The doctor will become very suspicious if he finds a swollen abdomen and the signs of free fluid within it (the term: ascites is used to describe the accumulation of fluid within the peritoneal cavity). He will arrange a blood test called a serumCA-125 - a test that picks up a molecule that is secreted by the tumour cells and shed into the blood and whose blood levels often mirror the tumour burden (i.e it can be used qualitatively for diagnosis and quantitatively for assessing response to therapy). The serum level is likely to be very high in ovarian cancer. Furthermore, he will arrange to sample the ascites for cytology (a sample of the ascitic fluid is very likely to contain shed cancer cells and these are separated from the fluid and examined down the microscope for diagnosis, a technique called cytology). An abdominal scan, which includes the whole pelvis, and a chest x-ray are also always performed.
