Gynecologic cancer | Ovarian Cancer | Diagnosis

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 What are the symptoms of ovarian cancer?

 Answer*: Often called the 'whispering disease' because it is difficult to detect, ovarian cancer is, unfortunately, rarely diagnosed in its early stages. Sometimes it's detected because an ultrasound or surgery is performed for some other reason. It can be discovered during routine pelvic exams. Often women will have soft or vague symptoms for weeks or months, and these include:

  • a sense of fullness
  • pressure in the pelvic area
  • a change in bowel habits
  • bloating
  • abdominal discomfort

In later stages, an accumulation of fluid or a mass indicates the possibility of disease. Unfortunately, it's estimated that 80% of ovarian cancer is found in later stages.

 Cyndee, Pennsylvania, USA: The symptoms of ovarian cancer include abdominal swelling, fatigue, backache, diarrhea, constipation, bloating, gas, and a general feeling of fullness. For me, the constant backache and fatigue was a big problem, but it was abdominal swelling that finally got me to go to a doctor and have it checked out.

 Janet M., Pennsylvania, USA: My diagnosis came after I suffered bloating due to fluid build-up, and shortness of breath due to fluid interfering with the lungs. I might add that even though I had discomfort from the fluid build-up, I was not in pain, and was very active.

 Gina, Pennsylvania, USA: I had MILD cramps, MILD indigestion ... nothing at all out of the ordinary, so of course, I thought I had a case of mild cramps and mild indigestion! A few days before a regular appointment with my gynecologist, though, I had some marked bloating, and the day before the doctor's appointment, I noticed a distinct large bulge in my abdomen, mostly noticeable when I was lying on my back. At my appointment the next day, my doctor felt the mass during my internal exam, sent me for an immediate transvaginal sonogram, and that's when they discovered a very large mass.

 Is there a standard screening test for ovarian cancer?

 Cyndee, Pennsylvania, USA: Unlike breast or cervical cancers, there is no consistent screening test to detect ovarian cancer. Its symptoms are so vague that it is often misdiagnosed. Most times it is undetected until it has reached an advanced stage of disease.

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 How was your ovarian cancer diagnosed?

 Cyndee, Pennsylvania, USA: My ovarian cancer was diagnosed using several tests. When I went to my doctor, I was in so much pain she could not even examine me. So she ordered a transvaginal ultrasound to help her figure out what was going on in my abdomen. When a mass was spotted, I was scheduled to see a gynecologic oncologist.  During my appointment, he did a vaginal and rectal examination and ordered and a computed tomography (CT) scan of the abdomen. He also ordered blood tests. One of the blood tests was a Cancer Antigen 125 (CA 125).

 Gina, Pennsylvania, USA:The day before my regular check-up with my gynecologist, I noticed a distinct large bulge in my abdomen, mostly noticeable when I was lying on my back. At my appointment, my doctor felt the mass during my internal exam, sent me for an immediate transvaginal sonogram, and that's when they discovered a very large mass.

Prior to surgery, I had blood work and the CA 125 level was raised, but no one gave me a definitive cancer diagnosis until after my surgery and biopsy. To be specific, they did a frozen section biopsy while I was on the operating table, and immediately after surgery told me it had come back negative. Then, a couple of days later, after the lab biopsy, they came back and told me that it was, in fact, cancer. I was told that the frozen section biopsies are about 90% accurate and I just happened to fall into the unfortunate 10%.

 What are some tests for ovarian cancer?

 CA 125 test: For more information about CA 125, please visit our section on Treatments and Tests:

 How does the CA 125 test work to detect ovarian cancer?

 How significant is a rise in my CA 125 if it is still below the "magic" level of 35 kU/ml?

Transvaginal Sonography: ultrasound provides a good view of the ovaries but it may show an abnormality that doesn't exist. Often this is why it's used in combination with the CA 125 test. See also:

 What is a transvaginal ultrasound, or sonogram?

Pelvic or Recto-Pelvic Examinations: Although an annual pelvic exam is a good idea, this procedure does not generally improve the detection of ovarian cancers, especially at the early stages. Pap tests do NOT detect ovarian tumours, they are used as a screening device for cervical cancers.

Colour Doppler Imaging: Tumours may have a different blood flow than normal tissue and this technique can be effective in showing the difference between normal and malignant tissue.

Source: "Ovarian Cancer and You" Supplemental to Current Oncology Journal, vol 5, supp 2. Nov 98.



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