A number of tests may be done to investigate symptoms of ovarian cancer and confirm a diagnosis. The more common tests include:
- physical examination of the abdomen and pelvis, including rectal examination and a Pap test of the cervix. A pap test is designed to detect cervical cancer.
- imaging of the pelvis and abdomen using transvaginal ultrasound, abdominal ultrasound, computed tomography (CT) scans, magnetic resonance imaging (MRI) scans or positron emission tomography (PET) scans
- chest X-rays
- blood tests to check for tumour markers such as CA125, and to measure complete blood count and levels of chemicals in the blood
- use of scopes to see inside the gastrointestinal tract
- biopsy – where a small sample of tissue is removed to be examined under a microscope. This is usually done as part of the initial surgery, because the only way to confirm a diagnosis of ovarian cancer is through an operation. The surgeon will also take samples of any fluid in the abdomen.
Ovarian cancer is surgically staged, based on the extent of the cancer. Knowing the stage of the disease helps your medical team plan the best treatment for you.
Surgical staging involves taking biopsy samples from tissues and organs that ovarian cancer often spreads to.
Ovarian cancer is divided into 4 main stages:
- Stage I: the cancer is in 1 or both ovaries and has not spread to other organs or tissues.
- Stage II: the cancer is in 1 or both ovaries and has spread to other organs in the pelvis, such as the uterus, fallopian tubes, bladder or colon.
- Stage III: the cancer is in 1 or both ovaries and has spread outside the pelvis to other parts of the abdomen or nearby lymph nodes.
- Stage IV: the cancer has spread to other parts of the body beyond the pelvis and abdomen, such as the lungs or liver.
Each stage has a number of substages.