How is Ovarian Cancer Diagnosed?

Ovarian cancer can be difficult to diagnose as the symptoms are often vague and many other conditions can have similar symptoms. If your doctor suspects ovarian cancer he will take a detailed history, examine you and recommend certain tests.

Medical history and examination:The doctor may sit with you and in a  session ask questions about family history, or  about current symptoms such aschange in bowel habits (constipation), fatigue, urination problems, loss of appetite, feeling of abdominal fullness and bloating; family history of ovarian cancer or other cancers; menstrual history; current medications.

The doctor will do a pelvic examination as a part of physical examination to look for any signs or symptoms of ovarian cancer. During the pelvic exam the doctor checks uterus, vagina, ovaries, fallopian tubes, bladder, and rectum for any abnormalities in their shape or size. At time a Pap test may be done. This test is a good test to screen or diagnose cancer of the cervix but is not a reliable way to find or diagnose ovarian cancer.

Tests for Diagnosis of Ovarian Cancer

Some of the tests that are helpful in diagnosing ovarian cancer include:

• blood tests
• ultrasound
• lower GI series (barium enema)
• CT scan
• laparotomy with biopsy.

Blood Test: A blood test that the doctor may recommend if ovarian cancer is suspected is a CA-125 assay. The test measures the level of CA-125 (a tumour marker). The blood level of this tumour marker is often elevated in women with ovarian cancer.

Ultrasound: This is a painless and non-invasive test that uses high-frequency sound waves to view the organs and structures inside the body. The sound waves used for ultrasound cannot be heard by humans. The pattern of the echoes produced when the sound waves are reflected from the internal organs such as ovaries uterus creates a picture called a sonogram. The radiologist can differentiate healthy tissues, fluid-filled cysts, and tumours on this picture.

Lower GI Series: A lower GI series or barium enema is a series of x-rays which are done to look at the colon and rectum. You will be given a white, chalky solution containing barium to drink and then series of X-ray are taken. The contrast produced by barium outlines the colon and rectum on the x-ray, and this makes tumours or other abnormal areas more obvious.

CT Scan: This is also a painless and non-invasive test, which takes a series of detailed pictures of part of the body that is being examined. If needed, your doctor will inject a dye during CT scan so that the ovary and other organs in the abdomen and pelvis show up clearly in the pictures. CT scan can show tumours in the ovary, regional spread of tumour or tumour in other places in the abdomen.

Magnetic resonance imaging (MRI): MRI scan is more sensitive than CT scan for detection of tumours or abnormalities in the ovary, other organs or places in the abdomen. It can detect tumours which are very small in size and may not be seen even on a CT scan.

Laparotomy with Biopsy: Your doctor will take a sample of tissue from the lump or growthand examine under a microscope to look for cancer cells in the tissue. To obtain the sample a laparotomy (an operation to open the abdomen) is done and if your doctor suspects cancer the surgeon will operate to remove the tumour.

After the Diagnosis

If an ovarian cancer is diagnosed, staging of the disease will be done using surgery, x-rays or other imaging procedures, and lab tests. Staging is done to assess the size and spread of cancer as it helps to decide treatment and predict the prognosis.