Ovarian Cancer

Diagnosis

To help with the diagnosis of ovarian cancer symptoms, a doctor evaluates a woman’s medical history. The doctor also performs a physical exam and orders diagnostic tests. Some exams and tests that may be useful are described below:

  • Pelvic exam includes feeling the uterus, vagina, ovaries, fallopian tubes, bladder, and rectum to find any abnormality in their shape or size. (A Pap test, a good test for cancer of the cervix, is often done along with the pelvic exam, but it is not a reliable way to find or diagnose ovarian cancer.)

  • Ultrasound refers to the use of high-frequency sound waves. These waves, which cannot be heard by humans, are aimed at the ovaries. The pattern of the echoes they produce creates a picture called a sonogram. Healthy tissues, fluid-filled cysts, and tumors look different on this picture.

  • CA-125 assay is a blood test used to measure the level of CA-125, a tumor marker that is often found in higher-than-normal amounts in the blood of women with ovarian cancer.

  • Lower GI series, or barium enema, is a series of x-rays of the colon and rectum. The pictures are taken after the patient is given an enema with a white, chalky solution containing barium. The barium outlines the colon and rectum on the x-ray, making tumors or other abnormal areas easier to see.

  • CT (or CAT) scan is a series of detailed pictures of areas inside the body created by a computer linked to an x-ray machine.

  • Biopsy is the removal of tissue for examination under a microscope. A pathologist studies the tissue to make a diagnosis of ovarian cancer. To obtain the tissue, the surgeon performs a laparotomy (an operation to open the abdomen). If cancer is suspected, the surgeon performs an oophorectomy (removal of the entire ovary). This is important because, if cancer is present, removing just a sample of tissue by cutting through the outer layer of the ovary could allow ovarian cancer cells to escape and cause the disease to spread.

If the diagnosis is ovarian cancer, the doctor will want to learn the stage (or extent) of disease. Ovarian cancer staging is a careful attempt to find out whether the cancer has spread and, if so, to what parts of the body. Staging of ovarian cancer may involve surgery, x-rays and other imaging procedures, and lab tests. Knowing the stage of the disease helps the doctor plan treatment.

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