If you have any of the symptoms of ovarian cancer, it’s important to see your GP as soon as possible.
Your GP will ask about your symptoms, your general health and whether there is a history of ovarian or breast cancer in your family. The GP may carry out a vaginal or internal examination to investigate your ovaries and womb. They may take some blood for testing.
Your GP may refer you to a specialist (a gynaecologist or gynaecological oncologist) at the hospital.
The specialist may carry out another internal examination. They will ask about your symptoms and general health. They may also do further tests to confirm the diagnosis of ovarian cancer, including a blood test and ultrasound.
Blood test (CA125)
You may have a blood test to look for a chemical called CA125 in the blood. This chemical is produced by some ovarian cancer cells and a raised level of CA125 in the blood may mean you have ovarian cancer.
However, a significant proportion of women with early stage ovarian cancers have a normal CA125 level. The chemical is also produced by other conditions and a raised level of CA125 does not definitely mean you have ovarian cancer.
Ultrasound
Ultrasound uses high frequency sound waves to produce an image of your ovaries. You may have an internal ultrasound (known as a transvaginal ultrasound), where the ultrasound probe is inserted into your vagina. Or you may have an external ultrasound, where the probe is put next to your stomach. The image produced can show the size and texture of your ovaries, as well as any cysts that may be present.
Further tests
If you've been diagnosed with ovarian cancer, you may have further tests to see how large the cancer is and whether it has spread. This is called staging.
These other tests may include:
- Chest X-ray – this can see if your ovarian cancer has spread to your lungs or if it has caused a build-up of fluid around the lungs (called a pleural effusion).
- CT scan or MRI scan – these imaging techniques are used to look for signs of cancer elsewhere in your chest, abdomen and pelvis.
- Abdominal fluid aspiration – if there is a build-up of fluid in your abdomen and it looks swollen, it could mean your ovarian cancer has spread. To find out, a thin needle is passed into your abdomen to take a sample of fluid to be tested for cancer cells.
- Laparoscopy – this small operation may be performed if the gynaecologist wants to take a better look at the ovaries. A thin viewing tube with a camera on the end (a laparoscope) is inserted through a small cut in your lower abdomen (stomach) in order to examine your ovaries. A small sample of tissue may be taken from your ovaries for testing (this is known as a biopsy).
Staging helps your doctors to decide on the best kind of treatment for your condition. However, it is important to remember that the stage of your ovarian cancer alone cannot predict how your condition will progress.
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Stages and grades of ovarian cancer
Staging
When your ovarian cancer is diagnosed, the doctors will give it a stage. This is often based on surgical findings. The stage describes the size of the cancer and how far it has spread. Ovarian cancer has four commonly used stages:
- Stage 1: the cancer only affects one or both of the ovaries.
- Stage 2: the cancer has spread out from the ovary and into the pelvis or uterus.
- Stage 3: the cancer has spread to the lining of the abdomen, the surface of the bowel and the lymph nodes in the pelvis.
- Stage 4: the cancer has spread to other parts of the body.
This is a simplified guide: each stage is divided into further categories called A, B and C. If you're not sure what stage you have, ask your doctor.
Grading
The grade of cancer refers to the appearance of the cells under a microscope.
- Low grade: the cells though abnormal, appear to be slow-growing.
- Moderate grade: the cells look more abnormal than low-grade cells.
- High grade: the cells look very abnormal and are likely to be fast-growing.
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