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How is Ovarian Cancer Detected?
How is Ovarian Cancer Detected?
If a doctor suspects ovarian cancer, they may perform tests such as a pelvic exam, transvaginal ultrasound, CT scan, or CA-125 blood test to learn more. It is important to know, however, that none of these tests are definitive on their own. A surgical biopsy is the only way to make a definitive diagnosis of ovarian cancer.
In This Section
Understanding Symptoms and Diagnosis
Though symptoms are often what lead an individual to pursue an ovarian cancer diagnosis, it’s important to know that not everyone with ovarian cancer experiences symptoms and the most common symptoms are not unique to ovarian cancer. Common symptoms may include bloating, fatigue, and abdominal discomfort; however, these can overlap with less serious conditions. Family history and risk factors should also be discussed with your physician in conversations about ovarian cancer.
To learn more about Ovarian Cancer Signs & Symptoms visit our dedicated page.
Annual check-ups and pelvic exams are useful for general reproductive health but usually do not detect ovarian tumors, which are often too small. Ovarian cancer also cannot be diagnosed through a Pap smear, which only screens for cervical cancer.
If ovarian cancer is suspected, doctors may conduct blood work or order imaging tests like transvaginal ultrasounds or CT scans. However, a surgical biopsy is the only definitive way to diagnose ovarian cancer.
If you notice persistent symptoms or have concerns about your ovarian cancer risk, we encourage you to speak with your doctor promptly. Early discussions can help guide necessary steps and provide peace of mind.
Physical and Gynecologic Exams
Ovarian cancer is rarely detected during routine physical or gynecologic exams due to its location deep in the body. Without an early detection tool, tumors are usually only found when they are more advanced. However, routine physical or gynecologic exams are crucial as initial steps that can lead to more detailed imaging tests and surgical procedures. For individuals at higher risk of ovarian cancer—such as those with BRCA mutations or a family history of ovarian or breast cancer—additional screenings, such as biannual ultrasounds and CA-125 tests, may be recommended.
It’s also important to ask your doctor about genetic counseling and testing, which can help identify if you are high-risk. If you’re concerned about your risk or experiencing symptoms, schedule an exam and discuss your concerns about ovarian cancer with your doctor.
Imaging Tests
Doctors may order imaging tests for detecting ovarian cancer, such as a CT scan or transvaginal ultrasound, if they suspect the disease. These tests help identify masses in the ovaries or pelvic area and assess whether they might be malignant. However, imaging tests alone cannot confirm an ovarian cancer diagnosis.
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CT scans employ x-rays to take multiple cross-sectional images of the tissues and bones in the body. Doctors can analyze the images or use software to make a three-dimensional model of the internal organs. A CT scan can define the boundaries of a tumor and show the extent of tumor spread, helping a doctor determine where to operate.
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An x-ray produces cross-body imaging using a type of radiation called electromagnetic waves. X-rays are rarely used in diagnosing ovarian cancer, but they are sometimes used to see if cancer has spread elsewhere in the body. A chest x-ray can display tumors in the lungs and fluid that has collected near the lungs, known as pleural effusion.
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An MRI, short for magnetic resonance imaging, is similar to an X-ray, except it does not use radiation. An MRI uses magnetic radio waves to produce images of the inside of the body. MRIs are rarely used to check for ovarian cancer initially, though they can be used to examine the spinal cord and the brain, where cancer can sometimes spread.
Blood Tests
Can Ovarian Cancer be Detected by Blood Work?
No single blood test can diagnose ovarian cancer. However, certain tests can help estimate risk, or monitor its progression. Below is an overview of tests that may be used in the evaluation process.
OVA1:
Purpose: Measures levels of five proteins that may change when ovarian cancer is present.
Usage: Helps determine if surgery should be done by a gynecologic oncologist. Not a screening tool, and does not provide definitive evidence of cancer.
Inhibin B and Inhibin A:
Purpose: May help detect and monitor granulosa cell tumors or other sex cord stromal tumors, a rare type of ovarian cancer.
Usage: Assesses risk of presence and recurrence of these specific tumors.
CA-125 Blood Test
What is CA-125 Blood Work?
CA-125 blood test, or “Cancer Antigen 125” is a test that measures a protein that is elevated in more than 80% of advanced ovarian cancers and 50% of early-stage cancers.
Usage: Useful for monitoring the response to treatment or for evidence of cancer recurrence but not recommended as a general screening tool due to the fact that it can often be elevated in benign or unrelated conditions.
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No, a high CA-125 does not always mean cancer is present. Generally speaking, the normal range of CA-125 is considered to be 0-35 units/mL, while a level above 35 units/mL is considered to be a high CA-125 level. Although a CA-125 blood test can be a useful tool for the diagnosis of ovarian cancer, it is not uncommon for a CA-125 count to be elevated in premenopausal women due to benign conditions since it fluctuates as part of their normal menstrual cycle, or due to benign conditions unrelated to ovarian cancer, such as diverticulitis, endometriosis, liver cirrhosis, pregnancy, or uterine fibroids, as Medscape details here. As a result, the CA-125 is generally only one of several tools used to help diagnose ovarian cancer in a patient with a pelvic mass or other suspicious clinical findings.
Learn more about the CA-125 blood test and its role in ovarian cancer diagnosis.
Surgical Procedures for Ovarian Cancer
A surgical biopsy is the only way to definitively diagnose ovarian cancer. In some cases, a minimally invasive surgery (laparoscopy or robotic surgery) may be performed first to confirm a diagnosis with biopsy and to determine whether to proceed with a full cancer resection or to administer chemotherapy first.
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In a laparoscopy or robotic surgery, a physician can examine the ovaries and other pelvic and abdominal organs using a camera inserted through a small incision in the abdominal wall. Both approaches to minimally invasive surgery can determine how large the tumors have grown and whether they can be completely resected. These procedures allow the surgeon to perform a biopsy to confirm the diagnosis and to collect more information about the tumor that may guide treatment decisions.
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The only way to definitively determine if a patient has ovarian cancer is through a biopsy. This is when tissues from a tumor are removed and tested in a lab. A laparoscopy may be performed to evaluate tumor spread and collect tissue for a diagnosis, or a diagnosis may be made by sampling tissue during a more extensive surgery to fully resect the cancer. In some cases, a biopsy may be performed using image guidance with a CT scan or ultrasound.
After a confirmed diagnosis, the next step is to determine the cancer stage. Staging helps your doctor understand the extent of the cancer’s spread and guides treatment planning.
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