Examination/diagnosis
If you have been experiencing symptoms that you or your doctor suspect could be signs of ovarian cancer, different tests may be required to confirm the diagnosis and to understand the extent of the disease. The results of these tests will provide information your doctor needs to make a treatment decision. Be aware doctors may need to do quite a few tests before they can be sure they’re making the right treatment choices for you:1,2
- First, doctors need to take a detailed medical history, including any family history of different conditions, including breast, ovarian, prostate, and pancreatic cancers. This can help to rule out more common issues that may have the same symptoms as cancer.
- One example of important family history is the presence of the BRCA gene, which can be passed down from either parent to children. You can learn more about BRCA here.
- As a result of where the ovaries are located in the body, ovarian tumours can grow a lot before you experience any discomfort. If an ovary has become very enlarged, it can be found by feeling around the pelvis with the hands (also known as “palpation”). However, just finding an enlarged ovary does not always mean you have ovarian cancer, as harmless “benign” tumours can also cause an increase in size. If a doctor can’t find signs of an ovarian tumour through examining by touch alone, they may test for chemical markers in the blood called CA 125, as well as use ultrasound.
- You may be familiar with ultrasound being used to check on babies in the womb – the process here is exactly the same. The reflection of the sound waves emitted by the ultrasound device creates an image of the study area showing the condition of the uterus, fallopian tubes, ovaries, and surrounding tissues. The ultrasound can be performed over the abdomen, or by inserting a probe into the vagina or occasionally the rectum. That may sound uncomfortable, but ultrasounds should be painless and are not known to cause any complications or risks. If you have any concerns, please talk to your doctor who will be able to explain it in more detail.
"Hearing all these medical terms can be intimidating but try not to worry. If you have any questions at all about any of the tests your healthcare team is performing, it is absolutely fine to ask questions and seek further information."
Tests for markers such as CA-125 require a blood sample. High levels of CA 125 may be a sign of ovarian cancer.3 The problem with these tests is that early-stage ovarian cancers don’t always produce these chemicals, so your results may not be entirely predictive of cancer status. Other markers of interest are:4
- nhibin (typically inhabin A and inhibin B)
- Beta-human chorionic gonadotrophin (β-hCG)
- Alpha-fetoprotein (AFP)
- Lactate dehydrogenase (LDH)
- Carcinoembryonic antigen (CEA)
- CA 19-9
If the test results aren’t clear, you may need to have more. These can include imaging like X-rays or CAT scans, which use radiation to take detailed pictures of your internal structures.
A biopsy may be performed to take a small sample of your ovaries, using a needle. This could be done via a laparoscopy or using ultrasound. A laparoscopy involves very small cuts in your abdomen. The surgeon then inserts a tiny camera.5 Alternatively, the biopsy needle may be guided through your abdomen to your ovaries using ultrasound. The needle will take a small clump of cells to be examined later to look for signs of cancer. You will be given medication so that you don’t feel pain during the procedure. There could be some discomfort afterwards, but your doctor should give you advice on how to manage it.6
Hearing all these medical terms can be intimidating but try not to worry. If you have any questions at all about any of the tests your healthcare team is performing, it is absolutely fine to ask questions and seek further information.
