How do doctors diagnose ovarian cysts and tumors?
The obstetrician/gynecologist or your regular doctor may feel a lump while doing a routine pelvic exam. Most ovarian growths are benign. But a small number can be cancerous. That’s why it’s important to have any growths checked. Postmenopausal women in particular should get examined. That’s because they face a higher risk of ovarian cancer.
Tests that look for ovarian cysts or tumors include:
- Ultrasound. This test uses sound waves to create an image of the ovaries. The image helps the doctor determine the size and location of the cyst or tumor.
- Other imaging tests. Computed tomography (CT), magnetic resonance imaging(MRI), and positron emission tomography (PET) are highly detailed imaging scans. The doctor can use them to find ovarian tumors and see whether and how far they have spread.
- Hormone levels. The doctor may take a blood test to check levels of several hormones. These include luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol, and testosterone.
- Laparoscopy. This is a surgical procedure used to treat ovarian cysts. It uses a thin, light-tipped device inserted into your abdomen. During this surgery, the surgeon can find cysts or tumors and may remove a small piece of tissue (biopsy) to test for cancer.
- CA-125. If the doctor thinks the growth may be cancerous, he might take a blood test to look for a protein called CA-125. Levels of this protein tend to be higher in some — but not all — women with ovarian cancer. This test is mainly used in women over age 35, who are at slightly higher risk for ovarian cancer.
If the diagnosis is ovarian cancer, the doctor will use the diagnostic test results to determine whether the cancer has spread outside of the ovaries. If it has, the doctor will also use the results to determine how far it has spread. This diagnostic procedure is called staging. This helps the doctor plan your treatment.
How are ovarian cysts and tumors treated?
Most ovarian cysts will go away on their own. If you don’t have any bothersome symptoms, especially if you haven’t yet gone through menopause, your doctor may advocate ”watchful waiting.” The doctor won’t treat you. But the doctor will check you every one to three months to see if there has been any change in the cyst.
Birth control pills may relieve the pain from ovarian cysts. They prevent ovulation, which reduces the odds that new cysts will form.
Surgery is an option if the cyst doesn’t go away, grows, or causes you pain. There are two types of surgery:
- Laparoscopy uses a very small incision and a tiny, lighted telescope-like instrument. The instrument is inserted into the abdomen to remove the cyst. This technique works for smaller cysts.
- Laparotomy involves a bigger incision in the stomach. Doctors prefer this technique for larger cysts and ovarian tumors. If the growth is cancerous, the surgeon will remove as much of the tumor as possible. This is called debulking. Depending on how far the cancer has spread, the surgeon may also remove the ovaries, uterus, fallopian tubes, omentum — fatty tissue covering the intestines — and nearby lymph nodes.
Other treatments for cancerous ovarian tumors include:
- Chemotherapy — drugs given through a vein (IV), by mouth, or directly into the abdomen to kill cancer cells. Because they kill normal cells as well as cancerous ones, chemotherapy medications can have side effects, includingnausea and vomiting, hair loss, kidney damage, and increased risk of infection. These side effects should go away after the treatment is done.
- Radiation — high-energy X-rays that kill or shrink cancer cells. Radiation is either delivered from outside the body, or placed inside the body near the site of the tumor. This treatment also can cause side effects, including red skin, nausea,diarrhea, and fatigue. Radiation is not often used for ovarian cancer.
Surgery, chemotherapy, and radiation may be given individually or together. It is possible for cancerous ovarian tumors to return. If that happens, you will need to have more surgery, sometimes combined with chemotherapy or radiation.
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