Usually you begin by seeing your GP, who will examine you and may arrange for you to have an ultrasound scan and blood tests. Your GP will refer you to a specialist doctor, usually a gynaecologist (a specialist in women’s health), for advice and treatment.
At the hospital, the gynaecologist will ask you about your general health and any previous medical problems. They will then examine you. This will include an internal (vaginal) examination to check for any lumps or swellings. Sometimes, you may also have an examination of your back passage (rectum). You can ask for a female doctor to do the internal examination if you prefer.
You may also have a chest x-ray to check your general health. You will have a blood test to check the levels of a protein called CA125. CA125 levels may be higher than normal in women with PPC or ovarian cancer.
The following tests are commonly used. You can read about these in more detail in our information about ovarian cancer.
Ultrasound scan
This test uses sound waves to build up a picture of the organs inside the tummy (abdomen) and pelvis. A computer converts the sound waves into pictures that you can see on a screen. There are two types of ultrasound that can be used:
Pelvic ultrasound
You will be asked to drink plenty of fluids before this ultrasound so that your bladder is full. This helps to give a clearer picture. The person doing the scan spreads a gel on to your tummy (abdomen). They then gently go over the area with a small handheld device, which produces the sound waves.
Vaginal ultrasound
The tip of an ultrasound probe (the size of a tampon) is gently inserted into your vagina. The probe produces sound waves. Although this may sound uncomfortable, you may find it easier than a pelvic ultrasound, as you don’t need a full bladder.
CT (computerised tomography) scan
A CT scan takes a series of x-rays that build up a three-dimensional (3D) picture of the inside of the body. It is painless and takes 10 to 30 minutes. It uses a small amount of radiation, which is very unlikely to harm you or 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 that allows particular areas to be seen more clearly. This may make you feel hot all over for a few minutes. It is 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.
MRI (magnetic resonance imaging) scan
This test uses magnetism to build up a detailed picture of areas of your body. Before the scan you may be asked to complete and sign a checklist. This is to make sure it is safe for you to have the MRI scan. Before the scan, you will be asked to remove metal belongings including jewellery. Some people are given an injection of dye into a vein in the arm. This is called a contrast medium and can help the images from the scan to show up more clearly. During the test, you will be asked to lie very still on a couch inside a long cylinder (tube) for about 30 minutes. It is painless but can be slightly uncomfortable, and some people feel a bit claustrophobic. It is also noisy, but you will be given earplugs or headphones.
Removing fluid from the tummy
If you have a build-up of fluid in the tummy (called ascites) your doctor may take a sample to check for cancer cells. They numb the skin over the area first with a local anaesthetic. The doctor then passes a needle through the skin into the fluid and draws some into a syringe.
If you have a lot of fluid it can be uncomfortable so your doctor may remove it by putting a short tube (a cannula) into the tummy (abdomen). The tube attaches to a bag that collects the fluid as it drains.
We have more information about ascites.
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.
Knowing about any genetic changes helps your doctor plan your treatment.
We have more information about cancer and genetic changes.
Laparotomy
Sometimes the surgeon needs to do an operation called a laparotomy to make a definite diagnosis of primary peritoneal cancer. A larger cut is made in the skin and muscle of the abdomen. This allows the surgeon to look at all the organs in the abdomen. This will involve an overnight stay in hospital.