How is ovarian cancer diagnosed?
It is essential to diagnose ovarian cancer early and accurately as possible. An early diagnosis helps to increase the chances of successful treatment and recovery for ovarian cancer patients. Doctors decide on the different kinds of tests a person should go through depending on the various factors like the type of cancer, age, medical history, and the results of earlier medical tests.
In the case of ovarian cancer, circumstances are different as most women don’t feel any symptoms until it has spread to other parts of the body.
Abdominal pelvic exam
Your doctor will conduct a detailed physical exam based on your medical history and symptoms. During the physical exam, it is likely for the doctor to look for signs like an enlarged ovary and fluid in the abdomen. The doctor will also check the uterus, vagina, ovaries, bladder, and rectum for unusual changes.
Investigations
The workup for ovarian cancer includes Hematological (blood tests), biopsy and imaging studies for diagnosis and proper staging of cancer.
Hematological tests
The blood tests in the setting of ovarian cancer include routine blood investigations (CBC, LFT, RFT, Serum Electrolytes) and test for tumor markers (CA-125, AFP, LDH, beta HCG, etc.)
CA-125 blood test
The CA-125 blood test is a test that measures the substance CA-125, which is a protein tumor marker. Women with ovarian cancer have higher levels of the protein. Additionally, women who have experienced menopause should do the test. However, women below 50 can have a high level of CA-125 related to conditions like endometriosis, pelvic inflammatory disease, and uterine fibroids.
Biopsy
A biopsy is a medical procedure that consists of the removal of a small amount of tissue that is later studied under a microscope by a pathologist to see if it is cancerous or not. Also, tests can suggest if the tissue is cancerous, but a biopsy is a more definitive method. It is the standard gold test for cancer diagnosis.
Usually, ovarian cancer biopsies do not happen before surgery. However, doctors recommend a biopsy or fine-needle aspiration cytology before initiating neoadjuvant chemotherapy.
Imaging studies
Besides confirmatory diagnostic tests, the following types of imaging tests check for signs of abnormalities before more in-depth investigation:
- Chest X-rays
- Ultrasound abdomen.
- CT or CAT (computed axial tomography) scans of the whole abdomen and chest
- PET (positron emission tomography) CT scans of the entire body.
- Transvaginal ultrasound.
Computed tomography (CT) scan
A CT scan creates a three-dimensional picture of inside the body using X-rays from different angles. A special kind of dye enhances the images and differentiate from tumor from healthy tissues. The color can be injected into the patient’s veins or can be given as a liquid to swallow or both.
Positron emission tomography (PET) scan
This scan detects the distant spread of the tumor. It creates images of the organs and tissues inside the body. A small amount of radioactive substance (sugar) is injected into the patient’s body. Cells that take up most of the energy from this substance are tumorous due to their nature. Additionally, a scanner is used to detect this substance and produce images of inside the body.
