Ovarian Cancer Tests and Diagnosis

What tests do you need for Ovarian Cancer:

Ovarian cancer at its early stages (I/II) is difficult to diagnose until it spreads and advances to later stages (III/IV). This is because most symptoms are non-specific and thus of little use in diagnosis.

You doctor may do some of the following:

• Physical examination (including a pelvic, vaginal, rectal examination). For young patients, an MRI is preferred
•  Transvaginal ultrasound
• Blood test (complete blood count, serum electrolyte test)
• CT or MRI scan
• Surgical procedures like laparotomy (incision through the abdominal wall) or keyhole surgery (laparoscopy) to take tissue samples and abdominal fluid for lab analysis
• Tumour marker testing
  

  Epithelial cell tumours	Beta-HCG to rule out pregnancy CA 125 (if > 65U/ml is highly suggestive, not to be used in isolation for diagnosis) HE4 decreases false positives when combined with CA-125 Inhibin mostly seen in mucinous subtypes
  Granulosa-theca cell tumours	CA 125 is likely to be normal Inhibin (type B is usually higher than A) Estradiol is elevated
  Germ cell tumours	CA 125 is likely to be normal B-HCG is elevated Alpha fetoprotein (AFP)* is elevated Neuron-specific enolase (NSE)*** is elevated Lactate dehydrogenase (LDH)** is elevated

  *AFP is a major plasma protein produced by the yolk sac and the liver during foetal development.

           **NSE is an enzyme seen concentrated in cancer cells.

          ***LDH is an enzyme involved in tumour initiation and metabolism.