Diagnostics

Confirmation of the diagnosis and precise determination of the stage of ovarian cancer occurs most often only through surgery. If ovarian cancer is suspected, some examinations are still carried out beforehand. With their help, the doctor can find out how likely it is to assume ovarian cancer, how common the process is, and whether other organs are affected.

When ovarian cancer is suspected, important steps are:

Clinical gynecological examination (palpation)

First, the doctor clarifies in detail the patient's complaints and possible risk factors and conducts a clinical examination. At the same time, through the abdominal wall, he palpates the body of the uterus, ovaries, and through the vagina and through the rectum, the cervix for possible changes (bimanual palpation). Thus, the doctor can already obtain important information about the size of the ovaries, and with recto-vaginal palpation, he can also evaluate the pelvic peritoneum. auch das Bauchfell des Beckens beurteilen. Similarly, the clinical examination includes palpation of the lymph nodes, including the lymph nodes of the neck (supraclavicular lymph nodes).

Ultrasound examination (sonography)

Ultrasound examination of the abdominal cavity (abdominal sonography) allows you to see the condition of such internal organs as the liver, kidneys, spleen, intestines. In this case, ascites (accumulation of fluid in the abdominal cavity) or pleural effusion (accumulation of fluid between the layers of the pulmonary pleura) can be diagnosed. It will be investigated whether the tumor has already spread to these organs or to lymph nodes in the surrounding areas (metastasis formation). An ultrasound examination of the internal genital organs is performed using a special ultrasound probe that is inserted into the vagina (transvaginal sonography). With this method, the doctor can determine if the ovaries are enlarged and if there is ascites. Ultrasound examination is painless.

Abdominal puncture for ascites

In exceptional cases, a puncture of the abdominal cavity is also required. At the same time, under ultrasound control, a fluid is taken from the abdominal cavity using a needle puncture, which is then examined under a microscope for the presence of malignant cells. With a very large amount of fluid in the abdominal cavity, you can also leave a drain, which will bring excess fluid out and thereby reduce intra-abdominal pressure.

Pleural puncture

With the accumulation of fluid in the chest cavity, the doctor can, as with a puncture of the abdominal cavity, puncture the chest under ultrasound control and, with a very large amount of fluid, also impose a drain that will remove the fluid.

X-rays

A chest x-ray is used to assess the condition of the heart and lungs, taking into account the upcoming operation. X-ray examination of the kidneys and urinary tract using a contrast agent is indicated only when there is a suspicion that the tumor is pressing on these organs or germinating them. Also, taking into account the upcoming operation, a contrast study of the ureters or their splinting may be required, especially if several operations on the abdominal organs have already been performed.

Cystoscopy and rectoscopy

These studies are necessary when there is a suspicion that the tumor has already sprouted into the bladder or rectum. During these examinations, the probe is inserted through the urethra into the bladder, respectively, through the anus into the rectum. At the same time, the doctor can examine the inner wall of the bladder and intestines and, if necessary, take a tissue sample from suspicious places, which will then be histologically examined under a microscope.

Laboratory research

The blood test provides information about the general condition of the patient, as well as the function of individual organs, such as the kidneys and liver. The results of the research are important for assessing the situation, taking into account the upcoming operation. In addition, the so-called tumor markers are determined. In this case, we are talking about substances that are produced by tumor cells and can be found in the blood. However, tumor markers are not found in all patients with ovarian cancer and may appear in healthy people or other diseases. Therefore, for diagnosis, they are only relevant for certain (rare) forms. First of all, they serve as a control over the course of subsequent chemotherapy.

Computed tomography (CT) and magnetic resonance imaging (MRI)

Both of these methods are used only in exceptional cases in order to determine the extent of the tumor in the abdominal cavity. In this case, metastases or enlarged lymph nodes can be determined. Nevertheless, the exact scale of the prevalence of the tumor process can only be determined within the framework of the operation. Magnetic resonance imaging (MRI) also allows you to present the body in the form of sections. The examination is carried out in a magnetic field; thus avoiding x-ray radiation.