Ovarian Cancer Symptoms and Diagnosis
Aggressive new therapies are being developed by the gynecologic cancer specialists at UC Irvine’s Ovarian Cancer Center, but early detection and diagnosis remain a woman’s best chance for successfully defeating ovarian cancer.
Ovarian cancer specialist Dr. Leslie Randall discusses warning signs of the stealth disease.
A woman’s first line of defense is a willingness to seek medical attention for non-specific symptoms. Women should consult their physician if they experience:
- Pressure or fullness in the pelvis
- Abdominal bloating
- Rapid weight gain
- Changes in bowel and bladder patterns that continue or worsen over a period of weeks or months
A physician may discover an ovarian or pelvic mass during a routine exam, or may suspect ovarian cancer based on such symptoms as abdominal swelling or bloating, weight gain and bowel or urinary tract changes.
The most common method to detect signs of ovarian cancer are imaging tests, usually a pelvic ultrasound (or sonogram), which can evaluate the presence and characteristics of an ovarian mass or cyst. Computed tomography (CT) scanning provides a more comprehensive image and may be done to evaluate the pelvic organs as well as the abdomen and chest.
Your doctor also may order a combined positron emission tomography (PET) and CT scan, which can detect the higher metabolic activity of any cancer cells present.
Other tests to further evaluate an ovarian mass include:
- CA 125 — The most common test is for cancer antigen 125. A blood level higher than 35 units per milliliter is considered abnormal. However, this test is generally helpful only for post-menopausal women. Pre-menopausal women can get a false positive reading because of menstrual cycles or conditions such as endometriosis and fibroid tumors.
- OVA1 — The OVA1 test measures the levels of five proteins in a woman’s blood. Although it an OVA1 test won't diagnose ovarian cancer earlier, an abnormal result can prompt referral to a gynecologic oncology specialist.
- Biopsy — Your gynecologic oncologist may need to remove sample tissue or fluid from the pelvic area to search for cancer cells. This is usually done laparoscopically through a small incision in the abdomen. The procedure also may involve removal of a small cyst or early ovarian cancer as well as help determine whether cancer has spread. A pathologist studies the biopsied tissue and/or fluids to determine whether cancer cells are present and then grade those cells. Grade 1 cancer cells are not as likely as to grow and spread as Grade 3 cells.
To plan the best treatment tailored to your specific circumstances, your doctor needs to know the grade of the tumor cells and the extent, or stage, of the disease. There are four stages, based on whether the tumor has spread and, if so, where.
- Stage I: Ovarian cancer is confined to the ovaries or in fluid collected from the abdomen
- Stage II: Ovarian cancer has spread beyond the ovaries to other reproductive organs and tissues in the pelvis
- Stage III: Ovarian cancer has spread to the abdomen and/or lymph nodes, and on the outside of the liver
- Stage IV: Ovarian cancer has spread beyond the abdomen or involves the liver, lungs or other organs
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