Ovarian Cancer Diagnosis

Because of an absence of early symptoms, many ovarian cancer tumors are first detected during routine pelvic examinations. The examining doctor may detect an unusual ovarian mass during palpation. This is not necessarily cause for alarm: the majority of ovary masses are ovarian cysts, which often disappear without treatment. Women in their childbearing years often develop benign ovarian cysts as a result of ovulation. After menopause, the risk of ovarian cancer rises, and any ovarian mass must be carefully monitored.

Transvaginal Sonography

Healthy OvariesIf an ovarian growth appears suspicious, the next stage of diagnosis is a specialized type of ultrasound called a transvaginal sonography. A hand-held probe is inserted into the vagina. This probe directs high frequency sound waves at the ovaries. The sound wave echoes are recorded by the probe, and compiled into a picture, or sonogram, that is displayed on a monitor.

Abnormal growths and healthy tissue will look different on the sonogram. Sonography can differentiate between tumors and cysts filled with fluid. It makes no distinction, however, between malignant tumors and benign cysts filled with solid material.

Laparotomy: Surgical Confirmation

Ovarian TumorsIf the results of the sonography are inconclusive, a laparotomy may be required. A laparotomy is a surgical procedure performed under general anesthetic. A small incision is made in the abdomen, through which the surgeon can examine the ovaries, the uterus and the pelvic cavity. During the operation, abnormal growths may be removed, or samples of tissue taken for biopsy testing.

Doppler Sonography

Although a laparotomy provides a conclusive diagnosis, false ultrasound results often lead to unnecessary surgery. A more accurate initial imaging test would cut down on the number of unneeded surgeries.

Doppler ultrasound measures the flow of blood through the body. By combining transvaginal sonography with Doppler ultrasound, researchers are hoping to develop an ultrasound test more sensitive at detecting ovarian cancer.

Blood Tests and Tumor Markers

Certain blood tests can be used to detect tumor markers: proteins associated with the tumor that build up in the blood stream. Blood tests can measure levels of human chorionic gonadotropin (HCG),lactate dehydrogenase (LDH), alpha-fetoprotein (AFP) and CA125. Of these tumor markers, CA125 is perhaps the most important, and is present in eighty percent of all ovarian cancers.

Elevated levels of CA125 do not automatically indicate cancer, however. Endometriosis, pelvic inflammatory disease (PID), pregnancy, and uterine fibroids also produce high levels of the protein. As a result, blood tests alone are not accurate enough to make an ovarian cancer diagnosis.


Beers, M. H.,