Your doctor will ask about your symptoms, and medical and family history. Your abdominal and pelvic regions will be thoroughly examined. This will include a pelvic exam. A pelvic exam is a thorough, manual evaluation of the vagina, cervix, uterus, fallopian tubes, and ovaries. Your doctor may suspect ovarian cancer based on your symptoms, but will look for other possible causes. If ovarian cancer is suspected, you will be referred to a doctor who specializes in gynecologic cancers.
If you have symptoms, your doctor may conduct certain tests to identify abnormalities. These may include:
Diagnosis of ovarian cancer is confirmed with a biopsy. A biopsy is the removal of suspicious tissue for examination under a microscope. Since ovarian cancer is usually found in advanced stages, there are different methods for determining if cancer is present. These may include:
If ovarian cancer is confirmed, results from completed tests and new tests will help determine the stage of cancer. Staging is used to determine characteristics of the tumor that will help develop the prognosis and treatment plan. Factors that play a role in staging include where the tumor is found, how far the original tumor has spread, whether lymph nodes are involved, if cancer has spread to other tissue, and microscopic cellular details.
Surgical staging is done with an exploratory laparotomy. An incision is made in the abdominal wall to gain access to the abdominal and pelvic cavities. The areas can be examined for the presence of tumors. For ovarian cancer, this may include surgical removal of tumors, tissue, or organs in advance of other staging tests.
Tests that may help determine ovarian cancer stage:
Ovarian cancer is staged from 1-4:
To help streamline treatment planning, stage 1 cancer is considered early stage cancer, while stages 2-4 are considered advanced stage cancer.
Committee on Gynecologic Practice, Society of Gynecologic Oncology. Committee Opinion No. 716: the role of the obstetrician-gynecologist in the early detection of epithelial ovarian cancer in women at average risk. Obstet Gynecol. 2017;130(3):e146-e149.
General information about ovarian epithelial, fallopian tube, and primary peritoneal cancer. National Cancer Institute website. Available at: https://www.cancer.gov/types/ovarian/patient/ovarian-epithelial-treatment-pdq. Updated October 13, 2017. Accessed January 29, 2018.
Ovarian cancer. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T900705/Ovarian-cancer. Updated November 17, 2017. Accessed January 29, 2018.
Ovarian cancer. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/gynecology-and-obstetrics/gynecologic-tumors/ovarian-cancer. Updated March 2017. Accessed January 29, 2018.
Stages of ovarian epithelial, fallopian tube, and primary peritoneal cancer. National Cancer Institute website. Available at: https://www.cancer.gov/types/ovarian/patient/ovarian-epithelial-treatment-pdq#section/_130. Updated October 13, 2017. Accessed January 29, 2018.
Tests for ovarian cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/ovarian-cancer/detection-diagnosis-staging/how-diagnosed.html. Updated March 20, 2017. Accessed January 29, 2018.
Woo YL, Kyrgiou M, Bryant A, Everett T, Dickinson HO. Centralisation of services for gynaecological cancer. Cochrane Database Syst Rev. 2012;(3):CD007945.
Last reviewed November 2018 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP Last Updated: 1/29/2017