As stated previously, no reliable or accurate test exists for ovarian cancer diagnosis or screening. Your doctor may employ any of the following methods to attempt to diagnose an abnormality within the ovary:
As with any physical exam, your doctor will look for generalized abnormalities. If you have specific complaints, such as abdominal discomfort, the doctor may perform a more pointed exam. For pelvic pain or pressure, your doctor will generally perform a pelvic exam since this is the simplest and quickest way to estimate the size of the ovaries and uterus. If an abnormally large ovary is found, this may prompt your doctor to order other tests.
This blood test measures the level of a protein produced by ovarian cancer cells. It is similar to the PSA test men receive once they have reached a certain age. Unfortunately, this test lacks the sensitivity and accuracy needed to be a reliable predictor of ovarian cancer. Over 50% of early stage tumors will have normal CA-125 levels. Extremely high levels may be present in cases of advances ovarian cancer, but high levels are also associated with non-cancerous conditions such as endometriosis, fibroids, pelvic infections and liver disease. This blood test is useful for tracking a patient’s response to treatment and can be used to monitor recurrence of the cancer recurrence if elevated CA-125 levels are found during the cancer.
Ultrasounds use sound waves to image the ovaries and uterus. Abnormal findings include cyst complexity, size greater than 5 centimeters, thick septations and internal echoes. A radiologist will assist in the interpretation of the images. The ultrasound will assist your doctor in determining your risk of ovarian cancer, or the presence of ovarian cancer.
The only true way to diagnose ovarian cancer is by tissue sample. A tissue sample is most commonly taken at the time of surgery. CT-guided pre-operative biopsies should be avoided as they risk rupturing tumor-containing cysts.