11 Ovarian Cancer Tests Used for Patient Diagnosis
- There are several tests used to detect ovarian cancer. If you’re experiencing symptoms of ovarian cancer, you’ll first see a primary care doctor or gynecologist.
- If the doctor suspects ovarian cancer as the cause, he or she may refer you to an oncologist for additional diagnostic tests.
- Doctors will use some combination of the following tests to pinpoint a diagnosis: medical history and physical exam, blood tests, pelvic exam, transvaginal ultrasound, CT scan, MRI, PET scan, laparoscopy, biopsy, genetic testing and molecular testing.
“There is no specific test to detect ovarian cancer,” says Dr. Teresa P. Diaz-Montes, associate director of The Lya Segall Ovarian Cancer Institute and medical director of The Neil B. Rosenshein Institute for Gynecologic Care. “When a patient presents with symptoms suggestive of ovarian cancer, then the workup includes a physical exam, imaging, and blood tests.”
Read MoreMedical History and Physical Exam
Your doctor will ask about your personal and family medical history. This helps determine your overall health and risk. Giving a detailed medical history can help your doctor make an accurate diagnosis. This includes any previous medical diagnosis, medications and surgeries you may have had.Pelvic Exam
During a pelvic exam, your doctor will put in a speculum to look into the vagina and see if any of your symptoms might be from the vagina or cervix. Your doctor will look for any noticeable abnormalities or signs of cancer. They may use a hysteroscope to visualize the inside of the uterus.Blood Tests
“There are blood tests that can help with the diagnosis, but these aren’t specific,” explains Dr. Diaz-Montes. “Just because a blood test is abnormal does not mean that the patient has cancer. About 80% of ovarian cancer patients can have an elevation in the CA-12 levels, however, other benign gynecologic conditions or medical conditions can elevate is as well.”
Specific blood tests that may be used to diagnose ovarian cancer include:
- CBC: A complete blood count that includes red and white blood cells, hemoglobin level and platelet count.
- Basic metabolic panel: A test of electrolytes and kidney function.
- CA-125: A tumor marker for ovarian cancer. This is one of the most common blood tests used for ovarian cancer screening.
- Liver chemistries: A blood test that measures proteins, liver enzymes and bilirubin levels.
- Tumor markers: Human chorionic gonadotropin (HCG), alpha-fetoprotein (AFP) and lactate dehydrogenase (LDH) levels are sometimes checked during the ovarian cancer screening process. These tests are more common when looking for a malignant germ cell tumor.
- Hormone panel: Inhibin, estrogen, and testosterone levels may be high in patients with ovarian stromal tumors (rare).
Transvaginal Ultrasound
Your doctor may use an ultrasound to visualize the ovaries and check for abnormalities, such as cysts or tumors. An ultrasound uses sound waves to create an image of your internal organs and surrounding structures.
How it’s performed:
During a transvaginal ultrasound, the doctor inserts a probe into your vagina to get closer to the ovaries. The probe sends sound waves into the body, which bounce back when they hit solid structures and create an image of those structures on a monitor.
CT Scan
CT scans use a combination of X-ray and computer technology to create detailed images. CT scans are used to allow your doctor to see what’s going on inside of your body. It allows for better visualization of the ovaries and other organs.
How it’s performed:
You’ll be asked to lie on your back on an exam table. The doctor may put a contrast solution into an IV, which allows for more detailed images. The technologist then leads you into a tunnel-shaped scanner where he or she will direct you to hold still.
During the test, the table will slide in and out of the scanner. You may be asked to take deep breaths or hold your breath for short periods so that each area can be examined separately.
Having a PET/CT scan: What to expect
Magnetic Resonance Imaging (MRI)
An MRI also creates a picture of internal organs and structures. It can make detailed images without ionizing radiation exposure. This test may be done to check for abnormalities or to look at the surrounding structures of a tumor.
