Ovarian Cancer Diagnosis and Treatment

Ovarian cancer begins either in the ovaries or the fallopian tubes. These organs produce and transport eggs for reproduction. Ovarian cancer can be difficult to detect as symptoms of the disease often don’t develop until the later stages.

To learn more about ovarian cancer, its symptoms, causes and prevention of the disease, click here.

In recent years, advances in medicine have improved the way ovarian cancer is treated, improving outcomes for many women.

How is ovarian cancer diagnosed?

As ovarian cancer often has no symptoms in the early stages, and there is no reliable screening test for the disease, it can be difficult to diagnose early.

If ovarian cancer is suspected, your doctor will first discuss your symptoms with you in detail and perform a pelvic exam, looking for any noticeable growths or enlarged organs.

Diagnostic tests may be ordered, including:

Imaging tests

Several imaging tests may be used, including:

• Pelvic ultrasound: Sound waves provide an image of the organs, allowing doctors to see abnormal growths.
• MRI (magnetic resonance imaging): A noninvasive imaging test that produces detailed images of the organs.
• CT scan (computed tomography): Uses a series of X-rays and a computer to produce many detailed images of organs and soft tissues.
• PET scan (positron emission tomography): Produces 3D images of the body using a mild radioactive liquid which shows up in areas where cells are more active than normal.

Imaging techniques, such as high-resolution ultrasound, MRI, and PET scans, have advanced in recent years. This has not only improved the accuracy of ovarian cancer diagnosis but allows for better assessment of the size and spread of the cancer which is crucial for treatment planning.

Blood tests

If ovarian cancer is suspected, a blood test looks for a protein called CA-125. High levels of this protein can be a sign of cancer. However, levels can be elevated when no cancer is present, and levels can be normal if cancer is present. This blood test is usually used in combination with other tests to diagnose ovarian cancer.

Recent advancements have improved the sensitivity and specificity of CA-125 testing. It is now more accurate at detecting elevated CA-125 levels, meaning the test is an important tool in not only diagnosing ovarian cancer, but in monitoring progression of the disease.

Surgical evaluation

Sometimes, ovarian cancer is diagnosed during surgery. If abnormal growths are found, they will usually be removed during the procedure.

Laparoscopy

A minimally invasive procedure during which a thin camera (laparoscope) is inserted into the abdomen through a small cut. The scope guides the surgeon so they can assess the cancer and take biopsies if needed. Sometimes, ovarian tumors can be removed during the procedure.

Interventional radiology

Image-guided biopsy can be performed without the need for surgery, helping to speed up the diagnostic process in some patients.

How is ovarian cancer treated?

Ovarian cancer treatment may include:

Surgery

Surgery usually involves the removal of the reproductive organs. Types of ovarian cancer surgery include:

• Laparoscopy: Also used as a diagnostic procedure, laparoscopy is a minimally invasive surgery to remove the reproductive organs.
• Laparotomy: An open surgery during which the abdomen is opened, and the ovaries and any other affected organs are removed.

Chemotherapy

Chemotherapy may be given before or after surgery. There are many different types of chemotherapy drugs available and the type you receive will depend on the location of the cancer, the stage or how advanced it is and your overall health. Chemotherapy drugs work by targeting cancer cells, killing them and preventing them from multiplying. It is an effective treatment but can cause side effects such as nausea, fatigue and hair loss.

Targeted Therapy

Targeted drugs identify and attack cancer cells without affecting normal cells. They target certain protein and gene changes within healthy cells that may cause them to turn into cancer. Doctors may use genetic testing to identify the specific treatment that will stop cancer cells from growing. For some patients, targeted therapies are less harmful and more effective than other traditional treatments.

Hyperthermic intraperitoneal chemotherapy (HIPEC)

HIPEC is a treatment for cancer in the abdominal cavity. Once the tumors have been surgically removed, chemotherapy drugs are heated and circulated in the abdomen. It is often used as a treatment for cancer which has spread to other parts of the abdomen. HIPEC can’t cure cancer but can increase cancer treatment response.

Surveillance

Once ovarian cancer treatment is complete, you will continue to be seen regularly for observation and tests may be performed, such as blood tests and imaging tests, to check that the cancer hasn’t returned. Always discuss any concerns or symptoms with your doctor.

Advanced evaluation and treatment options for gynecologic cancers

Comprehensive, multidisciplinary care for women with cervical, ovarian and uterine cancer.

Learn more