Virginia Commonwealth University

VCU Massey Cancer Center

Diagnosis and staging

How is ovarian cancer diagnosed?

Diagnosis includes a medical history and physical examination, including a pelvic examination to feel for masses or growths. A Pap test may be requested as part of the pelvic examination. The physician also may order other tests, including:

  • Ultrasound – an imaging technique that uses sound waves to visualize the ovaries and uterus.
  • Computed tomography (CT or CAT scan) – a noninvasive X-ray that takes pictures of the internal organs. This can visualize abnormalities that may not show up on an ordinary X-ray, such as fluid in the abdomen, enlarged lymph nodes or masses. 
  • Barium enema – X-rays of the colon and rectum using a contrast dye called barium. 
  • Intravenous pyelogram (IVP) – X-ray of the kidneys and ureters, taken after the injection of a dye. 
  • Blood test – to measure a substance in the blood called CA-125 (a tumor marker that is found to be elevated in the blood of women with ovarian cancer).

Staging

The stage of ovarian cancer is determined by the findings at surgery. Information from a chest X-ray and CAT scans also may help to determine the stage.

Stage I 

The cancer is confined to the ovaries. 

Stage II 

The cancer is confined to the pelvic organs and involves the fallopian tubes, uterus or lower colon. 

Stage III 

The cancer has spread to the upper abdomen or lymph nodes. 

Stage IV 

The cancer has spread to the tissues (not surface) of the liver or spleen, or has spread to the chest cavity.