If you have one or more symptoms that suggest ovarian cancer, your doctor must find out whether it is due to cancer or some other cause. Most women start with their gynecologist or a primary care physician. Your doctor may ask about your personal and family medical history as well as a physical exam. They will check from the outside for anything unusual in the abdominal area, such as lumps or an abnormal buildup of fluid (ascites). A sample of fluid can be taken to look for ovarian cancer cells. They will also perform an internal pelvic exam that feels for anything abnormal. (NOTE: A Pap test is not used to detect ovarian cancer; however, one may be performed to rule out cervical cancer.)
You may have one or more of the following tests as part of the process of determining if cancer is present. Your doctor can explain more about each test:
Your doctor may order blood tests. The lab may check the level of several substances, including CA-125. CA-125 is a substance found on the surface of ovarian cancer cells and on some normal tissues. A high CA-125 level could be a sign of cancer or other conditions. The CA-125 test is not used alone to diagnose ovarian cancer. This test is approved by the Food and Drug Administration for monitoring a woman’s response to ovarian cancer treatment and for detecting its return after treatment.
The ultrasound device uses sound waves people cannot hear. The device aims sound waves at organs inside the pelvis. The waves bounce off the organs. A computer creates a picture from the echoes. The picture may show an ovarian tumor. For a better view of the ovaries, the device may be inserted into the vagina (transvaginal ultrasound).
This type of image provides a cross-sectional view of the body so the doctor can see if there are tumors present. CT scans aren’t ideal for identifying small tumors but can identify larger ones and can help the doctors see if the cancer has grown in any nearby areas of the body. In some cases, this is combined with a PET scan.
A very small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is used. Malignant tumor cells appear brighter in the picture because they are more active and consume more glucose than normal cells. This can find tumors that are very small or not even detectable by the human eye.
If a tumor (or tumors) are found in the imaging tests, surgery is likely the next step in the process. Not all ovarian tumors are cancerous! That’s why it’s important to have any tumors tested. The doctor will likely perform a minimally invasive surgery to remove the affected ovary(s) and any other areas of the reproductive system that may be affected. They will send a sample of the tumors to a pathologist for review. This will be the final answer as to whether cancer is present and the specific type of ovarian cancer.
If cancer is found, an x-ray might be done to determine whether ovarian cancer has spread (metastasized) to the lungs.
MRI (Magnetic Resonance Imaging)
A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI). It’s used to see if cancer has spread to other areas of the body, especially in the brain or spinal cord.
Molecular Testing of the Tumor
In addition to genetic testing for inherited or germline mutations, your doctor may also recommend running laboratory tests on a tumor to identify specific genes, proteins, and other factors unique to the tumor. This can help the oncologist understand if there are specific targeted therapies or immunotherapies that might work best.
If cancer is detected, you’ll need to consult an oncologist who specializes in gynecologic cancers. They will perform some additional testing to see how far the cancer has spread. Learn more about how oncologists determine ovarian cancer staging.
Ovarian Cancer Care in the South Chicago Suburbs
If testing has detected ovarian cancer, the gynecologic oncologists at Affiliated Oncologists work with you to recommend a treatment specific to you. Our cancer centers are located in the South Chicago suburbs, including Downers Grove and Oak Lawn, IL. We also provide second opinions on diagnosis and treatment plans for ovarian cancer.