Diagnosis
How is PPC diagnosed?
Pelvic Exam
A pelvic exam is performed by a gynecologist during a yearly physical for most women or when experiencing pelvic pain. Your doctor will do an external and internal exam along with a Pap smear to look for abnormalities. A pelvic exam alone cannot diagnose PPC or ovarian cancer. The results may lead to blood tests, a transvaginal ultrasound or laparoscopy.
Blood Tests
You may be tested for CA (cancer antigen)-125, a tumor marker found in blood. CA-125 is elevated in some people with PPC or ovarian cancer. Normal levels of CA-125 are below 35. In people being treated for PPC or ovarian cancer, the CA-125 test can be useful to see if the treatment is working. It cannot be used as a cancer screening test because there are many "false positives" associated with CA-125. Your CA-125 may be elevated for a variety of other reasons, including: pregnancy, endometriosis, pancreatitis, benign tumors or ovarian cysts.
You may also be given the OVA1 test. This will assess the likelihood of ovarian or peritoneal cancer before surgery. It takes into account 5 biomarkers (Transthyretin, Apolipoprotein A-1, Beta2-Microglobulin, Transferrin and CA-125) and assigns a qualitative score to determine the probability of malignancy in patients who have an ovarian mass.
Transvaginal Ultrasound
This imaging technique may be used in women with an abnormal pelvic exam or pap smear. A small instrument is placed into the vagina and sound waves bounce off the uterus and ovaries, creating a picture that your doctor will see on a TV screen. This test can usually detect the difference between benign and cancerous lesions.
Laparoscopy
This surgical procedure uses a thin lighted tube placed into an incision in the belly to look at the abdominal and/or reproductive organs. Tissue samples can be taken for biopsy. A pathologist will look at the tissue sample under a microscope and diagnose PPC or ovarian cancer along with the Staging.
Your doctor may also recommend fluid aspiration if you have abdominal bloating (ascites) or recommend a CT scan to further examine the abdomen.