Tests for ovarian cancer

Several tests may be used to diagnose cancer of the ovary. The tests may also show the stage of the cancer  – whether or not it has spread to other parts of the body. These tests help your doctor to know the best way to treat the cancer.

You may have one or more of the following tests:

• Ultrasound scan – a quick, painless test that uses sound waves to build up pictures of the inside of the abdomen, the liver and the pelvis
• A computerised tomography (CT) or magnetic resonance imaging (MRI) scan –both use a computer to build up detailed, three-dimensional views of the inside of the body
• Abdominal fluid or chest fluid aspiration – a sample of fluid is taken from the abdomen (tummy area) or chest to check for any cancer cells
• Laparoscopy – a small operation that allows doctors to look at the ovaries, fallopian tubes, womb and surrounding area using a thin tube called a laparoscope
• Laparotomy – an operation that involves making an incision (cut) in the abdomen.

Ultrasound scan

You may have a pelvic or vaginal ultrasound to check for any enlargement or abnormalities of the ovaries, which may be due to a cyst or tumour. The test can also be used to show the size and position of a cancer. It will be done in the hospital scanning department.

If you have a pelvic ultrasound you will be asked to drink plenty of fluids so that your bladder is full. This helps to give a clearer picture. Once you are lying comfortably on your back a gel is spread onto your abdomen. A small device, which produces sound waves, is then rubbed over the area. The sound waves are converted into a picture by a computer.

If you have a vaginal ultrasound scan, a probe with a rounded end is put into your vagina. The probe produces sound waves, which are converted into a picture by a computer. Although this type of ultrasound scan may sound uncomfortable, many women find it more comfortable than having a pelvic ultrasound, as it’s not necessary to have a full bladder.

CT scan

A CT (computerised tomography) scan takes a series of x-rays, which build up a three-dimensional picture of the inside of the body. The scan takes 10–30 minutes and is painless. It uses a small amount of radiation, which is very unlikely to harm you and will not harm anyone you come into contact with. You will be asked not to eat or drink for at least four hours before the scan.

You may be given a drink or injection of a dye, which allows particular areas to be seen more clearly. This may make you feel hot all over for a few minutes. It’s important to let your doctor know if you are allergic to iodine or have asthma, because you could have a more serious reaction to the injection.

You’ll probably be able to go home as soon as the scan is over.

If there has been a build-up of fluid in the abdomen or chest, a sample of the fluid can be taken to check for any cancer cells. The doctor will use a local anaesthetic to numb the area before passing a small needle through the skin. Some fluid is drawn off into a syringe and examined under a microscope.

Sometimes the sample of fluid is taken while you are having an ultrasound scan. The scan helps guide the doctor to the fluid.

This operation allows the doctor to look at the ovaries, the fallopian tubes, the womb and the surrounding area. It’s done under a general anaesthetic. Most women usually go home the same day but you may have to stay in hospital overnight.

While you are under the anaesthetic, the doctor makes 3–4 small cuts, approximately 1cm (½ inch) in length, in the skin and muscle of the lower abdomen. A thin fibre-optic tube (laparoscope) is then inserted. By looking through the laparoscope the doctor can look at the ovaries and take a small sample of tissue (biopsy) for examination under a microscope.

During the operation, carbon dioxide gas is passed into the abdominal cavity and this can cause uncomfortable wind and/or shoulder pains. The pain is often eased by walking about or by taking sips of peppermint water. If the pain continues when you are at home, or you develop a fever, you should contact the hospital for advice.

After a laparoscopy you will have some small stitches in your lower abdomen. You should be able to get up as soon as the effects of the anaesthetic have worn off.

Sometimes cancer of the ovary cannot be diagnosed before a full operation| (laparotomy) is carried out.