If you have a symptom that suggests ovarian cancer, your doctor will likely suggest one or more of the following:
- Physical exam This checks general signs of health. Your doctor may press on your abdomen to check for tumors or an abnormal buildup of fluid (ascites). A sample of fluid can be taken to look for ovarian cancer cells.
- Pelvic exam Your doctor feels the ovaries and nearby organs for lumps or other changes in their shape or size. While a Pap test is part of a normal pelvic exam, it is not used to diagnose ovarian cancer, but rather as a way to detect cervical cancer.
- Blood tests Your doctor may order blood tests to check the level of several substances, including CA-125, 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. It 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.
- Ultrasound Sound waves from the ultrasound device bounce off the organs inside the pelvis to form a computer image that may show an ovarian tumor. For a better view of the ovaries, the device may be inserted into the vagina (transvaginal ultrasound).
- Biopsy A biopsy is the removal of tissue or fluid to look for cancer cells. Based on the results of the blood tests and ultrasound, your doctor may suggest surgery (a laparotomy) to remove tissue and fluid from the pelvis and abdomen to diagnose ovarian cancer.
Although most women have a laparotomy for diagnosis, some have a procedure known as laparoscopy. The doctor inserts a thin, lighted tube (a laparoscope) through a small incision in the abdomen. Laparoscopy may be used to remove a small, benign cyst or an early ovarian cancer. It may also be used to learn whether cancer has spread.
If ovarian cancer cells are found, the pathologist describes the grade of the cells. Grades 1, 2, and 3 describe how abnormal the cancer cells look. Grade 1 cancer cells are not as likely as to grow and spread as Grade 3 cells.