What Diagnostic Tests are used to Identify Ovarian Cancer?

Generally, if you have experienced one or more of the symptoms associated with ovarian cancer on a fairly regular basis, you will see your doctor, who will perform an exam and probably order tests as well. The physical exam will include a pelvic exam, during which the physician will attempt to determine whether either of your ovaries are enlarged, or whether there is fluid in your abdomen.

 

If there is reason to believe you might have ovarian cancer, based on your self-reporting of your symptoms and your physical exam, your doctor may order more tests, and will probably refer you to a gynecologic oncologist. This is a doctor or surgeon who specializes in treating women who have ovarian cancer. Your gynecologic oncologist will ensure you receive the very best treatment if it is determined you have ovarian cancer. Your gynecologic oncologist may order one or more of the following tests:

  • Imaging tests, such as MRI scans, an ultrasound, and a CT scan, can help determine whether there is a pelvic mass. These studies cannot, however, make a determination as to whether the mass is cancerous or benign, but they can help your doctor see if the ovarian cancer has spread. 

  1. Ultrasonography uses sound waves to create an image on a video screen. A small probe is placed on the surface of your abdomen or inside your vagina. Sound waves are released from this probe which create echoes as they enter the ovaries. The same probe detects the echoes which bounce back, and those echoes are translated into a picture. An ultrasound is often the first test used to determine whether ovarian cancer is present.
  2. A CT scan produces a detailed cross-sectional x-ray image of your body, however rather than taking one picture like a typical x-ray, the CT scanner takes numerous pictures as it rotates around you, combining these pictures into an image of a “slice” of your body. CT scans may now show smaller tumors well, but they can often tell if a tumor is growing into nearby organs. You may need to drink 1-2 pints of a liquid prior to your CT scan, or could have contrast dye injected via an IV line. A CT-guided needle biopsy may be ordered when metastasis is suspected.
  3. MRI scans use very strong magnets and radio waves rather than x-rays. The radio wave energy is absorbed, then released, where it forms a pattern according to the type of tissue and the disease. A computer then translates the pattern into a detailed image of the body. MRI scans are not used as often as ultrasounds and CT scans to determine whether ovarian cancer is present. Since you must remain in an MRI tube for about thirty minutes, those who are claustrophobic may have difficulty.

  • A chest x-ray may be done if the doctor suspects the ovarian cancer has metastasized (spread) to the lungs.
  • A PET scan can be useful in spotting small collections of cancer cells, as radioactive glucose “looks” for the cancer. Since cancers use glucose at a higher rate than normal tissues, the radioactivity will concentrate on the cancerous cells. In some cases, a PET scan, when combined with a CT scan can be very useful in finding ovarian cancer, however the test is expensive, and not always covered by insurance when it is used to look for ovarian cancer.
  • A thin, lighted tube, inserted through a small incision in the lower abdomen, allows doctors to look at the ovaries and other pelvic organs and tissues in the area, then sends those images to a video monitor.  Laparoscopy can help doctors confirm how far the tumor has spread, and can also allow them to perform a biopsy.

The only way to know for sure if a mass or growth is cancerous is to take a sample of the area, and examine it under a microscope. This is known as biopsy. For ovarian cancer, the biopsy is most often done by removing the entire tumor.  In patients who have fluid buildup in the abdomen, samples of that fluid can be used to diagnose ovarian cancer as well.

 

Finally, your doctor will order blood count tests to determine whether you have enough red and white blood cells and platelets, as well as to determine your kidney and liver function. Some germ cell cancers may cause elevated levels of HCG, AFP or LDH, while some ovarian stromal tumors can result in inhibin, estrogen and testosterone levels to go up.

 

Is there any Test or Imaging Study to Help Identify Talcum Powder Ovarian Cancer? Should I be concerned if I used baby powder with talc for feminine hygiene?

Many women across the United States have been hearing about a potential link between baby powder with talc and ovarian cancer. Since an estimated 40 percent or more American women use baby powder with talc for feminine hygiene, there may be reason for some concern. As far back as the 1970’s, talc fibers were found embedded in the ovary tissues removed from women with ovarian cancer. Since that time, numerous studies have been done regarding the issue, with a determination by many of the studies that women who use baby powder with talc or Shower to Shower for feminine hygiene could have as much as a 30-40 percent higher risk of developing talcum powder ovarian cancer.

 

The theory on talcum powder ovarian cancer is that when talcum powder is used in the genital region, the talc fibers could migrate up through the vagina, the uterus and the fallopian tubes, into the ovaries. Once the talc fibers burrow into the ovarian tissues, they cause inflammation—a well-known factor in the development of many types of cancers. As many as 1,200 talcum powder ovarian cancer lawsuits have been filed against Johnson & Johnson for failure to warn women about the potential risks associated with talcum powder, and the first three talcum powder lawsuits resulted in verdicts in favor of the plaintiffs, two of which were awarded $72 million and $55 million respectively. These talcum powder ovarian cancer lawsuits have left many women with questions regarding ovarian cancer in general as well as ovarian cancer and talcum powder.

 

The identification and diagnosis of a talcum powder related ovarian cancer is unfortunately inexact. From a qualitative standpoint, scientific studies have demonstrated a link between the use of talcum powder for feminine hygiene and an increased risk for ovarian cancer. Quantitatively, while there is no way to verify the presence of talc fibers in the ovaries by way of a blood test or by conventional imaging, there has been success in identifying talc fibers by having a well-qualified oncologic pathologist view tissue samples under a scanning electron microscope. Imaging Studies performed under Scanning Electron Microscopes can not only show visibly identifiable talc fibers, but can also demonstrate the presence of talc fibers by recognizing Magnesium Silicate in the tissue sample. The unfortunate drawback to this technique however is that these studies are expensive, require a high level oncologic pathologist, and often times require an entire excised ovary for a viable sample.

 

Is it Possible that Your Ovarian Cancer Could be related to the Use of Talcum Powder, Baby Powder w talc, or Shower to Shower?

If you are a victim of ovarian cancer and you used talcum powder (contained in baby powder with talc and/or “Shower to Shower”) for feminine hygiene, it could be beneficial to speak to a knowledgeable talcum powder ovarian cancer attorney who can help to ensure your rights are protected and your questions answered. You may be entitled to compensation for your injuries, including medical expenses and lost wages. In certain circumstances, a talcum powder ovarian cancer lawsuit may also warrant pursing damages for pain and suffering and potentially even punitive damages.


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