How is Ovarian Cancer Diagnosed?

Overview

The earlier ovarian cancer is found and treated, the better a woman’s chance for survival. It is important to know that early-stage symptoms can be difficult to detect, although not always silent. Women need to be aware, listen to their bodies and report signs or symptoms to their doctor.

Most women with ovarian cancer are diagnosed with advanced-stage disease (Stage III or IV). This is because the symptoms, particularly in the early stages, are often not severe and present vaguely. During a pelvic exam, the disease is not detected unless the doctor notes enlargement of either of the ovaries.

Did you know?

There is no effective screening test for ovarian cancer. A Pap smear test does not detect ovarian cancer, but rather screens for cervical cancer.

Detection and Diagnosis

Although there is no consistently reliable screening test to detect ovarian cancer, research in this area is ongoing.  If a woman has signs and symptoms of ovarian cancer, the following tests are available and should be offered especially to those at increased risk:

  • Pelvic exam: This checks for an enlarged ovary or signs of fluid in the abdomen. The doctor examines the uterus, vagina, ovaries, bladder and rectum for any unusual changes such as a mass. Some cancers are very small before they spread and cannot be reliably detected by pelvic examination.
  • Transvaginal ultrasound: This examination uses a small instrument placed in the vagina to look at the ovaries and uterus. This method is especially appropriate for women at increased risk for ovarian cancer or those with an abnormal pelvic exam.
  • CA-125 blood test: This measures the level of CA-125, a protein found in higher levels in women with ovarian/fallopian tube cancer.  While CA-125 is an important test, it is not always a key marker for the disease. Some non-cancerous diseases of the ovaries can also increase CA-125 levels, and some ovarian cancers may not produce enough CA-125 levels to cause a positive test. For these reasons the CA-125 test is not routinely used as a screening test for those at an average risk for ovarian cancer, but rather as a baseline for monitoring.

Positive Tests

If any test returns an abnormal result, a woman should consult a gynecologic oncologist. As a cancer specialist, they will evaluate the test results and may conduct a CT scan. However, the most accurate way to confirm an ovarian cancer diagnosis is by biopsy, a procedure in which the doctor takes a sample of the tumor and examines it under a microscope.

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