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 and how far it has spread in the body to determine the order of surgery and chemotherapy. Answering these questions before developing a patient’s treatment plan is crucial.

At Siteman, we ensure that patients are seen 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 gynecologic specialized pathologists to make sure we have the correct diagnosis.

Many patients travel great distances to be seen at Siteman, so we try to make your time with us as efficient as possible. This means coordinating multiple tests and appointments on the same day to spare you from having to make additional trips to our facility.

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. Your physician will conduct a pelvic exam, pressing on your lower abdomen and checking for anything abnormal in your ovaries and pelvis.

If your physician suspects something could be wrong, he or she may recommend an ultrasound to evaluate further. These ultrasounds are often performed transvaginally, meaning 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’s over.

If the ultrasound indicates that a tumor is present, your physicians will likely want to remove the affected ovary and/or perform a biopsy on the tumor tissue. You’ll undergo a surgical procedure under anesthesia called an oophorectomy.

In addition to performing a biopsy, your physicians 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 an ovarian tumor. However, if you have elevated CA-125 levels, it doesn’t necessarily mean you have cancer; many conditions can cause this, including pregnancy and liver problems.

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. This imaging may include a CT scan, an MRI or a PET scan. A PET scan is an imaging procedure in which a special glucose dye is used to make it easier for your physician to see areas of disease.

Staging ovarian cancer

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

Ovarian cancers are assigned stages ranging from I to IV, with IV being the most advanced. Ovarian cancer includes fallopian tube and primary peritoneal cancers. Cancers identified at stage I are limited to either the ovaries or the fallopian tubes. At Stage II, cancer cells have migrated into the pelvis. . Stage III ovarian cancers have spread from the pelvis into other parts of the abdomen and/or to nearby lymph nodes. Finally, Stage IV cancers have moved beyond the abdomen to other parts of the body.