Dr Douglas A. Levine: Hi! I am Dr Douglas Levine, and I am gynecologic oncologist at Memorial Sloan Kettering Cancer Center in New York City. I am also a member of the Ovarian Cancer Research Funds Scientific Advisory committee. Today I am going to speak a little about how ovarian cancer is diagnosed. If you have symptoms that's suggest ovarian cancer, your doctor has to find out if those symptoms are actually due to ovarian cancer or to another less serious cause. Unlike other women's cancers such as breast and cervical cancer, there is currently no method of early detection for ovarian cancer.
The Pap test which women receive regularly as part of a complete gynecologic exam detects only cervical cancer not ovarian cancer. Similarly, there is no one definitive test for ovarian cancer. There isn't a single blood test, or a single imaging test like an ultrasound that can definitively tell you and your doctor if you have the disease.
Tests do exist for women who are experiencing symptoms or who are at a high risk. If you have ovarian cancer symptoms, your doctors may order one of several tests or a combination of them. These tests are a physical and pelvic exam, blood tests, an ultrasound, a CT scan and a biopsy. In a pelvic exam, your doctor will feel the ovaries and nearby organs for unusual lumps or other changes in shape or size. Your doctor may order a Transvaginal ultrasound; the ultrasound will create a picture which may show an ovarian tumor if one is present. Your doctor may also order blood tests.
Cohen: There should be the use of serum markers looking for abnormal proteins which can circulate in the blood when a patient is developing an abnormality in the ovary. The most popular one is called CA-125 and unfortunately it is not so sensitive and so specific that it should be used as a single number alone without the sonographic test accompany. Douglas A Levine: A CT scan which looks more completely at the abdomen and pelvis is often ordered if anyone of the above tests are abnormal or if symptoms persist despite normal test results. Finally, your doctor may also do a biopsy to remove tissue or fluid from your abdomen to look for cancer cells.
If these tests strongly suggest ovarian cancer, surgery is usually needed to confirm the diagnosis. Some women ask why doctors don't just give all women a CA-125 test and a Transvaginal ultrasound. It's a complicated issue. These tests aren't accurate enough to use them on a large scale to screen all women like we do with mammograms.
Too many women, both with and without ovarian cancer, would be diagnosed inaccurately leading to potentially harmful and unnecessary treatments. Also, these screening tests have not yet been proven to detect ovarian cancer at its earliest stages when it is most curable. If you want to learn more about ovarian cancer, check out our other videos, including the next one, on how ovarian cancer is treated.