Diagnosing Ovarian Cancer

If you have a symptom that suggests ovarian cancer, your doctor must find out whether it is due to cancer or to some other cause. Initial tests may be run by your gynecologist or another medical professional you see for female reproductive health. 

In addition to a physical exam where your doctor will check your general health and learn more about your personal and family medical history, it is likely that you will have one or more of the following tests: 

  • Abdominal-pelvic exam: During this exam, your doctor feels the ovaries and nearby organs for any unusual changes, such as a mass. While a Pap test is part of a normal pelvic exam, the doctor may not include that in this diagnostic exam since Pap tests only diagnose cervical cancer. 
  • Blood tests: Your doctor may order a specific blood test that measures a substance called CA-125, which is found on the surface of ovarian cancer cells and on some normal tissues. A high CA-125 level could be a sign of cancer or other conditions. The CA-125 test is not used alone to diagnose ovarian cancer. This test is approved by the Food and Drug Administration for monitoring a woman’s response to ovarian cancer treatment and for detecting its return after treatment.
  • Ultrasound: The ultrasound device uses sound waves that people cannot hear to create a picture of the ovaries and surrounding tissues. For a better view of the ovaries, the device may be inserted into the vagina (transvaginal ultrasound). The doctor will look for any tumors on or near the ovaries.
  • Biopsy: A biopsy is the removal of tissue or fluid to look for cancer cells.While other tests can suggest the presence of cancer, only a biopsy can make a definitive diagnosis. In most cases this is only done if there are tumors removed. Performing a separate procedure just to biopsy suspected ovarian cancer tumors could potentially spread the cancer cells. 
  • CT and/or MRI Scan: Computerized tomography (CT) and magnetic resonance imaging (MRI) scans are two procedures that provide more detail than conventional x-rays. Both scans are similar in the fact that they show cross-sectional pictures of the body, however, they differ in their techniques. To get a series of pictures, CT scans use multiple x-rays, taken at different angles, while MRIs use magnetic fields and radio frequencies.
  • PET Scan: The positron emission tomography scan (PET) is an imaging test used to find malignant (cancerous) tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein and then the PET scanner makes a picture of where the glucose is being used in the body. Since cancers use glucose at a higher rate than normal tissues, malignant tumor cells will show up brighter in the picture.  
  • Molecular testing of the tumor: In some cases, your doctor might recommend running tests on a tumor to identify specific genes, proteins, and other factors that are considered to be unique to the tumor in addition to genetic testing for inherited, or germline mutations. Genetic changes in the tumor cells are called somatic mutations. Somatic tumor testing is highly encouraged for women who have been diagnosed with ovarian cancer but do not carry a germline mutation.  

After your diagnostic tests are completed, your doctor will review all of the results with you. If the diagnosis is cancer, these test results help your doctor describe the cancer. This process is called staging.