ovaries are deep within the body and the doctor cannot feel them easily. While the Pap test helps to find cervical cancer early, it is not really useful for finding ovarian cancer at an early stage.

See a doctor if you have symptoms: Early cancers of the ovaries tend to cause somewhat vague symptoms. These symptoms might include:

• swelling of the stomach (abdomen) or bloating caused by a build-up of fluid or a tumor
• pelvic pressure or stomach pain
• trouble eating or feeling full quickly
• 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.

When these symptoms are caused by ovarian cancer, they tend to go on and are a change from normal -- for example, they happen more often or get worse. If you have symptoms that you can't explain nearly every day for more than a few weeks, talk to your doctor right away.

By the time ovarian cancer is thought of as a possible cause of these symptoms, it may already have 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 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

Screening tests: Screening tests and exams are used to find a disease such as cancer in people who don't have any symptoms. Women with a very high risk of ovarian cancer (such as those with a strong family history of the disease) may be screened with ultrasound and with blood tests. But early studies of women at average risk of ovarian cancer show that these tests did not lower the number of deaths caused by ovarian cancer. For this reason, these tests are not used for routine screening of women who don't have strong risk factors.

Seeing a specialist

If there is any reason to suspect ovarian cancer, the doctor will use one or more methods to find out if the disease is really present. One of the first steps will be a meeting with a doctor who has special training in treating women with this type of cancer (a gynecologic oncologist). Treatment by a gynecologic oncologist 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 whether there is a mass in the pelvis, but they cannot tell whether it is cancer.

Ultrasound: This test uses sound waves to make a picture on a video screen. A small probe 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. CT scans are useful in showing how large the tumor is, whether lymph nodes are swollen, and whether the tumor has spread to other organs. 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).

CT scans take longer than regular x-rays. You will need to lie still on a table while they are being done. But CT scans are getting faster. 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.

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 may be done instead (more information below).

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. They are not often used to look for ovarian cancer.

Chest x-rays: X-rays may be taken to see whether 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 all always covered by insurance.

Other tests

Laparoscopy: This 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 if and how far the tumor has spread and then 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 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 kidney and liver function, and look for a substance called CA-125. CA-125 is a protein in the blood that may be higher than normal in some women with ovarian cancer.

Last Medical Review: 09/14/2009
Last Revised: 09/14/2009