Ovarian cancer is difficult to detect because its symptoms are often vague and can be attributed to other medical conditions. In addition to the signs and symptoms that can alert someone with ovarian cancer to its presence, there are physical examinations, laboratory tests, diagnostic tests and surgical procedures that can be used to detect ovarian cancer.
Signs & Symptoms
The signs and symptoms of ovarian cancer may prompt a woman to get medical attention. Because these signs and symptoms can be caused by many less-severe conditions, some women ignore them until they become worse. Women with ovarian cancer may experience urinary urgency, pelvic pain and abdominal pressure more consistently than women without this type of cancer. Other signs and symptoms of ovarian cancer include frequent constipation, persistent indigestion, changes in bladder function, persistent nausea or gas, bloating, pain during intercourse, loss of appetite or quickly feeling full after meals.
Physical Examination
The physical examination for ovarian cancer will include a pelvic examination. During this examination, the doctor places one or two gloved fingers in the vagina. Using the other hand, the physician puts pressure on the pelvis and lower part of the abdomen. This allows the ovaries, uterus and fallopian tubes to be felt. The pelvic examination may also include a rectal exam, which is when the doctor inserts a gloved finger into the anus. This allows the doctor to feel the ovaries through the wall that separates the vagina from the rectum. Both examinations may allow the doctor to feel any masses or enlargement of the ovaries that can signal ovarian cancer.
Laboratory Test
The CA-125 blood test may be done to assist in detecting ovarian cancer. This test determines the level of a protein known as CA-125 in the blood. This protein can be elevated in women who have ovarian cancer. This test is very simple and is performed on a sample of blood that is taken from a vein in the arm. This test alone cannot detect ovarian cancer, because CA-125 levels can be elevated when other noncancerous conditions are present. Women with early stage ovarian cancer may also have normal levels of CA-125.
Diagnostic Tests
Several diagnostic tests may be used to determine if an ovarian mass is present. Pelvic or transvaginal ultrasound is one of these tests. During this test, a technician places a transducer into the vagina or over the pelvis, and the probe detects sound echoes that bounce back, creating a computer image. Ultrasound can be used to determine if a mass is a cyst or a solid tumor that needs to be examined by a pathologist. Computed tomography (CT) provides cross-sectional images of the body that can be used to determine if an ovarian tumor is present and if it has spread to other parts of the body. Magnetic resonance imaging, which uses radio waves and magnets to create cross-sectional images, may also be used to detect ovarian cancer.
Surgery
The only way to tell for sure if a mass is cancerous is to have it biopsied. This can only be done after a piece of the tissue is removed surgically. During a laparoscopy, a thin tube is inserted through an incision in the abdomen. Once it is in place, images of the pelvis are transmitted to a video monitor. Small instruments can be inserted into the incisions to retrieve tissue for a biopsy. Some patients cannot have laparscopic surgery due to their medical histories or the size of the mass. When laparoscopy cannot be used, an open laparotomy is performed. This procedure involves making a large incision in the abdomen and pelvis, so it is more invasive and requires a longer recovery period than laparoscopy. Tissue from an ovarian mass can be removed during this procedure, and doctors can see if cancer has spread into the organs of the abdomen.
