Doctors may be able to suspect ovarian cancer based on imaging and blood tests. However, only biopsies allow doctors to diagnose ovarian cancer with certainty. After a diagnosis, individuals can discuss treatment options with a doctor.

Ovarian cancer occurs when some of the ovaries’ cells divide and grow abnormally quickly.

According to National Cancer Institute’s Surveillance, Epidemiology, and End Results Program (SEER), the average 5-year relative survival rate is around 49.7%. However, a prompt diagnosis can greatly improve the outlook for this condition.

Localized-stage ovarian cancer has a 5-year relative survival rate of around 93.1%. This decreases to 30.8% if the cancer spreads to more distant parts of the body.

This article takes a detailed look at ovarian cancer diagnosis. It provides an overview of this process, before describing some common diagnostic tests.

The article also looks at what happens after an ovarian cancer diagnosis, and if it is possible to find ovarian cancer early.

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According to the American Cancer Society (ACS), a doctor will investigate the person’s medical history. Doing so allows them to spot potential ovarian cancer risk factors. They will also ask the person about any symptoms of ovarian cancer.

Doctors may recommend a pelvic exam, which can spot certain signs of ovarian cancer. These include enlarged ovaries or fluid buildup within the abdomen.

After taking all this information into account, the doctor will gauge the probability that their patient has ovarian cancer. If they judge that the risk is high, they will recommend further tests and a consultation with a specialist.

The individual’s doctor should refer them to a gynecologic oncologist. A gynecologic oncologist is a doctor who specialises in cancers of the female reproductive system. They can provide the best possible advice about further tests and treatment.

Tests can include the following:

  • ultrasound
  • CT scan
  • barium enema X-ray
  • MRI scan
  • chest X-ray
  • PET scan
  • biopsy
  • blood tests

Imaging tests will produce an image of someone’s ovaries.

During an imaging test, doctors will use special technologies to look for tumors within and around a person’s ovaries.

As the ACS explains, several imaging tests are useful to diagnose ovarian cancer:

  • Ultrasound: This is often the first test doctors use to diagnose ovarian cancer. It can help to determine the difference between a tumor and a cyst.
  • CT scan: This imaging test can help to see larger tumors and see if the cancer is spreading to nearby structures.
  • PET scan: This test can check for cancer cells. It is not as detailed as other scans, but can still provide doctors with useful information about whether abnormal areas are cancerous or not.

Other imaging tests doctors use include:

  • MRI scan: This can help determine if the cancer has spread to the brain and spinal cord.
  • Chest X-ray: This can allow doctors to see if the cancer has spread to the lungs.
  • Barium enema X-ray: This is to help see if the cancer has spread to the colon.

Doctors rarely perform a barium enema X-ray, instead preferring colonoscopies.

Results

Larger growths should be visible in these images, taking the form of a mass. However, imaging tests cannot always discriminate between cancerous growths, and more benign ones.

For this reason, imaging tests are insufficient to diagnose ovarian cancer.

According to the ACS, blood tests can provide evidence for or against ovarian cancer.

During a blood test, medical staff will use a needle and syringe to withdraw a sample of blood. They will send this sample to a laboratory, which tests it for ovarian cancer biomarkers. These are chemicals that the body can release in response to ovarian cancer.

Results

A positive blood test result means that doctors have found elevated levels of certain biomarkers. These include:

  • CA-125
  • chorionic gonadotropin (HCG)
  • alpha-fetoprotein (AFP)
  • lactate dehydrogenase (LDH)
  • inhibin

Although a positive blood test result can indicate ovarian cancer, other conditions can cause elevated levels of these biomarkers. Positive blood tests results will therefore indicate the need for further testing.

Biopsies provide the best possible diagnostic test for ovarian cancer. The ACS states that biopsies provide the only method of being certain that an ovarian growth really is cancerous.

The biopsy involves doctors surgically removing all or some of an ovarian growth. A laboratory will then test this sample for cancer cells.

Learn more about an ovarian biopsy and what to expect.

Results

Cancer cells leave distinctive traces under a microscope. Medical experts can use these traces to tell whether someone has ovarian cancer. The traces can also help doctors define the type of ovarian cancer, and determine its stage.

The United Kingdom’s National Health Service (NHS) states that this process can take up to several weeks.

During this time, specialist medical staff will interpret the test results.

Eventually, all this information will go to the individual’s doctor. The doctor will then organize an appointment to discuss the results.

If a doctor believes that a person has ovarian cancer, they will discuss next steps with the individual.

The Centres for Disease Control and Prevention (CDC) states that typical ovarian cancer treatments involve both surgery and chemotherapy. However, particular treatment programs will vary from case to case.

Support options

It can be challenging to journey through ovarian cancer diagnosis and treatment.

Psychological and practical support from loved ones can be extremely beneficial. Additionally, some organizations are able to support individuals with ovarian cancer.

For example, the ACS can offer the following assistance:

  • a 24/7 cancer helpline
  • assistance for lodging during treatment
  • assistance for rides to treatment

Find out more about getting support for ovarian cancer.

According to a 2022 review, it can be challenging to find ovarian cancer early. This is partly because other diseases share its symptoms. These symptoms include:

  • bloating
  • nausea
  • feeling full more quickly than usual
  • bowel movement changes
  • weight loss
  • back pain
  • fatigue

Usually, ovarian cancer symptoms can be noticeable only during the condition’s later stages. Even early symptoms of ovarian cancer are often very subtle. Nonetheless, anyone who has symptoms of ovarian cancer should seek medical advice.

Sometimes, doctors can find ovarian cancer early by finding signs during a regular pelvic exam. However, the ACS states that this is rare. This is rare because a pelvic exam typically reveals tumors that are large enough to feel.

Screening tests and guidelines

Screening tests look for a condition in the absence of any signs or symptoms. Scientists have developed screening tests for many cancers.

As the ACS explains, there are currently two screening tests for ovarian cancer:

  • transvaginal ultrasound
  • CA-125 blood test

These tests are important diagnostic tools in people who have signs or symptoms of ovarian cancer. However, they are unreliable when screening for this condition. This is because they frequently yield false positives.

Ovarian cancer is often asymptomatic in its early stages. Doctors also cannot screen for this condition. However, there are several diagnostic tests for ovarian cancer. Positive test results are the first step toward treatment, which often involves chemotherapy and surgery.

Larger ovarian tumors show up as abnormal masses on imaging studies. Additionally, blood tests can reveal elevated levels of cancer biomarkers. However, these tests can also yield false positives. For this reason, doctors can only be confident that someone has ovarian cancer after a biopsy.