Getting a diagnosis
If your GP thinks you have ovarian cancer
If your GP thinks you may have ovarian cancer, they might do a blood test to measure your CA125 level. This is a protein that can be raised if ovarian cancer is present. But it can also be raised because of other – less serious – conditions.
The threshold reading is 35 units of CA125 in a millilitre (one thousandth of a litre) of blood. A level of 35 or more means that ovarian cancer could be a possible diagnosis. However, having your period, ovarian cysts or fibroids are just some of the conditions that can also cause your CA125 level to rise.
If the level is raised, or you still have symptoms and the cause has not been found, your GP may ask for an ultrasound scan of your abdomen and pelvis.
This may be a transvaginal scan, when a small ultrasound probe is placed in the vagina to get a good view of the ovaries. If you are not comfortable with this, you can ask for an abdominal scan. You don’t have to give a reason.
Speak to our support line.
Do you have questions about ovarian cancer or your diagnosis?
Our support line is here:
Monday - Friday 10am-5pm.
Call 0808 008 7054 or email support@ovacome.org.uk
If the ultrasound scan shows any abnormalities that affect your ovaries and could be ovarian cancer, then your GP should refer you to a specialist gynaecological oncologist.This is a doctor who is a gynaecologist who is also trained to treat people who have, or may have, cancer.
Your first hospital appointment
Your specialist should tell you what will happen next and how a diagnosis will be made. This may mean having an MRI or CT scan. If you haven’t had a CA125 test and an ultrasound, these will be done too. See more information about tests for ovarian cancer here.
After this appointment, if it is decided that you should have surgery followed by chemotherapy you will receive a date for admission to hospital for your operation. You will usually be asked to attend a preoperative assessment a few days before surgery.
You will get an appointment to come back and discuss the test results. Your results will be reviewed by the team of clinical staff who will be overseeing your care. This is the multidisciplinary team (MDT) which will include staff from different specialisms:
- Gynaecological cancer surgeons.
- Oncologists, who can prescribe chemotherapy.
- Radiologists, who will look at your scans.
- Pathologists, who examine your biopsy samples to make sure your diagnosis is correct.
The MDT will discuss your diagnosis and recommended treatment plan with you.
Your second hospital appointment
If your tests show that you could have ovarian cancer, your MDT may advise you to have surgery. This will be to remove the cancer and confirm the diagnosis.
Your tests may have shown that your cancer is at a very early stage (stage 1a or 1b) and has not spread. This means you may need surgery only and no chemotherapy at all.
See more information about the staging and grading of ovarian cancer here: ovacome.org.uk/stages-of-ovarian-cancer-booklet
If your cancer has stayed in the pelvis and not spread further, then you may need surgery first with chemotherapy afterwards.
If your scans have shown that the cancer has spread outside the pelvis, then your MDT may recommend that you have chemotherapy before your operation. This can shrink the tumour and make it easier to remove. After your operation you will have more chemotherapy.
This way of having chemotherapy, then surgery followed by more chemotherapy is called interval surgery.
Your specialist will tell you about the risks and benefits of the treatments they recommend. This should include information about possible side effects. You should be given time to think about your choices and what is best for you. You should be told where you can find services to support you.
Having surgery
If you are having surgery only, or surgery followed by chemotherapy, you will be given a date for your admission to hospital for your operation. You will usually be asked to come to a pre-surgery assessment to check your health. This will be a few days before your surgery.
Having chemotherapy before surgery
You can read more about chemotherapy here.
Having chemotherapy after surgery
If you had chemotherapy before your operation, you will need a further three cycles afterwards. You can start these once you are fit enough after surgery.
If you had your surgery first, to be followed by chemotherapy, you are likely to be offered a cycle (dose) of chemotherapy every three weeks for six cycles, which lasts for a total of 18 weeks.
If any of the cancer remains after surgery, your doctor may suggest using bevacizumab (Avastin).This is a targeted treatment that can reduce the tumour’s blood supply. This can delay a recurrence of the cancer.
You may be offered other drugs that are maintenance therapies. These can prevent or delay the cancer coming back. They include PARP inhibitors such as olaparib, niraparib, and rucaparib. They act on the cancer’s DNA to stop it repairing itself.
You can see more information about targeted therapies here.
At the end of your treatment
At the end of your chemotherapy or maintenance therapy, you may have a scan and then a programme of regular follow-up appointments.
These may be face to face or using the telephone or online. You will be asked about your health and then have a blood test. If you develop further symptoms, you may have a scan.
Some people find follow-up appointments make them anxious. It can be hard to adjust when you have longer between appointments, so you are monitored less often. You may feel uncertain about your health and have a lot of questions.
You can still speak to your clinical nurse specialist (CNS) or call the Ovacome free support line on 0800 008 7054.
Here are some questions you may want to ask:
- How will I be followed up and for how long?
- What further investigations may be done?
- Who can I contact between appointments?
- How long will I take to recover?
- Can I use HRT (Hormone Replacement Therapy)?
- What local support is available for me?
Did you find this page helpful?
We welcome your feedback. If you have any comments or suggestions, please email r.grigg@ovacome.org.uk or call 0207 299 6653.
Get support
Ovacome is the UK 's national ovarian cancer support charity. We've been providing emotional support and personalised, expert information since 1996. Contact our support line by phone, email or text if you have questions about a diagnosis, or if you just want to talk things through.
We support anyone affected by ovarian cancer, including family members, carers, those with an inherited risk, and health professionals working in the field.
Ovacome has 50 information booklets on a variety of topics about ovarian cancer.
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