Often, ovarian cancers does not cause symptoms until it has spread beyond the ovaries. If you have symptoms or if your doctor found a mass during a routine pelvic exam, he or she is likely to ask questions about your:
Personal medical history
Family history of cancer
Reproductive history, such as whether or not you've ever been pregnant
In addition to asking you questions, your doctor may also do a physical exam, and other tests.
This exam allows your doctor to feel for any unusual masses (lumps) or other problems. During a pelvic exam, you lie on your back on an exam table, with your feet in stirrups. Your doctor inserts one or two fingers of a gloved hand inside your vagina and uses the other hand to press on your lower abdomen (belly) to feel for masses. Your doctor may also insert a finger in your rectum to feel for anything unusual that might suggest that the cancer has spread.
This test allows your doctor to see if a cyst or tumor is present. The doctor aims sound waves at your ovaries either by inserting a small probe into your vagina (called a transvaginal ultrasound) or aiming them at the surface of your abdomen (called an abdominal ultrasound). The pattern of the echoes makes a picture, called a sonogram, on a video screen. The echoes are different for healthy tissues, fluid-filled cysts, and tumors. The test can be uncomfortable, but is not painful, and you don't need sedation.
This blood test shows how much of a protein called CA-125 is in your blood. An elevated CA-125 may indicate the presence of tumor cells, but it also can be elevated in many non-cancer conditions. After a diagnosis of ovarian cancer, your doctor may use this blood test to see whether you are responding to treatment, or if the cancer has come back. This test is usually combined with an ultrasound.
This test makes pictures of organs and tissues in the pelvis or abdomen. An X-ray machine linked to a computer takes several pictures. You may be given contrast material by mouth and by injection into your arm or hand. The contrast material helps the organs or tissues show up more clearly.
This is a series of X-rays of the lower intestine. You are given an enema with a barium solution. The barium outlines the intestine on the X-rays. Areas blocked by cancer may show up on the X-rays. This procedure may be used to see if cancer has spread into the lower intestine or rectum. The test is usually not part of an evaluation for ovarian cancer.
For this test a doctor inserts a long, lighted tube into the rectum and colon, is used to determine if cancer has spread to the colon or rectum.
Unlike many other types of cancer, a biopsy is rarely used to diagnose ovarian cancer before surgery. A diagnosis of ovarian cancer is usually confirmed at the time of surgery. At that time, the surgeon removes the tumor or tumors and takes samples of surrounding tissues to find out if the cancer has spread. In a lab, a pathologist examines the removed cells to determine if cancer is present.