The problem is the signs and symptoms of ovarian cancer aren’t always easy to recognize, and they can mimic those of other conditions. Only about 20 percent of ovarian cancers are found at an early stage, when they’re most treatable. Early and accurate ovarian cancer diagnosis is important, because it may improve the odds of successful treatment. An example of a screening test is a Pap test (or Pap smear), which identifies cervical cancer. A Pap smear, however, doesn’t detect ovarian cancer. A diagnostic test is used to diagnose a condition when a person has symptoms of cancer. The purpose of a diagnostic test is to find out what’s causing the symptoms. Sometimes, a diagnostic test is also used if you have a strong family history of cancer or your physician suspects you have cancer for other reasons. There are several diagnostic tests for ovarian cancer, including a pelvic exam, blood tests, and imaging tests. Sometimes, healthcare providers can find ovarian cancer at an early stage by performing a pelvic exam. But most early ovarian tumors are hard to feel. A pelvic exam can also help find other cancers or conditions.
Blood Tests: Is There an Ovarian Cancer Blood Test?
A physician investigating whether or not you have ovarian cancer may order a blood test to look for elevated levels of a protein called CA-125. But this test is not definitive. While women with ovarian cancer may have abnormally high CA-125 levels, they don’t always. What’s more, an increase in the amount of CA-125 in the blood is more likely to be caused by more common health conditions, such as pelvic inflammatory disease or endometriosis. Some rare forms of ovarian cancer — germ cell and stromal — may cause increases in other substances in the blood.
Imaging Tests Can Help Doctors Make a Diagnosis
Doctors use imaging tests to see if there is a mass inside the pelvis that may be cancer and to look for tumors elsewhere in the body that show the cancer has spread. Some common imaging tests include: (3)
UltrasoundComputerized tomography (CT) scansPositron emission tomography (PET) scans
Ultrasound
A pelvic ultrasound involves inserting a small probe into the vagina that releases sound waves. The ultrasound machine translates the echoes into images on a screen. Ultrasound can detect the presence of a pelvic mass and reveal how big it is and whether it is solid (a tumor) or fluid-filled (a cyst). Researchers are studying whether ultrasound screening tests can help detect ovarian cancer in women who don’t have any symptoms.
Computerized Tomography (CT) Scans
These scans use X-rays to create a cross-sectional, 3-D image of the body that reveals any abnormalities or tumors. A CT scan can be used to determine how large a tumor is and how much the cancer has spread. However, it is difficult for a CT scan to detect tumors or abnormalities smaller than about 5 millimeters (1/5 inch).
Positron Emission Tomography (PET) Scans
PET scans look for cancer cells throughout the body and can help doctors determine whether any abnormalities detected by other imaging tests are cancerous or not. Doctors inject a form of radioactive sugar into the bloodstream and use the PET scan to look for clusters of radioactivity in the body. These clusters indicate the presence of cancer cells, which take up more sugar than normal cells in order to get the energy they need to drive their rapid growth.
Surgeries: A Helpful Tool for Diagnosing Ovarian Cancer
Surgery to remove a tumor is often done to help diagnose ovarian cancer. (4) This procedure might involve using techniques, such as minimally invasive laparoscopy or robotic approaches. Removing the abnormal tissue lets doctors examine it, so they can determine if it’s cancerous. Sometimes, your doctor can’t be sure you have cancer until surgery is performed.
A Biopsy Is the Only Definitive Test for Diagnosing Ovarian Cancer
A biopsy — removal of a small amount of tissue, usually with a needle — is necessary to make an ovarian cancer diagnosis. (5) Doctors examine the tissue sample under a microscope to see if cancer cells are present. Doctors will typically remove tissue for an ovarian cancer biopsy during a surgery that also aims to remove the tumor. For patients suspected of having advanced cancer, physicians may be concerned that a surgical biopsy might spread cancer. In these cases, they may choose to get a tissue sample through a laparoscopy procedure or by inserting a needle through the skin of the abdomen directly into the tumor. When a patient has fluid buildup in their abdomen, doctors may use a syringe to get a sample of fluid for biopsy.
What Happens After a Diagnosis Is Made?
After you get an ovarian cancer diagnosis, your doctor will attempt to stage your disease. Staging allows providers to assess the extent of the cancer and give you an accurate prognosis. (6) Once your stage is determined, you and your physician will come up with an appropriate treatment plan. This may include surgery and chemo. (7) Though a diagnosis of ovarian cancer can be scary, it’s a critical step to understanding your disease and establishing a successful treatment plan. Additional reporting by Julie Marks.
