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Ovarian cancer diagnosis

Physical examination

A physical examination for ovarian cancer involves checking for any lumps or masses by feeling the abdomen and doing an internal examination.

If the doctor thinks a woman's symptoms should be investigated further, she will be referred for imaging and a blood test.

Imaging

Various methods are used to provide images of the ovaries that can be seen on a screen. These images can show possible signs of ovarian cancer in and around the ovaries.

Imaging tests to look for ovarian cancer usually involve ultrasound. The ultrasound is usually done internally (transvaginal ultrasound) by inserting a small probe into the vagina. An ultrasound is used to check for cysts, tumours or other changes that might or might not be ovarian cancer. Ultrasound results cannot be used to give a definite diagnosis of ovarian cancer.

Imaging of the chest and abdomen (tummy) may also be done to look for spread of the cancer. This usually involves ultrasound or computed tomography (CT) scans. Magnetic resonance imaging (MRI) scans or X-rays may sometimes be used.

Blood tests

If a transvaginal ultrasound shows a cyst or tumour on the ovary, a CA125 blood test might be used to find out whether ovarian cancer may be present.

CA125 is a protein found in the blood. CA125 can be produced by ovarian cancer cells. Increased levels of CA125 may indicate that ovarian cancer is present.

There are many other causes for raised CA125 levels such as ovulation, menstruation, endometriosis, fibroids or benign ovarian cysts. Illnesses such as liver or kidney disease can also cause an increase in CA125 levels. For these reasons, a CA125 test alone cannot be used to diagnose ovarian cancer.

A CA125 test is more helpful in diagnosing ovarian cancer in post-menopausal women than in pre-menopausal women. About half of all women with early-stage ovarian cancer have normal CA125 levels.

If your CA125 blood test results are normal but your symptoms persist or get worse, go back to your doctor.

Paracentesis

If there's a build-up of fluid in the abdomen, a fluid sample can be taken by paracentesis (through a needle passed through the skin). The fluid is checked under a microscope for cancer cells.

Biopsy

The only way to definitely find out whether a woman has ovarian cancer is with an operation and a biopsy of the tumour or cyst.

If the other test results show that a woman might have ovarian cancer, she should be referred to a gynaecological oncologist who will be responsible for her surgical care. Research shows survival for women with ovarian cancer is improved when their surgical care is directed by a gynaecological oncologist.

Treatment for ovarian cancer begins with this surgery. It's therefore important that women find out as much as they can about the operation before having it.

Sometimes it is helpful to talk to others about your experience.

Ovarian Cancer Australia can provide more information on ovarian cancer through their website www.ovariancancer.net.au, or by calling their information line on 1300 660 334.

Cancer Council Australia also offer support for you and your loved ones via their helpline on 13 11 20.

Sources: Cancer Australia (Ovarian cancer - Understanding your diagnosis), Cancer Council Australia (Ovarian Cancer), NHS Choices, UK (Diagnosing ovarian cancer), Ovarian Cancer Australia (Homepage)

Last reviewed: August 2015

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