How Ovarian Cancer Is Diagnosed
If you have concerning symptoms, schedule a pelvic exam.
Your exam should include a rectovaginal exam, along with a general physical exam.
- If the exam is abnormal, ask for a transvaginal or pelvic ultrasound to evaluate the ovaries.
- If the exam is normal, it is reasonable to wait 2-3 weeks to see if the symptoms resolve. If they do not, then a transvaginal or pelvic ultrasound should be performed.
If an abnormality of the ovaries is found, additional studies may be performed. These may include a CT scan or MRI and a blood test for the protein CA-125. CA-125 is elevated in approximately 80 percent of women with advanced stage epithelial ovarian cancer, although elevations can occur for reasons other than ovarian cancer.
The Role of the Gynecologic Oncologist
If you suspect or have been diagnosed with ovarian cancer, it is important to see a gynecologic oncologist. This is a physician with special training in the care of women’s reproductive cancers.
The Women’s Cancer Network has a “Find a Doctor” feature on its Web site (www.wcn.org) where visitors can search for a gynecologic oncologists by ZIP code. Women can also find the nearest gynecologic oncologist by calling (800) 444-4441.
Multiple studies have shown that an ovarian cancer patient’s chance of survival is significantly improved when her surgery is performed by a gynecologic oncologist. One analysis of multiple studies found that women whose surgeries were performed by gynecologic oncologists had a median survival time that was 50 percent greater than women whose surgeries were done by general gynecologists or other surgeons inexperienced in optimal debulking procedures.
Evaluating the Extent of Ovarian Cancer
When ovarian cancer is diagnosed, it is vital to determine if the cancer has spread beyond the ovaries. Your treatment team may do more tests to determine if the cancer has spread. In addition, during surgery, certain additional steps should be performed to determine the extent of the disease, a process is called staging. Staging helps to determine the exact extent of your cancer and what treatment plan is best for you.
It is important that your surgery be performed by a gynecologic oncologist. Following surgery your cancer will be categorized into one of the following stages:
Stage I: The cancer is found in one or both ovaries. Cancer cells also may be found on the surface of the ovaries or in fluid collected from the abdomen.- Stage II: The cancer has spread from one or both ovaries to other tissues in the pelvis. For example, it may have spread to the fallopian tubes or to the uterus. Cancer cells may also be found in fluid collected from the abdomen.
- Stage III: The cancer has spread outside the pelvis or nearby lymph nodes. Most commonly the cancer spreads to the omentum, diaphragm, intestine and the surface of the liver.
- Stage IV: The cancer has spread to tissues outside the abdomen and pelvis. Most commonly the cancer has spread to the space around the lungs. If the cancer spreads inside the liver or spleen, it is considered stage IV.
The cancer will also be assigned a grade. Grade refers to how abnormal the cells appear under a microscope. Low grade tumors, also called grade 1, have features that resemble normal ovarian cells. In contrast, high grade tumors (grades 3 or 4) have a greatly altered microscopic appearance.
More Resources
- Ovarian Cancer Diagnosis (National Cancer Institute)
Here are more details about the tests and procedures doctors may use to diagnose women with symptoms of ovarian cancer.
Our Sources