Diagnosing Ovarian Cancer

Diagnosing ovarian cancer is more complex than simply determining whether malignant cells are present in the ovaries, peritoneum, or fallopian tubes. Physicians must also evaluate what type of tumor it is, whether it’s malignant or benign, whether it involves certain genetic mutations in the tumor itself (which is different from other genetic factors like Lynch syndrome or the BRCA gene), and if it has spread in the body or not. The answers to these questions become the foundation for the treatment plan Washington University Physicians create for your specific circumstance.

At Siteman, we excel at seeing patients in a timely manner so as not to delay diagnosis and treatment. When you come to see us, your records, tests, and previous biopsies will be reviewed again by our specialized pathologists to make sure we have the correct diagnosis.

Because Siteman is an NCI-designated Comprehensive Cancer Center, many patients travel great distances for our expertise. For patients’ convenience, we try to make visits with us as efficient as possible. This means coordinating multiple tests and appointments on the same day to minimize the number of trips and time spent traveling to one of our locations.

What tests are used to diagnose ovarian cancer?

The diagnostic process for ovarian cancer starts with a simple exam in an ob-gyn’s office. During the exam, your physician will press on your lower abdomen and perform a pelvic exam, checking for anything abnormal in your ovaries and pelvis.

If your ob-gyn suspects something could be wrong, he or she may recommend an ultrasound to evaluate further. These ultrasounds are often performed transvaginally, which means that the ultrasound wand is placed inside the vagina for a closer view of the pelvic organs. Patients don’t need to do any special preparation for the exam, and they are free to resume their usual activities when it is over.

Your physician may order a blood test called a CA-125 assay. CA-125 is a protein secreted by cancer cells, including ovarian cancer cells. If your levels of CA-125 are found to be elevated, that could indicate the presence of a malignant ovarian tumor.  Additional specialized blood tests may be performed too.

You may also undergo one or more imaging scans to visualize the tumor inside your body, or to see if cancer cells have begun to spread. These might include a CT scan, an MRI, or a PET scan.

What are the stages of ovarian cancer?

Once cancer has been found or is suspected, it’s important to determine how advanced it is and how far it has spread in the body. This is called staging the cancer.

Ovarian cancers are assigned stages from I to IV, with IV being the most advanced.

  • Stage I: Cancers are only found in either the ovaries or the fallopian tubes.
  • Stage II: Cancer cells have moved beyond the ovaries and/or fallopian tubes and are in the pelvis, too.
  • Stage III: The ovarian cancer has spread outside of the pelvis to parts of the abdomen or into the lymph nodes.
  • Stage IV: Cancer is more widespread in the body including liver, spleen or lungs, for example.