Ovarian Cancer Diagnosis

If you have a symptom that suggests ovarian cancer, your doctor must find out whether it is due to cancer or to some other cause. Your doctor may ask about your personal and family medical history. Most often a gynecologist will perform these tests or refer you to a local imaging center or lab.

You may have one or more of the following tests. Your doctor can explain more about each test:

  • Physical exam: Your doctor 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. A Pap test is part of a normal pelvic exam, but it is not used to collect ovarian cells and does not diagnose ovarian cancer. The Pap test detects cervical cancer.
  • Blood tests: Your doctor may order blood tests for signs that indicate cancer may be present. The lab will check the level of several substances in your blood, including CA-125. CA-125 is 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.
  • Transvaginal ultrasound: The transvaginal ultrasound (TVU) is a procedure used to examine the vagina, uterus, fallopian tubes, and bladder. An ultrasound transducer (probe) is inserted into the vagina and used to bounce waves off the organs to make echoes. A computer then creates a picture (songram) from the echoes, which may show tumors caused by ovarian cancer.
  • PET Scan: The positron emission tomography scan (PET) is an imaging test used to find malignant (cancerous) tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein and then the PET scanner makes a picture of where the glucose is being used in the body. Since cancers use glucose at a higher rate than normal tissues, malignant tumor cells will show up brighter in the picture.  
  • CT and/or MRI Scan: Computerized tomography (CT) and magnetic resonance imaging (MRI) scans are two procedures that provide more detail than conventional x-rays. Although they are similar in the fact that they show cross-sectional pictures of the body, they differ in their techniques. To get a series of pictures, CT scans use multiple x-rays, taken at different angles, while MRIs use magnetic fields and radio frequencies.
  • Biopsy: A biopsy is the removal of tissue or fluid to look for cancer cells. Based on the results of other tests, your doctor may suggest surgery (a laparotomy) to remove the tumor, extra fluid from the pelvis and abdomen, and possibly remove some organs to prevent the cancer from spreading further. To learn more about ovarian cancer surgery, see the “Ovarian Cancer Treatment” section.

Genetic Testing and Counseling for Ovarian Cancer

If you have been diagnosed with ovarian cancer, your doctor may suggest that you meet with a genetic counselor to determine if you should be tested for certain inherited gene changes, such as BRCA1 or BRCA2 mutations. Some ovarian cancers are linked to these hereditary gene mutations. Understanding more about your genetic makeup can help you and your family members make different lifestyle choices and may change how they screen for some cancers, including breast cancer.