Ovarian Cancer Diagnosis: Right from the Start

At Roswell Park, we have some of the most advanced imaging tools and pathology resources available so that we get your diagnosis right from the start.

Not all cancers are created equal. Each is comprised of cells that vary from cancer to cancer, and from individual to individual. And tumors may range in size, from millimeters to inches. Accurately identifying the extent of disease and the makeup of your cancer is imperative when determining the best possible approach to treatment.

If you have a symptom that suggests ovarian cancer, your doctor must find out whether it is due to cancer or to some other cause. You may have one or more of the following tests:

• Physical exam: Your doctor checks general signs of health. Your doctor may press on your abdomen to check for tumors or an abnormal buildup of fluid (ascites). A sample of fluid can be taken to look for ovarian cancer cells.
• Pelvic exam: Your doctor feels the ovaries and nearby organs for lumps or other changes in their shape or size. A Pap test is part of a normal pelvic exam, but it is not used to collect ovarian cells. The Pap test detects cervical cancer. The Pap test is not used to diagnose ovarian cancer.
• Blood tests: Your doctor may order blood tests. The lab may check the level of several substances, including CA-125.
• Ultrasound: The ultrasound device aims sound waves at organs inside the pelvis. As the waves bounce off the organs, a picture is created based on the echoes and may reveal an ovarian tumor. For a better view of the ovaries, the device may be inserted into the vagina (transvaginal ultrasound).
• Biopsy: A biopsy is the removal of tissue or fluid to look for cancer cells. Based on the results of the blood tests and ultrasound, your doctor may suggest surgery (a laparotomy) to remove tissue and fluid from the pelvis and abdomen to make a definitive cancer diagnosis. 

Although most women have a laparotomy for diagnosis, some women have a less-invasive procedure known as laparoscopy during which the doctor inserts a thin, lighted tube (a laparoscope) through a small incision in the abdomen. Laparoscopy may be used to remove a small, benign cyst or an early ovarian cancer. It may also be used to learn whether cancer has spread.

State-of-the-Art Imaging Technology

With some of the most advanced imaging tools at our fingertips, and physicians trained to maximize their potential, we consistently provide reliable diagnostic results. Quality imaging enables the Roswell Park medical team to develop the best treatment plan and helps the surgeon map the most direct and effective approach to remove an identified tumor.

One of the more revolutionary imaging devices, the combined Positron Emission Tomography (PET)/Computed Tomography (CT) scanner is used to give a total-body overview of glucose (sugar) metabolism, which can reveal metabolic changes of cancer before anatomic abnormalities can be detected with conventional imaging tools such as stand-alone CT and ultrasound.

Special software is used to fuse PET images with CT scans, providing a union that is both functional and anatomic. PET-CT scans can differentiate malignant from benign tissue and can lead to early detection of recurring cancer. They can also grade tumors, define distant metastases, assist in treatment selection and evaluation.