Ovarian cancer examinations and tests
Many examinations and tests are used to determine if a woman has ovarian cancer.
Every woman should have regular cervical screening tests (smear tests) because although the smear test is designed to check for pre-cancerous changes that can become cervical cancer, there have been some rare cases in which abnormal ovarian cells were identified with this test. Because ovaries are normally small and deep within the pelvis, pelvic examinations may not be very effective in detecting early ovarian cancer. Masses large enough to be felt may represent advanced disease. More often, they are harmless growths or other non-cancerous conditions.
Ultrasound: If a mass is present, the doctor may recommend an ultrasound examination to find out what kind of mass it is.
- Ultrasound imaging can detect small masses and can distinguish whether a mass is solid or fluid filled (cystic).
- A solid mass or complex mass (having both cystic and solid components) may be cancerous.
- Incorporating Doppler technology to identify certain patterns associated with tumours seems to improve the usefulness of ultrasound screenings.
- If the ultrasound shows a solid or complex mass, the next step is to obtain a sample of the mass to see whether it is a cancerous tumour.
CT (computed tomography) scanning: If ultrasound reveals a solid or complex mass, a CT scan of the pelvis may be done.
- A CT scan is a type of X-ray that shows much greater detail in three dimensions.
- A CT scan provides more information about the size and extent of the tumour. It can also show whether the tumour has spread to other organs in the pelvis.
The doctor can also arrange laboratory tests to gather information about the woman's medical condition and to detect substances released into the blood by ovarian cancers (tumour markers).
The doctor may request a pregnancy test if there is any chance the woman could be pregnant. Ovarian masses during pregnancy may be associated with ectopic pregnancies (pregnancy outside the womb) or may be normal structures that produce other hormones important in gestation.
The woman's blood will probably be checked for tumour markers. Doctors suspicious that ovarian cancer is present usually conduct the CA-125 test.
- The level of the most widely studied tumour marker, CA-125, is elevated in more than 80% of women with advanced ovarian cancer and in about 50% of women with early ovarian cancer.
- The level of this marker value can be affected by a number of factors, including age, menstrual status and conditions such as endometriosis, pregnancy, liver disease and congestive heart failure.
- Cancers of the breast, pancreas, colon and lung also secrete the CA-125 marker.
- Because this marker can be influenced by so many factors that have nothing to do with ovarian cancer, this marker is not generally used for routine screening of women who have no symptoms.
Doctors may recommend genetic screening for women with a strong family history of ovarian or breast cancer at a specialist genetic screening centre.