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Diagnosis

How Is Ovarian Cancer Diagnosed?

Ovarian cancer is often diagnosed in the late stages when the disease is already advanced. This is because the symptoms are vague and often attributed to other conditions, which delays diagnosis. Sometimes, these common symptoms are more severe in women with ovarian cancer, but this isn't always the case. Early-stage diagnosis is beneficial because it improves survival rates. Therefore, it is important for women to be aware of overall changes in the way they feel and see their physician if they notice any new symptoms that don't improve over time.

If a primary care physician suspects that ovarian cancer might be the cause of his or her patient’s symptoms, he or she will be refer the patient to a gynecologist or gynecologic oncologist, a physician who specializes in treating conditions of the ovaries, uterus, and cervix.

Starting with her first visit to BMC, the patient will receive coordinated, multidisciplinary care that is managed by a gynecologic oncologist. At this time, specialists will use one or more of the following methods to diagnose ovarian cancer:

Physical Exam

Your physician will ask you a series of questions and is likely to do a physical exam. The physical exam will including examining any specific areas of concern, especially as they relate to the reason for your visit to the office.

Imaging tests

Doctors may perform one or more of the follow imaging tests: Bone x-rays, CT scan, MRI, PET scan.

Ultrasound

Diagnostic ultrasound, also called sonography or diagnostic medical sonography, is an imaging method that uses high-frequency sound waves to produce images of structures within the body. The images can provide valuable information for diagnosing and treating a variety of diseases and conditions. Most ultrasound examinations are done using a sonar device outside the body, though some ultrasound examinations involve placing a device inside the body.

Computed Tomography (CT) Scan

CT scans use x-ray equipment and computer processing to produce 2-dimensional images of the body. The patient lies on a table and passes through a machine that looks like a large, squared-off donut. Doctors order CT scans when they want to see a two-dimensional image of the body to look for tumors and examine lymph nodes and bone abnormalities. If contrast dye is used to improve the computer image, the patient may need to avoid eating or drinking for 4 to 6 hours before the test. Patients should tell their provider before the test if they have any allergies or kidney problems.

The physician will likely order one or more diagnostic tests. If a cancer diagnosis is made, multiple specialists will review the patient’s case at a biweekly Tumor Board meeting. This interdepartmental review process guides recommendations for treatment. In consultations with the patient and her primary care physician, the best course of treatment is planned based on the type and extent of the cancer and the patient’s overall health.

Staging

Staging is the process of determining how extensive the cancer is. It is an important part of diagnosis because it is used to determine the most appropriate treatment options for patients. The stages of ovarian cancer range from Stage I (the least severe stage) to Stage IV.

 

Stages of Ovarian Cancer

Stage I: Cancer is present in one or both ovaries.

Stage II: Cancer is present in one or both ovaries and has spread to other organs in the pelvic region (e.g., the uterus, fallopian tubes, bladder, sigmoid colon, or rectum).

Stage III: Cancer is present in one or both ovaries and has advanced beyond the pelvis to the lining of the abdomen and/or the lymph nodes in the back of the abdomen.

Stage IV: Cancer has spread to organs outside of the peritoneal (abdominal) cavity.. Cancer cells in the fluid around the lungs also mean Stage IV ovarian cancer.

(American Cancer Society 2015, Society of Gynecologic Oncology 2014)

For more detailed information on the stages of ovarian cancer, visit the staging section of the American Cancer Society’s ovarian cancer website.

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