If your healthcare provider thinks you might have ovarian cancer, you will need certain exams and tests to be sure. Diagnosing ovarian cancer starts with your healthcare provider asking you questions. He or she will ask you about your health history, your symptoms, risk factors, reproductive history (such as if you've ever been pregnant), and family history of disease. Your healthcare provider will also give you a physical exam.
You may have one or more of the following tests:
CA-125 blood test
This is often the first exam done. It allows your healthcare provider to feel for any abnormal lumps (masses) or other problems. During a pelvic exam, you lie on your back on an exam table, with your feet in stirrups and your legs apart. Your healthcare provider puts 1 or 2 fingers of a gloved hand inside your vagina. He or she uses the other hand to press on your lower belly (abdomen) to feel for masses. Your healthcare provider may also put a finger in your rectum to feel for anything abnormal that might suggest that the cancer has spread.
This test allows your healthcare provider to see if there's a cyst or tumor on your ovary, or if there is fluid in your abdomen Your healthcare provider aims sound waves at your ovaries. He or she does this either by putting a small probe into your vagina (transvaginal ultrasound) or aiming them through the skin of your abdomen (abdominal ultrasound). The pattern of the echoes makes a picture on a video screen. This is called a sonogram. The echoes are different for healthy tissues, fluid-filled cysts, and tumors. The test can be uncomfortable, but it isn’t painful. It doesn’t use X-rays. You don’t need to be sedated.
This test makes detailed 3-D pictures of organs and tissues in your pelvis or abdomen. An X-ray machine linked to a computer takes several pictures. You may get contrast material by mouth and by injection into your arm or hand. The contrast material helps the organs or tissues show up more clearly.
This blood test shows how much of a protein called CA-125 is in your blood. A high (elevated) CA-125 may be a sign of tumor cells. But it also can be elevated in many noncancer conditions. This is called a false positive result. After a diagnosis of ovarian cancer, your healthcare provider may use this blood test to see if you’re responding to treatment. Or the test can be used to check if the cancer has come back.
Unlike many other types of cancer, a biopsy is rarely used to diagnose ovarian cancer before surgery. If a cancer is present and just in the ovary, doing a biopsy breaks the covering of the ovary. This may allow the cancer to spread. Sometimes your healthcare provider may recommend a biopsy of a tumor or lymph node that is not near the ovary. This is done to see if the cancer has spread to another area. A diagnosis of ovarian cancer is often confirmed at the time of surgery. At that time, the surgeon removes the tumor or tumors and takes samples of nearby tissues to find out if the cancer has spread. In a lab, a pathologist looks at the removed tissues to see if cancer is present.
When your healthcare provider has the results of your tests, he or she will contact you with the results. Your provider will talk with you about other tests you may need if ovarian cancer is strongly suspected. Make sure you understand the results and what follow-up you need.