Ovarian Cancer
Diagnosis

To help find the cause of your symptoms, your doctor will evaluate your medical history, perform a physical exam and recommend diagnostic tests. The exams and tests may include some of the following:

• Pelvic exam. A pelvic exam consists of feeling the uterus, vagina, ovaries, fallopian tubes, bladder and rectum to find any abnormality in their shape or size. A Pap test, an effective 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. Ultrasound refers to the use of high-frequency sound waves that 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. This 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. Also called a barium enema, this 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, which outlines the colon and rectum on the X-ray, making tumors or other abnormal areas easier to see.
• Computed tomography (CT) scan. A CT scan is a series of detailed pictures of areas inside the body created by a computer linked to a X-ray machine.
• Biopsy. Biopsy is the removal of tissue for examination under a microscope. A pathologist studies the tissue to make a diagnosis. To obtain the tissue, the surgeon performs a laparotomy, an operation to open the abdomen. If cancer is suspected, the surgeon performs an oophorectomy, where the entire ovary is removed. 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 cancer cells to escape and cause the disease to spread.