Ovarian Cancer Tests, Diagnosis, Prognosis and Stages

Doctors at Banner MD Anderson Cancer Center use the latest screening and diagnostic tests available to find cancer in its earliest stages. Ovarian cancer often is not diagnosed until later stages because early symptoms go unnoticed. And, unlike the Pap test for cervical cancer, there are no screening tests for ovarian cancer. That’s why our ovarian cancer experts implore patients to practice body awareness – know your body and pay attention to changes. If you’re at high risk for ovarian cancer, we can help monitor your health to catch warning signs as soon as possible.

Are There Screening Tests for Ovarian Cancer?

There is no easy and effective way to screen for ovarian cancer. Unless you’re at high risk for ovarian cancer, regular screening exams are not recommended. Generally, patients are diagnosed with ovarian cancer after seeing a doctor for symptoms.

Ovarian Cancer Screening Guidelines for Women at High Risk

The U.S. Preventive Services Task Force (USPSTF) only recommends ovarian cancer screening tests for women at increased risk of getting the disease. If you have ONE of the following, you’re considered high risk and should get regular ovarian cancer screenings:

• Mutations of the BRCA1 or BRCA2 gene
• Suspected risk of mutations of the BRCA1 or BRCA2 gene
• One close blood relative with ovarian cancer who has a suspected mutation of the BRCA1 or BRCA2 gene
• Lynch Syndrome (hereditary nonpolyposis colorectal cancer)

If you’re considered high risk for ovarian cancer, talk to your doctor about this screening schedule:

• Transvaginal ultrasound – Every 6 to 12 months
• CA 125 blood test – Every 6 to 12 months

If you have BRCA1 or BRCA2 mutations, you should get these screening tests every six months. Also, talk to your doctor about having a salpingo-oophorectomy to remove your fallopian tubes and ovaries. This surgery may reduce your risk for ovarian cancer and is strongly recommended for women with BRCA1 or BRCA2 mutations who are finished having children.

Ovarian cancer screenings follow strict guidelines. Check with your insurance provider before scheduling an exam as not all carriers cover the cost.

How Is Ovarian Cancer Diagnosed?

Early-stage ovarian cancer symptoms can be difficult to detect. Listen to your body. If you notice any changes or persistent symptoms, talk to your doctor. Many women with ovarian cancer are not diagnosed until advanced stages. The sooner ovarian cancer is found and treated, the better the chance for survival.

It’s important to note that a Pap test does not detect ovarian cancer, only cervical cancer. And, unless an ovary is enlarged, a routine pelvic exam will not detect ovarian cancer either.

The following tests can help detect ovarian cancer:

• Pelvic exam: By inserting fingers into the vagina, your health care provider will check the ovaries or for any indication of fluid in the abdomen.
• Transvaginal ultrasound: A small ultrasound wand is inserted in the vagina to look for tumors on the uterus, fallopian tubes or ovaries.
• CA-125 blood test: A blood test to measure the level of CA-125, a protein produced by ovarian cancer cells. However, some non-cancerous diseases also increase CA-125 or some ovarian cancers may not increase CA-125 levels enough for a positive test.
• Computed tomography (CT) test: This imaging exam will provide information about the size, shape and position of a tumor as well as information on any enlarged lymph nodes where cancer may have spread.

Depending on your results, your doctor may recommend additional tests to determine the cause or confirm a diagnosis. At this point, you should consult with a gynecological oncologist who is specially trained in treating female reproductive system cancers. To diagnose ovarian cancer, your doctors will conduct imaging tests to look for tumors and do a biopsy surgery to remove a tissue sample for examination by a pathologist.

Research into new ovarian cancer screening and diagnostic tests is ongoing. At Banner MD Anderson, we’re dedicated to using the latest research developments to ensure the best possible care for our patients.

What Is the Prognosis for Ovarian Cancer?

Early detection of ovarian cancer generally results in a better prognosis. When diagnosed and treated in stage I, the 5-year relative survival rate is 92%; however according to the American Cancer Society only about 20% of ovarian cancers are diagnosed at an early stage.

Ovarian Cancer Staging

Staging helps determine how much cancer is in the body and how best to treat it. Ovarian cancer is staged based upon the size of the tumor, how deep it is in tissues or lymph nodes and if it’s spread (metastasis) to other parts of the body.

• Stage I (Stage 1): Tumor is limited to the ovary or ovaries
• Stage II (Stage 2): Tumor is limited to one or both ovaries and other parts of the pelvis
• Stage III (Stage 3): In addition to one or both ovaries, cancer has spread to the upper abdomen or nearby lymph nodes
• Stage IV (Stage 4): Cancer is in one or both ovaries and has spread to further parts of the body such as the lungs or liver

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