Contents
Ovarian cancer is not more dangerous than other cancers, but it is difficult to detect at an early stage. Despite the progress of medicine, effective methods of early diagnosis of this disease have not been found.
If oncologists could change anything on the list of symptoms of ovarian cancer, they would certainly wish it would hurt. Most often, it is pain that is the symptom that prompts patients to visit the clinic and undergo diagnostic tests. If ovarian cancer was already troubling in the first stages of its development, many more patients could be saved. Much to the worry of oncologists, 75% of cases of this type of cancer are not diagnosed until the cancer has entered stage III or IV. Polish women who suffer from it are the most terrified of statistics. Only one in five survives – repeat the patients. This common opinion is incorrect – now the disease can be controlled in the long term in about 30% of women diagnosed with ovarian cancer. And there could be even more.
Oncological vigilance
Scientists do not yet know the precise, specific cause of this cancer. Instead, they can identify a risk group and advise gynecologists to exercise what they call “oncological vigilance”. Patients belonging to the group at increased risk should be well informed and, together with the gynecologist, monitor for the appearance of disturbing symptoms. More frequent tests aimed at detecting this type of cancer should be carried out by women over 40 years of age. In Poland, ovarian cancer most often affects 45-year-old women, and it is generally said that women in the perimenopausal and menopausal age are at the highest risk. Women at genetic risk should also see a gynecologist more often. If there has been a family history of ovarian cancer, hereditary breast cancer, or hereditary nonpolyposis colorectal cancer, cancer of the endometrium or upper gastrointestinal tract, you will need to tell your doctor so that he can suggest appropriate tests. The risk of developing the disease is reduced by factors that contributed to the reduction of the number of ovulations. Each past delivery reduces the risk of developing the disease by 10%. Women who breastfed and those who used hormonal contraceptive pills also suffer less frequently. By carefully studying the data from the Oncology Center in Warsaw, it can be seen that city dwellers suffer slightly more often than women living in rural areas, and the greatest number of patients with ovarian cancer is recorded in Wielkopolska and Podlasie. It seems that the type and malignancy of an ovarian tumor are correlated with the age of patients. Young women who develop ovarian cancer most often suffer from a less malignant type of tumor.
A deceptively painless problem
It is estimated that currently in Poland, ovarian cancer is in the fifth place among cancers that cause deaths in women. It is not a very common problem, but about 3 people suffer from this type of cancer annually in the country. women (in the United States there are 21 new cases annually), which is less than, for example, from breast cancer. However, a full recovery in ovarian cancer patients is much less likely than in women with breast cancer. For a long time it was believed that ovarian cancer in the first stages of development did not produce any symptoms. Doctors who have been dealing with patients with this disease for years, however, say that this is not entirely true. The developing neoplasm causes symptoms so non-specific that the patients do not associate them with a serious gynecological problem. The first symptoms may be: flatulence, abdominal discomfort, diarrhea and constipation, loss of appetite, pressure on the bladder and frequent urination, low back pain.
It happens that women first go to a urologist or gastrologist, without associating these signals with the possibility of cancer development. According to oncologists, if such symptoms occur with a high frequency and do not disappear after symptomatic treatment, you should definitely go to the gynecologist. An ovarian tumor can be detected by testing when it is at least a centimeter in diameter and weighs at least a gram. Such a tumor, however, is already a bomb full of cancer cells that have the potential to metastasize to the organs of the abdominal cavity, lungs or even the brain.
Remove the tumor
The main treatment for this type of cancer is surgery. The surgeon assesses the severity of the tumor and checks if it has spread throughout the abdomen. It removes the tumor, and microscopic examination allows you to answer the question about the stage and the exact type of tumor. In more advanced stages and when the entire tumor has not been removed, chemotherapy is also used. The prognosis largely depends on the stage of the cancer. The diagnosis is not a sentence. If the cancer is detected in its non-advanced stage, the chances of survival are about 90%. In advanced cases, the statistics are not that successful – about 2 in 10 patients still live many years after the diagnosis.
It will not pass by itself
Ovarian cancer is the type of disease in which the prognosis may depend largely on the patient’s behavior while the tumor is still developing. The aforementioned symptoms cannot be underestimated and wait for them to “pass by themselves”. If, for example, we belong to the risk group and suddenly, instead of urinating 5 times a day, we have to run to the toilet 10 times a day, and the urine test shows no infection, it is time to go to the gynecologist immediately and share your observations with him. Despite the development of diagnostic methods, the interview collected from the patient, followed by gynecological examination and ultrasound (in this order) remain the methods giving the best chance of detecting this type of cancer in the early stages.
Knowing that we are at risk of ovarian cancer, we cannot rely solely on the doctor’s intuition. Ovarian cancer develops quickly, even the recommended gynecological examination once a year does not guarantee that it will be detected at an early stage. Within a year, the tumor may develop so far that it will be too late for effective treatment. Initially, therefore, the most important element needed to make a diagnosis is us and our “oncological vigilance”. Quite high hopes for improving the detection statistics of this type of cancer in the early stages were associated with the discovery of the importance of the Ca-125 protein. Its elevated blood levels may indicate the development of the disease, but it may also be a sign of the development of other diseases. Sometimes this protein is found in quite high concentrations in women who do not suffer from ovarian cancer, so it is now considered that testing its level is the most effective indicator in women who are already in the advanced stage of the disease. Currently, experts recognize that the use of screening tests for the presence of the Ca-125 marker will not bring a revolution in diagnostics. At the American Society of Clinical Oncology (ASCO) conference, it was also announced that the Ca-125 test does not give satisfactory results in women who check for recurrence of the disease after ovarian cancer treatment.
Hope in diagnostics
Independent groups of scientists are investigating the discovery of an effective way to detect ovarian cancer at an early stage in many laboratories around the world. In February 2008, the journal Clinical Cancer Research published the results of a study by scientists at Yale University who developed a test called “OvaSure”, which they believe can identify early-stage ovarian cancer with 95% success rate. The market price of the test, which measures the level of several specific proteins in a blood sample, was wanted to be close to $ 200. The US Food and Drug Administration (FDA), however, is skeptical of “OvaSure” and has so far prevented it from being marketed.
Text: Sylwia Skorstad