Further tests for ovarian cancer

After a first diagnosis of cancer, it is usual to have more tests. These are to see how far the cancer has grown, and whether it has spread. This is called staging. There is more information about the stages of ovarian cancer in the section on treating cancer of the ovary.

With ovarian cancer, it is not always possible to diagnose the exact type until after you have had surgery. The surgeon will get tissue samples during the operation. These will be closely examined in the lab.

As well as giving more information about how far the cancer has grown, the test results will help your specialist to decide on the best treatment for you.  You will not have all the tests mentioned here. Which ones you have will depend on your symptoms, and on the tests you have had so far.

You may have a chest X-ray to check for any sign of cancer spread to your lungs or fluid build up around the lung (a pleural effusion). You may also have a CT scan or ultrasound scan to check for any signs of cancer elsewhere in your tummy (abdomen). Your specialist may suggest an MRI scan, but this is not always necessary.

Your doctor may suggest that you have tissue samples (biopsies) taken from your ovaries or from a sheet of fatty tissue inside the abdomen. This sheet is called the omentum. Ovarian cancer can sometimes spread there.

Image guided biopsy means the doctor uses a scan to guide where to put the needle. This test may be guided by CT or by ultrasound scan. You have the test done in the scanning room. You will have a local anaesthetic. The procedure takes about 10 to 20 minutes. While watching on the CT or ultrasound scan, the doctor will put a needle in, aiming for the part of the ovary or omentum where they want to take the tissue samples. You may have samples taken from different places, so you may have several needle puncture sites. The doctor will send the tissue samples off to the lab to be examined for cancer cells.

After the test, you will rest in bed for a while and your nurse will check your pulse and blood pressure regularly.  If all seems well, you will be able to get up and eat and drink normally within a few hours. You can have this done as an out patient or you may stay overnight in hospital. It will depend on how well you are and on the time of day you have the test done.

An image guided biopsy is not suitable for all women, for example if your tumour is in an area that is difficult to get to. In this situation you may have a laparoscopy instead.

This is a test using a small camera to see inside the body. You have a laparoscopy in hospital under a short general anaesthetic. Your doctor can examine your ovaries and the surrounding area without you having to have a big operation. The laparoscopy camera and a light are contained inside a thin, flexible tube.

The doctor makes a small cut, about half an inch long, in your abdomen. They put the tube through the cut and into the abdominal cavity. First, the doctor will pump a small amount of carbon dioxide gas inside. This makes it easier to see and examine you thoroughly.

Usually, the doctor will take biopsies and send them to the laboratory to be examined for cancer cells. It is also possible to remove the ovaries with keyhole surgery, rather than having an operation with a large cut in your tummy. If you have your ovaries removed, they will be sent to the laboratory to be examined for signs of cancer.

When the examination is finished, the doctor takes out the tube and puts in a couple of stitches to close the cut. The stitches stay in for about a week. You will be able to get up as soon as your anaesthetic has worn off. The carbon dioxide gas may make you feel bloated and uncomfortable at first, but it will gradually disappear over a couple of days.

If you have a swollen tummy (abdomen), this may be due to fluid build up. Fluid build up in the abdomen is called ascites. It can be a sign of ovarian cancer that has spread. It can also be caused by other conditions that are not cancer. Your specialist will want to take a sample of fluid to check for cancer cells.

You may have this test in the out patients department. First, you have a local anaesthetic injection into the skin of your abdomen. Once the skin is numb, your doctor puts in a needle to draw out some of the fluid. The fluid then goes to the laboratory to be examined for cancer cells.

If you have a lot of fluid, your doctor may want to drain it to relieve pressure in your abdomen and make you more comfortable. This is called an abdominal tap or abdominal paracentesis (para-sent-ee-sis).

When your test results have come through, your doctor will probably want you to come back to the hospital to discuss them. Getting results is bound to take a little time. You may feel very anxious while you are waiting.  It may help to talk to a close friend or relative about how you are feeling. 

You could also contact a cancer support group, to talk to someone who has been through a similar experience.  Look at our list of ovarian cancer organisations - some of them can help put you in touch with a support group.  There is also a list of counselling organisations.  They can help you to find emotional support and counselling in your area.