Ovarian Cancer Screening and Diagnosis

Ovarian cancer is hard to detect in the early stages, when it is most treatable. To determine an ovarian cancer diagnosis, our doctors perform thorough exams. They also ask questions about your past health and symptoms. It’s important to see your doctor regularly.

The 3 main types of primary ovarian cancer are:

• Epithelial ovarian carcinoma: The most common type of ovarian cancer, these tumors begin in the cells that cover the ovaries outer surface or in the fallopian tube.
• Germ cell carcinoma: These tumors start in the cells that produce the eggs.
• Stromal carcinoma: This is the least common ovarian cancer. These tumors grow in the connective tissue cells that hold the ovary together and make female hormones.

Presently, the 2 tests used most often to diagnose ovarian cancer are the transvaginal ultrasound and the CA-125 blood test:

• Transvaginal ultrasound: TVUS uses sound waves to look at the uterus, fallopian tubes and ovaries by placing an ultrasound wand into the vagina. Your abdomen is full of many tissues and organs, and the ovaries are very small. Using the wand makes detecting the ovaries easier. The test can locate a mass in the ovary, but it can’t determine if the mass is cancerous or benign. Your doctor may use this test to detect a lump on your ovary.
• Cancer antigen 125 blood test: CA-125 is a protein in the blood. Many women with ovarian cancer have elevated levels of CA-125. The cancer antigen 125 test can help indicate ovarian cancer, but it is not definitive. Having too much of this antigen can also be caused by the menstrual cycle, endometriosis and ovarian fibroids, as well as other types of cancer. This test can be useful as a tumor marker to help guide treatment in women known to have ovarian cancer, because a high level often goes down if your treatment is working.

These and other follow-up tests help your healthcare team:

• Detect ovarian cancer
• Learn how far ovarian cancer has spread (also called staging)
• Develop an ovarian cancer treatment plan

Like other gynecologic cancers, ovarian cancer stages are typically classified according to the FIGO staging system:

• Stage 1: The cancer is only present in the ovaries and hasn’t spread to other areas, including the lymph nodes.
• Stage 2: The cancer is in one or both ovaries and has spread to nearby areas, such as the fallopian tubes or uterus.
• Stage 3: The cancer is in one or both ovaries and has spread to the abdominal lining or nearby lymph nodes.
• Stage 4: The cancer has spread (metastasized) to areas of the body that are further away, such as organs outside the pelvic area.