Diagnosis

Your doctor is likely to start with a pelvic examination:

  • The outer part of your genitals is carefully inspected.
  • The doctor then inserts two gloved fingers into the vagina and simultaneously presses a hand on your abdomen to feel your uterus and ovaries.
  • A device (speculum) is inserted into the vagina so that the doctor can visually check for abnormalities.

Your doctor also may recommend:

  • Imaging tests, such as ultrasound or CT scans, of your abdomen and pelvis. These tests can help determine the size, shape and structure of your ovaries.
  • Blood test, which can detect a protein (CA 125) found on the surface of ovarian cancer cells.
  • Surgery to remove a tissue sample and abdominal fluid to confirm a diagnosis of ovarian cancer. Minimally invasive or robotic surgery may be an option. If cancer is discovered, the surgeon may immediately begin surgery to remove as much of the cancer as possible.

Staging ovarian cancer

Doctors use the results of your surgery to help determine the extent — or stage — of your cancer. Your cancer's stage helps determine your prognosis and your treatment options.

Stages of ovarian cancer include:

  • Stage I. Cancer is found in one or both ovaries.
  • Stage II. Cancer has spread to other parts of the pelvis.
  • Stage III. Cancer has spread to the abdomen.
  • Stage IV. Cancer is found outside the abdomen.

Treatment

Treatment of ovarian cancer usually involves a combination of surgery and chemotherapy.

Surgery

Treatment generally involves removing both ovaries, the fallopian tubes, the uterus as well as nearby lymph nodes and a fold of fatty abdominal tissue (omentum) where ovarian cancer often spreads. Your surgeon also will remove as much cancer as possible from your abdomen.

Less extensive surgery may be possible if your ovarian cancer was diagnosed at a very early stage. For women with stage I ovarian cancer, surgery may involve removing one ovary and its fallopian tube. This procedure may preserve the ability to have children.

Chemotherapy

After surgery, you'll likely be treated with chemotherapy to kill any remaining cancer cells. Chemotherapy drugs can be injected into a vein or directly into the abdominal cavity or both.

Chemotherapy may be used as the initial treatment in some women with advanced ovarian cancer.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.

Coping and support

A diagnosis of ovarian cancer can be extremely challenging. Here are some suggestions that may make dealing with cancer easier:

  • Find someone to talk with. You may feel comfortable discussing your feelings with a friend or family member, or you might prefer meeting with a formal support group. Support groups for the families of cancer survivors also are available.
  • Let people help. Cancer treatments can be exhausting. Let people know what would be most useful for you.
  • Set reasonable goals. Having goals helps you feel in control and can give you a sense of purpose. But choose goals that you can reach.
  • Take time for yourself. Eating well, relaxing and getting enough rest can help combat the stress and fatigue of cancer.

Preparing for your appointment

Start by making an appointment with your family doctor, general practitioner or a gynecologist if you have any signs or symptoms that worry you. If your primary care doctor suspects you have ovarian cancer, you may be referred to a specialist in female reproductive cancers (gynecologic oncologist). A gynecologic oncologist is an obstetrician and gynecologist (OB-GYN) who has additional training in the diagnosis and treatment of ovarian and other gynecologic cancers.

What you can do

  • Be aware of any pre-appointment restrictions, such as not eating solid food on the day before your appointment.
  • Write down your symptoms, including any that may seem unrelated to the reason why you scheduled the appointment.
  • Write down your key medical information, including other conditions.
  • Write down key personal information, including any major changes or stressors in your life.
  • Make a list of all your medications, vitamins or supplements.
  • Ask a relative or friend to accompany you, to help you remember what the doctor says.
  • Write down questions to ask your doctor.

Questions to ask your doctor

  • What's the most likely cause of my symptoms?
  • What kinds of tests do I need?
  • What treatments are available, and what side effects can I expect?
  • What is the prognosis?
  • If I still want to have children, what options are available to me?
  • I have other health conditions. How can I best manage them together?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask other questions that occur to you.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may make time to go over points you want to spend more time on. You may be asked:

  • When did you first begin experiencing symptoms, and how severe are they?
  • Have your symptoms been continuous or occasional?
  • What, if anything, seems to improve or worsen your symptoms?
  • Do you have any relatives with ovarian or breast cancer?
  • Are there other cancers in your family history?

Ovarian cancer care at Mayo Clinic

June 12, 2014
References
  1. Chen L, et al. Overview of epithelial carcinoma of the ovary, fallopian tube, and peritoneum. http://www.uptodate.com/home. Accessed Feb. 18, 2014.
  2. Mann WJ, et al. Epithelial ovarian cancer: Initial surgical management. http://www.uptodate.com/home. Accessed Feb. 18, 2014.
  3. Lentz GM, et al. Comprehensive Gynecology. 6th ed. Philadelphia, Pa.: Mosby Elsevier; 2012. http://www.clinicalkey.com. Accessed Feb. 17, 2014.
  4. Niederhuber JE, et al., eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2014. http://www.clinicalkey.com. Accessed Feb. 17, 2014.
  5. Hoffman BL, et al. Williams Gynecology. 2nd ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://accessmedicine.com/resourceTOC.aspx?resourceID=768. Accessed Feb. 17, 2014.
  6. AskMayoExpert. What are the symptoms of ovarian cancer? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2013.
  7. Chen L, et al. Epithelial carcinoma of the ovary, fallopian tube, and peritoneum: Clinical features and diagnosis. http://www.uptodate.com/home. Accessed Feb. 18, 2014.
  8. Moynihan TJ (expert opinion). Mayo Clinic, Rochester, Minn. March 12, 2014.
  9. Gershenson DB, et al. Overview of sex cord-stromal tumors of the ovary. http://www.uptodate.com/home. Accessed Feb. 18, 2014.
  10. Chen L, et al. Epithelial carcinoma of the ovary, fallopian tube, and peritoneum: Epidemiology and risk factors. http://www.uptodate.com/home. Accessed Feb. 18, 2014.
  11. Havrilesky LJ, et al. Oral contraceptive pills as primary prevention for ovarian cancer: A systematic review and meta-analysis. Obstetrics & Gynecology. 2013;122:139.
  12. Trabert B, et al. Aspirin, nonaspirin nonsteroidal anti-inflammatory drug, and acetaminophen use and risk of invasive epithelial ovarian cancer: A pooled analysis in the ovarian cancer association. Journal of the National Cancer Institute. 2014. In press. Accessed Feb. 18, 2014.
  13. Cook AJ. Decision Support System. Mayo Clinic, Rochester, Minn. March 10, 2014.