How is ovarian cancer diagnosed?

It is important to diagnose ovarian cancer as 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 or pain until the cancer is in the advanced stage and has also 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 {insert symptoms of ovarian cancer article hyperlink here}. During the physical exam, it is likely that the doctor will look for signs such as an enlarged ovary and fluid in the abdomen. The doctor will also feel the uterus, vagina, ovaries, bladder, and rectum to check for unusual changes.


The work up for ovarian cancer include Hematological (blood tests), biopsy and imaging studies for diagnosis and proper staging of the 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 and is also known as a tumor marker. It is found to be in higher levels with women who have ovarian cancer. It is more relevant to do the test with women who have experienced menopause, as women below 50 can have a high level of CA-125 and that can be related to conditions like endometriosis, pelvic inflammatory disease, and uterine fibroids.


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. There are also other tests that can suggest if the tissue is cancerous but a biopsy is a more definitive method. It is gold standard test for cancer diagnosis.

But usually ovarian cancer biopsy is not done before surgery. Biopsy or fine-needle aspiration cytology is indicated before initiating neoadjuvant chemotherapy.

Imaging studies

Aside from the confirmatory diagnostic tests, the following types of imaging tests {insert screening tests article hyperlink here} are also used to check for signs of abnormalities before a deeper investigation can be ordered:

  • 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 whole body.
  • Transvaginal ultrasound.

Computed tomography (CT) scan

A CT scan creates a three-dimensional picture of inside the body using X-rays that are taken from different angles. A special kind of dye is also used to enhance the images and differentiate from tumor from normal tissues. The dye 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 is done to know distant spread of the tumor. A PET scan is the kind of scan that is used to create images of the organs and tissues inside the body. A small amount of radioactive substance (sugar) is injected into the patient’s body. The substance is taken by the cells that use most of it for the energy and cancer cells are seen as the cells that take up most of the energy. A scanner is used to detect this substance and produce images of inside the body.

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