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Tests and diagnosis

The doctor is likely to start with a pelvic examination

  • The outer part of your genitals is carefully inspected.
  • The doctor then inserts two gloved fingers into the vagina and simultaneously presses a hand on your abdomen to feel your uterus and ovaries.
  • A device (speculum) is inserted into the vagina so that the doctor can visually check for abnormalities.
  • Your doctor also may recommend:

    • Imaging tests, such as ultrasound or CT scans, of your abdomen and pelvis. You may have an internal 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, plus any cysts or other swellings that are present.
  • Blood test, which can detect a protein (CA 125) found on the surface of ovarian cancer cells.A very high level of CA125 may indicate that you have ovarian cancer.However, CA125 isn′t specific to ovarian cancer and it can be raised in conditions including endometriosis, fibroids, pelvic inflammatory disease and pregnancy, so a raised CA125 level doesn′t definitely mean you have ovarian cancer.

Further tests

  • If you′ve been diagnosed with ovarian cancer, you may have further tests to see how large the cancer is and if it′s spread. This is called staging.

Other tests you may have include

  • a chest X-ray
  • a CT scan or MRI scan
  • abdominal fluid aspiration – a thin needle is passed into your abdomen, so that a fluid sample can be taken and tested for cancerous cells
  • laparoscopy– a thin tube with a camera on the end is inserted through a small incision in your lower abdomen, so that your ovaries can be examined; a small tissue sample may also be taken from your ovaries for testing (a biopsy)

If cancer is discovered, the surgeon may immediately begin surgery to remove as much of the cancer as possible.

Stages and grades of ovarian cancer

Staging - If your test results indicate that you have ovarian cancer, it will be given a stage. The stage describes the size of the cancer and how far it has spread. The four commonly used stages of ovarian cancer are:

  • stage 1 – where the cancer only affects one or both of the ovaries
  • stage 2 – where the cancer has spread from the ovary and into the pelvis or womb
  • stage 3 – where the cancer has spread to the lining of the abdomen, the surface of the bowel and the lymph nodes in the pelvis
  • stage 4 – where the cancer has spread to other parts of the body, such as the liver, spleen or lungs

This is a simplified guide. Each stage is further divided into categories A, B and C. Ask your doctor if you′re not sure what stage you have.

Grading - The grade of cancer refers to the appearance of cells under a microscope. The grades are as follows:

  • low grade – although abnormal, cells appear to be slow-growing
  • moderate grade – cells look more abnormal than low-grade cells
  • high grade – cells look very abnormal and are likely to be fast-growing

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