MRIs provide a more detailed picture compared to CT scans, but they are more expensive and take longer to complete.
How it’s performed:
You’ll be asked to remove any metal from your body that might interfere with the test. You may be given a gown and earplugs to wear during the procedure, as the machine can be loud.
You’ll be asked to lie down on your back on a narrow table. The MRI technician will move you into a tunnel-shaped scanner that surrounds your body and contains a strong magnetic field. You’ll be asked to hold still while the machine takes pictures of your organs and structures. The table may move in and out of the machine.
Positron Emission Tomography (PET) Scan
A PET scan is a type of nuclear imaging test that uses a small amount of radioactive material, called a radiotracer, to help determine the presence or extent of cancer. The radioactive substance travels through the body and cells that are more metabolically active (such as cancer cells) will take up more of the tracer, which correlates to brightness on a PET scan. This information is used to produce two or three-dimensional images on a computer screen or in film.
How it’s performed:
You’ll be asked to remove any jewelry, eyeglasses, or other objects that might interfere with the test. After putting on a gown, you'll be positioned on a narrow table that slides you into the PET scanner, which contains a strong magnetic field.
The technician will lead you through a series of steps to make sure your body is positioned for the clearest images possible. Wires or straps are sometimes used to help keep your body in position while pictures are taken.
Diagnostic Procedures
Laparoscopy
A laparoscopy is a surgery used to let doctors view the inside of the abdomen, obtain a biopsy, or remove the malignant tumor. The doctor will use a laparoscope, which is about the size of a pencil. The laparoscope has a light attached that allows the doctor to see inside your abdomen. You will be sedated during this procedure.
How it’s performed:
While sedated, a small incision is made on your abdomen to pass the laparoscope and other tools into the body. In some cases, the doctor may make several incisions, each just large enough for the laparoscope to fit through. They can also remove tissue samples or a tumor during this procedure.
Biopsy
A biopsy may be used to diagnose and stage ovarian cancer. They are more commonly used for metastatic disease (stage IV) and rarely for localized ovarian cancer, as this may increase the risk for seeding (when cancer cells spread to other parts of the abdominal cavity).
It involves taking a sample of tissue from the tumor to look for cancer cells under a microscope. Surgeons and interventional radiologists can perform this procedure. The location of the area being biopsied determines which physician will perform the biopsy.
How it’s performed:
If you have a surgical biopsy, you will probably receive general anesthesia so that you’re fully asleep and pain-free during the procedure. A small incision is made in your abdomen. The doctor inserts a long, thin needle into your abdomen and removes a small sample of tissue from the tumor and surrounding tissue. They may take several biopsies during the diagnosis process.
Gene Testing After Diagnosis
If an ovarian cancer diagnosis is made, your doctor may recommend genetic testing to see if the cancer is linked to an inherited gene mutation that might increase your risk of other cancers.
Genetic testing can help your doctor:
- Detect other cancer risks based on your genetic makeup
- Provide information about other family members who may also be at risk for the disease
- Help determine the treatment that might work best for your cancer
How it’s performed:
Many patients are referred to a genetic counselor for this testing. Different types of genetic tests are used to detect gene mutations. Some look for changes in specific genes, such as BRCA1 or BRCA2, linked to hereditary ovarian cancer. Other tests check all the genes for certain markers that code for inherited conditions. A sample of your blood is needed for most genetic tests.
Why genetic testing is important for women diagnosed with ovarian cancer
Molecular Testing
Molecular tests are laboratory tests that look for genetic abnormalities in a patient’s tumor. Some types of molecular tests can help doctors choose targeted therapies that might work best during treatment.
How it’s performed:
Molecular testing is most often done using tissue samples from biopsies. Occasionally, it can be done using a blood sample. The test requires specialized equipment and highly trained staff to work with the samples. When a sample of the tumor’s tissue is removed, it’s sent to a laboratory where the molecular tests are performed.
Learn more about SurvivorNet's rigorous medical review process.