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Ovarian Cancer - Diagnosis

How Is Ovarian Cancer Diagnosed? 
How Is Ovarian Cancer Treated? 
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How Is Ovarian Cancer Diagnosed? 

Ovarian cancer is often diagnosed in the late stages when the disease is already advanced. This is because symptoms are vague and often attributed to other conditions, thus delaying diagnosis. Sometimes, these common symptoms are more severe in women with ovarian cancer, but this isn't always the case. Early stage diagnosis is beneficial because it will improve the survival rates for most women. Therefore, it is important for women to be aware of overall changes in the way they feel and see their physician if they notice any new symptoms that don't improve over time.

If your primary care physician suspects ovarian cancer might be the cause of your symptoms, you will be referred to a gynecologist or gynecologic oncologist, a doctor who specializes in treating conditions of the ovaries, uterus, and cervix. These specialists will use one or more of the following methods to diagnose endometrial cancer.

Starting with your first visit to BMC, you will receive coordinated, multidisciplinary care that is managed by a gynecologic oncologist. At this time, specialists will use one or more of the following methods to diagnose ovarian cancer.

  • Physical Exam – Your physician will ask you a series of questions and is likely to do a physical exam.  The physical exam may include feeling the pelvic area to find enlarged ovaries or fluid in the abdomen area (ascites).

  • Imaging Tests – There are a variety of imaging tests that may be done to help diagnose ovarian cancer.  These imaging tests may include ultrasound or CT scans.

  • Ultrasound – Ultrasound is a safe, noninvasive, painless procedure that can help diagnose ovarian cancer. Using high-frequency sound waves, it is used to examine the abdomen. Ultrasound imaging—also called ultrasound scanning or sonography—provides real-time pictures of the body, and also evaluates size and movement of structures, such as blood flow.

  • CT scans – Computed tomography (CT) scans provide a two-dimensional image of your body, including a view of your glands (lymph nodes). If a contrast dye is used to improve the image, you may need to fast for several hours before the test. Tell your clinician in advance if you have allergies or kidney problems or are a diabetic.

Your physician will likely order one or more diagnostic tests. If a cancer diagnosis is made, multiple specialists will review your case at a biweekly Tumor Board meeting. This interdepartmental review process guides our recommendations for treatment. In consultations with you and your primary care physician, we plan the best course of treatment for you based on the type and extent of your cancer and your overall health.

Staging

Staging is an important part of diagnosis because it is used to determine the most appropriate treatment options for cancer patients.  Staging is a process that is used to determine how extensive the cancer is. The stages of ovarian cancer range from Stage I to Stage IV.  Stage grouping derived from the American Joint Committee on Cancer (AJCC) is included below.

  • Stage I:  Cancer is present in one or both ovaries.
  • Stage II: Cancer is present in one or both ovaries and has spread to other organs in the pelvic region (i.e. the uterus, fallopian tubes, bladder, the sigmoid colon, or the rectum).
  • Stage III: Cancer is present in one or both ovaries and has progressed beyond the pelvis to the lining of the abdomen and/or spread to the lymph nodes.
  • Stage IV: The cancer has spread to regions outside of the abdomen such as the lungs, liver, and/or other organs.

For a more detailed description of staging, please refer to the chart below.

Staging for Ovarian Cancer
Stage I Cancer is present in one or both ovaries.
Stage IA Cancer is present in one ovary.
Stage IB Cancer is present in both ovaries.
Stage IC Cancer is present in one or both ovaries, and 1) cancer is present on the outer surface of at least one of the ovaries, 2) the outer covering (called the capsule) of the tumor has burst, and/or 3) cancer cells are present in the fluid of the peritoneal cavity (the space in the body where most of the organs in the abdomen are found, also called the abdominal cavity) or in washings of the peritoneum (tissue lining the peritoneal cavity).
Stage II Cancer is present in one or both ovaries and has spread to other organs in the pelvic region (i.e. the uterus, fallopian tubes, bladder, the sigmoid colon, or the rectum).
Stage IIA Cancer has spread to the uterus and/or fallopian tubes. No cancer cells have been found in fluid from the abdomen.
Stage IIB Cancer has spread to other organs in the pelvic region, such as the bladder, the sigmoid colon, or the rectum. No cancer cells have been found in fluid from the abdomen.
Stage IIC Cancer has spread to other organs in the pelvic region, and cancer cells were found in fluid from the abdomen.
Stage III Cancer is present in one or both of the ovaries and has advanced beyond the pelvis to the lining of the abdomen and/or to the lymph nodes.
Stage IIIA The tumor is found in the pelvis only, but cancer cells invisible to the naked eye are found in the lining of the upper abdomen.
Stage IIIB Cancer is present in one or both of the ovaries, and deposits of cancer of 2 cm or less (visible to the naked eye of the surgeon) are found in the abdomen.
Stage IIIC Cancer is present in one or both ovaries, and deposits of cancer of 2 cm or greater are found in the abdomen and/or cancer has spread to the lymph nodes.
Stage IV Cancer has spread beyond the abdomen to other organs in the peritoneal (abdominal) cavity, such as the liver and lungs. Cancer cells in the fluid around the lungs also mean Stage IV ovarian cancer.
(Source: National Cancer Institute, American Cancer Society)


(Source: American Cancer Society, National Cancer Institute)

 

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