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Diagnosing ovarian cancer

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The symptoms of ovarian cancer are often subtle and may mimic common digestive issues. Finding an appropriate treatment plan starts with an accurate diagnosis. Gynecologic oncologists use a variety of tools designed for diagnosing ovarian cancer and determine the type and stage of the disease, including:

Imaging tests

Imaging tests for ovarian cancer may include:

CT scan: After conducting a physical exam and, in some cases, an ultrasound, we may use a CT scan to locate a tumor before surgery. We also may use a CT scan to determine tumor size, what other organs may be affected and whether lymph nodes are enlarged.

MRI: An MRI is often used in combination with other tests as part of the diagnostic evaluation process. An MRI has greater soft tissue contrast than a CT scan, making it useful in detecting tumors or recurrences in other areas of the body, such as the head.

PET/CT scan: This technology is sometimes used to help diagnose ovarian, fallopian tube or peritoneal cancer. The scan measures a tumor"s ability to use glucose, which is a type of sugar. Faster-growing cells use more sugar and show up brighter on a PET/CT scan. This may indicate the presence of cancer before it’s detected by other means. GE Discovery™ PET/CT 600 scanner is a four-dimensional CT scanner that produces detailed cross-sectional X-ray images of structures within the body. It also enables our radiologists to plan treatment in accordance with patients’ breathing patterns.

Ultrasound: This technology uses sound waves to create an image of internal organs, including the ovaries, uterus and cervix. The sound waves that bounce off cancerous tissue are different than those reverberating off healthy tissue, allowing an ultrasound to differentiate between normal tissue and some tumors. We also use transvaginal ultrasound to measure increased blood flow to the ovaries, which may serve as another indicator of cancerous tissue.

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Lab tests

Advanced genomic testing: Genomic testing examines a tumor to look for DNA alterations that may be driving cancer’s growth and other behaviors. By identifying the mutations that occur in a cancer cell’s genome, we can better understand the tumor behavior, and we may be able to tailor your treatment based on these findings.

Nutrition panel: With this test, we evaluate patients for deficiency of nutrients, such as vitamin D and iron. The test helps us identify the nutrients patients need replaced or boosted to support their quality of life and help reduce the risk of complications from surgery.

CA-125 test: CA-125 is a protein found in the blood. High amounts of CA-125 may indicate ovarian, fallopian tube or peritoneal cancer, as well as less serious conditions, such as endometriosis or inflammation in the abdomen. We often use this test in combination with other diagnostic methods. CA-125 levels are also often monitored during cancer treatment. High levels of CA-125 that begin to decline may indicate that the treatment is having an effect. If the level instead continues to rise, your doctor may consider changing your treatment regimen.

Pelvic exam

A pelvic exam is usually one of the first steps in evaluating a patient with a known or suspected diagnosis of ovarian cancer.

During a pelvic exam, the doctor will manually examine the abdomen and pelvic area for nodules or bumps. The doctor also will check for signs of an enlarged ovary or fluid in the abdomen. Although pelvic exams may be beneficial, early ovarian tumors are often difficult to detect without the use of other diagnostic tools.

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