Ovarian cancer

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.

Want to know more?

• Target Ovarian Cancer: coping with the news.
• Ovacome: just diagnosed.
• Ovarian Cancer Action: coping with the news.

The specialist may carry out another internal examination and will ask about your symptoms and general health.

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 could mean you have ovarian cancer. However, the chemical is also produced by other conditions and a raised level of CA125 does not definitely mean you have ovarian cancer.

Ultrasound scan
An ultrasound scan will 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 an external ultrasound, where the probe is put next to your stomach. The image produced can show the size and texture of your ovaries, and whether any cysts are present.

Want to know more?

• Diagnosing ovarian cancer.
• Target Ovarian Cancer: undergoing tests.
• Cancer Research UK: ovarian cancer tests.

If you've been diagnosed with ovarian cancer, you may have further tests which will show how large the cancer is and if 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.
• CT scan or MRI scan These imaging techniques are used to look for signs of cancer elsewhere in your abdomen.
• Abdominal fluid aspiration If there is a fluid build-up in your abdomen (stomach) 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).

Want to know more?

• Ovacome: talking to your medical team.
• Diagnosing ovarian cancer.
• Macmillan: how ovarian cancer is diagnosed.
• Cancer Research UK: further tests for ovarian cancer.

Currently, there is no general screening for ovarian cancer. However, several ongoing clinical trials in the UK and around the world are trying to find the best way of screening for ovarian cancer.

Want to know more?

• News: ovarian cancer screening.
• Ovacome: screening for ovarian cancer (PDF).

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 when they're looked at under a microscope.

• Low grade: the cells though abnormal, appear 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.

Want to know more?

• Ovacome: the staging of ovarian cancer (PDF).
• Cancer Research UK: stages of ovarian cancer.
• Macmillan: staging and grading of ovarian cancer.