OVARIAN CANCER

Learn about ovarian cancer, including risk factors, diagnosis, treatment, stories from our community, and where to find support.

OVARIAN CANCER DIAGNOSIS

Diagnosing ovarian cancer definitively requires invasive surgery and biopsy.

Currently, there are limited reliable screening tests and procedures for ovarian cancer diagnosis. In particular, a habitual and accessible early detection test – a pap test does not test for ovarian cancer, it screens for cervical cancer.

The signs and symptoms of ovarian cancer can often be vague and mimic that of other common conditions such as menstruation, constipation or irritable bowel syndrome, or other more serious health conditions such as Polycystic Ovary Syndrome, Endometriosis and Ovarian Cysts. Hence, attaining a definitive ovarian cancer diagnosis can at times be difficult.

THE FIRST STEP TO GETTING AN OVARIAN CANCER DIAGNOSIS

If you notice various changes in line with the common signs and symptoms, or something just ‘doesn’t feel right,’ visit your doctor and advocate for yourself.

Based on your symptoms and experience, your doctor may complete a CA125 blood test, physical pelvic examination, suggest a transvaginal, abdominal ultrasound or recommend tissue biopsy through surgery. While most of these tests are unlikely to definitively diagnose ovarian cancer alone, they might be used in combination with another.

TESTS AVAILABLE FOR OVARIAN CANCER

Below in more detail, are all the currently available examination and testing options to make an ovarian cancer diagnosis.

CA125 blood test

CA125 which stands for ‘cancer antigen 125’ is a protein that is often raised in people with ovarian cancer. Your doctor may request a CA125 blood test if ovarian cancer is suspected.

The Cancer Antigen 125 protein is released into the bloodstream from the surface of cancerous cells and will be at an increased level in more than 80% of women with advanced ovarian cancers and 50% in early stage cancers.

Other special ‘tumour markers’ may be tested for, but some tumours will not have elevations of these markers.

How reliable is a CA125 blood test?

Sometimes, an elevated CA125 reading can indicate that there is a cause for concern. However, there are other reasons for raised CA125 levels apart from ovarian cancer, such as menstruation, endometriosis or ovarian cysts. The CA125 blood test is more reliable in postmenopausal women and as stated above, half of all women with early stage ovarian cancer do not have elevated CA125 markers.

It is for these reasons that the CA125 blood test is not recommended as a sole screening test for diagnosing ovarian cancer.

Source: Cancer Council

Ovarian cancer pelvic examination

Your doctor may perform an initial pelvic examination to test for ovarian cancer. This physical examination requires your doctor to press gently on parts of the outside of the abdomen and inside the vaginal canal to assess the size, shape and position of your ovaries and uterus to feel for any abnormalities.

This examination is not painful but might be uncomfortable and typically only detects particular types of ovarian cancers that grow in a mass and in advanced stages.

Ultrasound for ovarian cancer

Your doctor may perform an ultrasound (or medical imaging scan) to test for ovarian cancer. Two common types of ultrasound are transvaginal and abdominal.

Transvaginal ultrasound for ovarian cancer

A transvaginal ultrasound is an internal scan of a person’s reproductive organs and bladder. This scan is performed whilst lying on your back and a narrow-shaped device, called a transducer is inserted in the vagina. This scan creates images of the ovaries and other pelvic-region organs via sound waves.

This scan can reveal masses or irregularities on the surface of ovaries; however, due to the various ways ovarian cancer cells can develop, an ultrasound on its own is not a reliable way to diagnose ovarian cancer.

Abdominal Ultrasound for ovarian cancer

An abdominal ultrasound is another medical imaging scan that uses sound waves to create an image of the abdominal region. This non-invasive examination will scan the outside of the abdominal area to see if the ovarian cancer has spread to nearby organs.

It should be noted that this is not a definitive ovarian cancer diagnosis, and will still require tissue sample collection.

Ovarian cancer biopsy

Currently, the only way to make a definitive diagnosis of ovarian cancer is through a biopsy procedure to obtain a tissue sample.

A biopsy to test for ovarian cancer will be completed either through laparoscopic surgery – a minimally-invasive surgery that makes several small incisions on the abdomen, or open surgery, depending on numerous factors of the suspected ovarian cancer.

The tissue sample is sent to a pathology laboratory where it is analysed to make a formal and accurate ovarian cancer diagnosis.

Asking the right questions after an ovarian cancer diagnosis.

Being told you have ovarian cancer may result in any further questions about ovarian cancer in general, your diagnosis or what is next in your ovarian cancer treatment and journey.

It is important to ask the right questions, below are some recommended questions you might like to ask your doctor and specialist:

What type of ovarian cancer do I have? Is this a common type?
Has the cancer spread beyond the primary tumour? If so, where has it spread to?
Is the cancer growing fast?
Are the latest tests and treatments for this cancer available in this hospital? If not, where should I/will I be receiving treatment?
What sort of genetic testing can I have? Do you recommend I have my cancer genetically tested?
Will a multidisciplinary team be involved in my care? What kind of specialists will I see during my treatment?
Who is my primary point of contact if I have questions after this appointment?
Are there clinical guidelines for this type of cancer?
Do you have any information sheets I can take home with me and share with my loved ones?

See more helpful questions and a glossary of terms via the Cancer Council question checklist in the Understanding Ovarian Cancer booklet (pages 67-71).

Why funding early detection research into ovarian cancer is critical

Proportionally, more women die from ovarian cancer than breast cancer, because in over 70% of cases, women are diagnosed with ovarian cancer in the advanced stages.

The Ovarian Cancer Research Foundation strongly supports the development of a highly accurate, non-invasive and accessible early detection test that will form part of every woman’s annual health check-up, like the mammogram.

See what research projects the OCRF is funding in early detection, prevention, recurrence and treatment.

Learn more