How do health care professionals diagnose ovarian cancer?

Often vague symptoms eventually lead to a clinical diagnosis, or one based on suspicion generated by exams (for example, a pelvic exam that detects a mass or lump that is abnormal), laboratory tests, and imaging. However, an accurate diagnosis requires some of the mass or tumor to be removed, either by biopsy (less often), or preferably, surgery to verify the diagnosis. Often a high clinical suspicion can trigger a referral to a gynecologic oncologist.

 

Various types of imaging studies can be used to preliminarily diagnose this disease and lead to tissue sampling. Pelvic or abdominal ultrasound and CT scans are the most commonly done studies. These often can give images that show masses in the abdomen and pelvis, fluid in the abdominal cavity (ascites), obstructions of the bowels or kidneys, or disease in the chest or liver. Many times, this is all that is necessary to trigger a referral to a specialist, as the suspicion for ovarian cancer can be quite high. PET scans can be used but often are not necessary if a CT scan is able to be performed.

 

Blood work can be helpful as well. The CA-125 is a blood test that is often, but not always, elevated with ovarian cancer. If a postmenopausal woman has a mass and an elevated CA-125, she has an extremely high risk of having a cancer. However, in younger women, CA-125 is extraordinarily inaccurate. It is elevated by a large number of disease processes, including but not limited to, diverticulitis, pregnancy, irritable bowel syndrome, appendicitis, liver disease, stomach disease, and more. No one should get this test done unless they actually have a mass, or their doctor has some reason to get it. It should not be drawn just to see the level since it is not a reliable screening test for ovarian cancer.