Go to a GP if you have symptoms of ovarian cancer. They will do some initial tests and may refer you for further tests in hospital.
Visiting your GP
Your GP may:
- ask about your symptoms and general health
- gently feel your tummy to check for any swelling or lumps
- do an internal examination
- ask if there's a history of ovarian or breast cancer in your family
- take a sample of blood – this will be sent to a laboratory and checked for a substance called CA125
Your GP may refer you to a hospital specialist, usually a gynaecologist, for further tests without having a blood test.
Blood test (CA125 test)
CA125 is produced by some ovarian cancer cells. A high level of CA125 in your blood could be a sign of ovarian cancer.
But a high level of CA125 does not mean you definitely have cancer. It can also be caused by other conditions such as endometriosis, fibroids and even pregnancy.
If the test shows a high level of CA125, you'll be referred for a scan to check for possible causes.
Sometimes your CA125 level can be normal in the early stages of ovarian cancer. If you've had a normal blood test result but your symptoms do not improve, you may need to be re-tested.
Ultrasound scan
The GP will arrange for you to have an ultrasound scan if a blood test suggests you could have ovarian cancer.
This is a type of scan where high-frequency sound waves are used to create an image of the inside of your body.
There are 2 ways it can be done.
Abdominal ultrasound
A small device called an ultrasound probe is moved over your tummy to create an image of your ovaries. This scan is performed like a pregnancy ultrasound scan.
Transvaginal ultrasound
An ultrasound probe is passed into your vagina to create a clearer image of your ovaries. You will feel some pressure in your vagina but it should not be painful.
The scan can show changes in your ovaries. These changes may be caused by cancer or other problems such as endometriosis or a build-up of fluid.
If any abnormalities are found, you'll be referred to a specialist for further tests.
Further tests
The following tests may be done by a specialist in hospital to confirm or rule out ovarian cancer:
- a CT scan - several x-rays are taken from different angles to create a detailed image of your ovaries
- a needle biopsy - a needle is passed through your tummy to remove a sample of ovary cells or fluid from around the ovaries, so it can be checked for cancer
- a laparoscopy - a small cut is made in your tummy and a tube with a camera is inserted to look at your ovaries, a small tissue sample may also be removed for testing
If ovarian cancer is found, these tests can also help find how far it has spread.
Stages and grades of ovarian cancer
If you're diagnosed with ovarian cancer, it will be given a 'stage'.
This describes the size of the cancer and how far it has spread. It can help your doctors plan the best treatment for you.
The 4 main stages of ovarian cancer are:
- Stage 1 - the cancer only affects 1, or both ovaries
- Stage 2 - the cancer has spread from the ovary and into the pelvis or womb
- Stage 3 - the cancer has spread to the lining of the tummy, the surface of the bowel, omentum or to the lymph glands in the pelvis or tummy
- Stage 4 - the cancer has spread to other parts of the body, such as the liver or lungs
Your cancer will also be given a 'grade'. This is a way of describing how quickly the cancer is likely to grow or spread.
The grades range from grade 1 (more likely to grow slowly) to grade 3 (more likely to grow quickly).