What To Do First Information for those newly diagnosed with ovarian cancer 
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If your doctor suspects ovarian cancer, he or she will first perform a pelvic exam to feel for lumps or changes in and around the ovaries. Additional diagnostic tests may be necessary if your doctor finds a pelvic mass or abdominal swelling during your examination, particularly if you have felt persistent abdominal bloating or discomfort.
Following a pelvic exam, your doctor may perform a transvaginal ultrasound by inserting a special wand (called a transducer) into the vagina. Sound waves are emitted from the device and bounce off organs within the pelvis to help identify potential tumors. This kind of ultrasound is superior to a traditional abdominal ultrasound because it enables the technician to place the transducer close to the ovaries, thus allowing a more definitive diagnosis. In addition, a computed tomography (CT) scan of the abdomen and pelvis is performed.
Blood Tests
The progress of ovarian cancer can be followed with a simple blood test that measures the level of the CA-125 protein, which is a kind of serum, or tumor marker. This protein is released by most epithelial ovarian cancer cells and also by a number of other cells, including those of many benign tissues. The CA-125 test is often used to aid diagnosis, monitor the effectiveness of treatment (particularly that of chemotherapy), and identify cancer recurrences.
Biopsy & Staging
If a pelvic exam and an ultrasound show an abnormality, your doctor may perform a biopsy by removing a sample of tissue from the ovary for microscopic examination. A pathologist will examine the sample to see if it contains precancer or cancer cells.
If the CT scan shows evidence of advanced ovarian cancer, surgery may be recommended as the next step without performing a biopsy.
Another way to diagnose ovarian cancer is through a surgical procedure known as laparotomy. A laparotomy is when an incision is made into the abdominal region, and the tumor is biopsied and staged, and any visible disease is removed.
For a more detailed description of ovarian cancer surgery, visit the treatment section.
Minimally Invasive Surgery
If the tumor appears to be confined to the ovary, another method used for biopsy and for tumor removal is a minimally invasive procedure called laparoscopy. A thin, lighted tube with a camera at its tip (called a laparoscope) is inserted through a tiny incision in the abdominal wall. Guided by the highly magnified image generated by the camera, the surgeon can take a sample of the tissue using specially designed surgical instruments. Like the open surgical procedure laparotomy, laparoscopy can be used to stage (to determine the extent of the tumor) and to remove cancerous tissue.
Imaging Tests
If initial tests indicate a diagnosis of ovarian cancer, your doctor may order additional procedures to determine if the cancer has spread, or metastasized, elsewhere in the body. He or she might recommend a cytoscopy (examination of the bladder using a lighted tube), proctoscopy (examination of the rectum), a chest x-ray, or other imaging tests -- such as ultrasound, CT, magnetic resonance imaging (MRI), or positron emission tomography (PET), if not already performed.
Two other potential diagnostic imaging tests used for ovarian cancer are barium enema and intravenous pyelogram (IVP). For the former, a silver-white metallic compound known as barium is injected into the rectum and colon through the anus. Barium helps to show the image of the lower gastrointestinal tract on an x-ray. An intravenous pyelogram (IVP) is a series of x-rays of the urinary system (kidneys, ureters, and bladder) taken after the injection of a contrasting agent, or dye, is injected into a blood vessel.
