How Do You Check for Ovarian Cancer?

Certain ways to find ovarian cancer early include:

• Regular health or pelvic examination
  • A pelvic exam can find some cancers at an early stage, but most ovarian tumors are difficult or impossible to feel early.
  • To perform a pelvic examination, the doctor will place two gloved fingers into the vagina while pressing on your abdomen with their other hand. You may get a vaginal examination using an instrument that gently separates the walls of the vagina.
  • Screening tests used for cervical cancer, such as a Pap test or human papillomavirus test, cannot effectively diagnose early-stage ovarian cancer but can be used in advanced stages.
• Biopsy
  • To confirm the diagnosis, a tissue sample from the tumor is obtained and checked under a microscope.
• Screening tests
  • In addition to a thorough pelvic examination, these two tests are used most often to screen for ovarian cancer.
  • Transvaginal ultrasound: A test that uses sound waves to look at the uterus, fallopian tubes, and ovaries by inserting an ultrasound wand into the vagina.
  • Ultrasounds are not very effective at finding early ovarian cancer because they often show cysts that are benign (noncancerous), which can lead to unnecessary surgery.
  • CA-125 blood test: This measures the amount of a protein called CA-125 in the blood (found on the surface of ovarian cancer cells), which is raised in ovarian cancer. However, this tumor marker can mislead because this can be high in the case of common conditions, such as cirrhosis, fibroids, endometriosis, and pelvic inflammatory disease. 
  • Moreover, half of the women with early cancer have a normal CA-125 level, which could be falsely reassuring.
• Imaging scans
  • Computed tomography scan: X-rays are used to create a detailed picture of the inside of the body.
  • Positron emission tomography scan: A specialized imaging test that uses a radioactive substance called a tracer to know the spread of cancer in the body.
  • Magnetic resonance imaging scan: Detailed pictures of the inside of the body are created by using a powerful magnet and radio waves.

Ovarian cancer is an abnormal and uncontrolled growth of cells that starts in the ovaries.

According to the American Cancer Society, the chances of a woman getting ovarian cancer in their lifetime are about 1 in 75.

According to the National Ovarian Cancer Coalition, only 19 percent of ovarian cancer is diagnosed in the early stages. If found early, almost 94 percent of patients have a survival rate of more than five years after diagnosis.

Depending on the cells where the cancers start, ovarian cancer is divided into three types:

1. Epithelial
   • The most common type of ovarian cancer (90 percent of cases)
   • Usually begins after the age of 60 years 
   • Initiates in the cells on the surface of the ovary (epithelium)
     • Serous: High-grade serous carcinoma occurs in about 70 percent of ovarian cancer cases.
     • Endometrioid
     • Clear cell
     • Mucinous
2. Stromal cell
   • A rare type (4 percent or less)
   • Usually occurs between the ages of 40 and 60 years
   • Initiates in the cells in the ovaries that produce the hormones estrogen and progesterone
3. Germ cell
   • A rare type of ovarian cancer (approximately 4 percent of cases)
   • Usually occurs before the age of 40 years
   • Initiates in the egg-producing (germinal) cells

According to the American Cancer Society, screening tests should only be performed if the woman has symptoms of ovarian cancer or if the healthcare provider feels something abnormal during a physical examination.

• Women at average risk: No recommended screening tests (transvaginal ultrasound or the CA-125 blood test) for ovarian cancer for women who do not have symptoms or are considered at low or average risk.
• Women at high risk: Transvaginal ultrasound and CA-125 may be offered to screen women who have an inherited genetic syndrome, such as Lynch syndrome, BRCA gene mutations, or a strong family history of breast and ovarian cancer.

The symptoms of ovarian cancer that generally develop at an advanced stage of the condition are:

1. Pelvic or abdominal pain or cramping
2. Reduced appetite
3. Indigestion or upset stomach
4. Nausea
5. Passing urine more often or urgently than normal
6. Unexplained exhaustion
7. Bloating and constipation
8. Excessive flatulence
9. Increase abdominal girth or abdominal swelling
10. Unexplained pain while having sex
11. Menstrual changes (heavier than normal or irregular bleeding)
12. Weight loss
13. Difficulty breathing

The specific cause of ovarian cancer is still unclear though doctors have identified factors that can increase the risk of the disease, such as:

1. Older age: It is most common in women aged 50 to 60 years though it can occur at any age.
2. Inherited gene mutations: A small percentage of ovarian cancers are caused by genetic mutations inherited from the parents. The genes known to increase the risk of ovarian cancer are called breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2). These genes increase the risk of breast cancer.
3. Other gene mutations: Other gene mutations that can cause ovarian cancer include those associated with Lynch syndrome.
4. Family history of ovarian cancer: People with close relatives with ovarian cancer have an increased risk of the disease.
5. Reproductive history: Women who have not had children, who have had assisted reproduction, or who have had children after the age of 35 years may be slightly more at risk.
6. Lifestyle factors: Some types of ovarian cancer have been linked to smoking or being overweight.
7. Estrogen hormone replacement therapy: It can be a cause of ovarian cancer, especially with long-term use and in large doses.
8. Age when menstruation started (menarche) and ended (menopause): Beginning menstruation at an early age, starting menopause at a later age, or both may increase the risk of ovarian cancer.
9. Endometriosis: A condition caused by tissue from the lining of the uterus growing outside the uterus.