Ovarian cancer is often diagnosed during routine physical exams or when symptoms such as abdominal pressure, pelvic pain, and bowel or bladder changes persist. Ultrasound or CT images and a blood test for the tumor marker CA125 are used to diagnose the cancer. Surgery is performed to remove the cancer and determine its stage.
The diagnosis of ovarian cancer often begins when a mass is felt on the ovaries during a routine physical exam or during an exam to determine the cause of persistent, abnormal symptoms. After detecting a mass, ultrasound or computed tomography (CT) images will be ordered, and a blood test for the tumor marker CA125 will be done. Additional images of the chest and colon may be ordered if metastatic ovarian cancer is suspected. If warranted, surgery will be performed to examine both the reproductive organs and the abdominal cavity and remove the cancer.
Symptoms are typically the first sign of a medical problem and are often used in diagnosis. The symptoms of ovarian cancer are similar to several benign medical conditions and therefore often don’t require a gynecological visit. As a result, tumors are often found during routine gynecological exams. In some cases, several persistent symptoms, such as abdominal pressure, pelvic pain, loss of appetite, and bowel or bladder changes, may disqualify a doctor’s visit and warrant a pelvic exam.
During a gynecological exam, your doctor will feel your reproductive organs. If a mass is felt or suspected, the next step in diagnosing ovarian cancer will be a picture of the ovaries. Ultrasound or CT images will be used to examine the ovaries and look for signs of metastatic cancer throughout the abdominal cavity. If the tumor has metastasized, further imaging, such as a chest X-ray, barium enema X-ray, or magnetic resonance imaging (MRI) may be ordered to determine whether the tumors have spread.
Ovarian cancer cells, other types of cancer cells, and sometimes normal cells will have a protein tumor marker on their surface called CA125. This semi-specific protein can be used as an indicator of ovarian cancer and helps in the diagnosis of ovarian cancer. When CA125 is elevated in the blood it can suggest the presence of ovarian cancer, but some benign conditions, such as pregnancy, endometriosis and fibroid tumors can also produce an elevated CA125 value. The CA125 blood test is used as a small piece in diagnosing ovarian cancer. This test is also used to establish a baseline for monitoring the effectiveness of any future chemotherapy.
If a mass is seen on the ovaries or in the abdominal cavity, surgery will be ordered. Surgery for the diagnosis of ovarian cancer can be performed by laparoscopic surgery or as an open laparotomy. During the surgical procedure, your ovaries, internal organs, diaphragm, abdominal walls, abdominal fat and lymph nodes will be examined for any signs of cancer.
A small sample will be taken if cancerous cells are suspected. In the operating room, the samples will be flash frozen, sectioned into extremely thin slices for microscopic review, and examined by a pathologist. All identified cancerous cells will be removed. The stage or spread of ovarian cancer will be accurately recorded and used later to determine the type of treatment.
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