Medical history and physical exam. Your doctor will take your medical history, and will likely do a pelvic exam to check for an enlarged ovary or signs of fluid in the abdomen. If there is reason to suspect you have ovarian cancer based on your symptoms and/or physical exam, your doctor will order some tests to check further.
Consultation with a specialist. If the results of your pelvic exam or other tests suggest that you have ovarian cancer, you will meet with a gynecologic oncologist, who is specially trained in treating cancers of the female reproductive system. This helps ensure that you get the best kind of surgery for your cancer.
Laparoscopy. A thin, lighted tube through which your doctor can look at your ovaries and other pelvic organs and tissues in the area. Laparoscopy provides a view of organs that can help plan surgery or other treatments, and can help us confirm the stage of the cancer. We can also manipulate small instruments through the laparoscopic incision(s) to perform biopsies.
Biopsy. The only way to determine for certain if a growth is cancer is to remove a piece of it and examine it in the lab. For ovarian cancer, the biopsy is most commonly done by removing the tumor during surgery. In rare cases, a suspected ovarian cancer may be biopsied during a laparoscopy procedure or with a needle placed directly into the tumor through the skin of the abdomen. We would only do this if you cannot have surgery because of an advanced stage of cancer or some other serious medical condition, because there is concern that a biopsy could spread the cancer.
Blood tests. Your doctor will order blood count tests to make sure you have enough red blood cells, white blood cells and platelets, and tests to measure your kidney and liver function as well as your general health. Your doctor will also order a CA-125 test. If you have a high CA-125 level, we would refer you to a gynecologic oncologist.
Genetic counseling and testing. If you have been diagnosed with an epithelial ovarian cancer, we will recommend that you get genetic counseling to help you decide if you should be tested for a mutation in the BRCA1 or BRCA2 gene. Some ovarian cancers are linked to mutations in these or other genes.
Ultrasound. Often the first test done if a problem with the ovaries is suspected.
Computed tomography (CT) scans. Helps us see if ovarian cancer has spread. We don’t use CT scans to biopsy an ovarian tumor, but we can use it to help biopsy a suspected metastasis in a procedure called a CT-guided needle biopsy.
Barium enema x-ray. Tests to see if the cancer has invaded the colon or rectum.
Magnetic resonance imaging (MRI) scans. MRI scans are not used often to look for ovarian cancer, but they are particularly helpful to examine the brain and spinal cord where cancer could spread.
Chest x-ray. Might be done to determine whether ovarian cancer has metastasized to the lungs.
Positron emission tomography (PET) scan. A test to see if the cancer has spread to lymph nodes or other parts of the body.
PET/CT scan. Some machines can do both a PET and CT scan at the same time.