Ovarian cancer

You usually start by seeing your GP. The GP will ask about your symptoms and do an internal (vaginal) examination to check for any lumps or swelling in the ovaries or womb.

They may also arrange for you to have:

• a CA125 blood test
  This blood test checks for raised levels of a protein called CA125.

• an ultrasound scan
  You may have ultrasound scans to check the organs inside the abdomen (tummy area) and the pelvis.

If your GP is worried about cancer, they will arrange for you to see a specialist doctor within 2 weeks. This specialist is usually a gynaecologist (a doctor who treats female reproductive system problems).

Some people are admitted directly to hospital if they have a symptom that is making them very unwell.

The specialist doctor will ask you about your general health, any previous health problems, and whether you have any history of cancer in your family. They will do an internal (vaginal) examination again. If you have not already had a CA125 blood test and ultrasound, they will usually arrange for you to have these tests.

The doctor may use the results of your tests to check your Risk of Malignancy Index (RMI) score. This is a system that checks how likely it is that your symptoms are caused by cancer. It takes into account:

• whether you have gone through the menopause
• the level of CA125 in your blood
• the results of your ultrasound.

The specialist doctor may also organise further tests. These may help your team diagnose the cancer but also help them plan your treatment. You may have the following:

• CT scan
  A CT scan takes a series of x-rays, which build up a 3D picture of the inside of the body.
• Fluid taken from the abdomen
  Sometimes swelling or bloating in the tummy is caused by a build-up of fluid. This is called ascites. If you have ascites, your doctor may want to take a sample of this fluid to check for cancer cells.
  The doctor injects some local anaesthetic into the skin on your tummy (abdomen) to make it numb. They gently pass a small needle through the skin and collect some fluid in a syringe. The fluid is sent to the laboratory to be examined.
• Biopsy
  This is when the doctor removes a small sample (biopsy) from the lump or abnormal area. The sample is then sent to the laboratory and looked at under a microscope.
• Genetic testing
  Your doctor may talk with you about having a blood test to look for genetic changes that are linked to cancer. This is only done if you have certain types of cancer, such as high-grade serous or endometrioid cancer.

Waiting for tests results can be a difficult time. We have more information that may help.

A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT).

Your cancer doctor or specialist nurse will explain the different treatments and their side effects. They will also talk to you about the things you should consider when making treatment decisions.

Treatments for cancer that starts in the ovary include:

• Surgery
  Surgery is one of the main treatments for cancer of the ovary. The aim is to remove all of the cancer.

• Chemotherapy
  Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. Carboplatin is the main chemotherapy drug used to treat cancer of the ovary. It may be given in combination with paclitaxel.

Targeted therapies may be used to treat ovarian cancer that has come back or advanced ovarian cancer. Targeted therapies interfere with the way cells grow.

Radiotherapy is sometimes used to treat an area of cancer that has come back when other treatments are no longer possible. It may also be used to control symptoms, such as bleeding, pain or discomfort. This is known as palliative radiotherapy.

Other treatments are also used to control symptoms caused by advanced cancer. This may include a procedure to drain fluid called ascites, that can build-up in the tummy.

We have more information about how different treatments are used to treat ovarian cancer.

You may have some treatments as part of a clinical trial.