Contents
What is ovarian cancer
Ovarian cancer is a malignant tumor that develops from the tissue of the ovaries. Unfortunately, 5% of cancer deaths are due to ovarian cancer, that is, the mortality from this disease exceeds the mortality from uterine cancer and cervical cancer combined.
The disease is most common in older women over 70 years of age. The innovation is growing very fast. Metastases can occur in the thyroid gland, gastrointestinal tract, uterus, mammary gland. Among women who have impaired ovarian function (use of ovulation inducers, frequent abortions, infertility), the prevalence of the disease is higher.
Causes of ovarian cancer
The exact cause of ovarian cancer has not yet been found. Cancer develops when normal cells, under the influence of various mutations, acquire the ability for uncontrolled aggressive growth and resistance to apoptosis (cell death).
Risk factors that increase the chance of ovarian cancer:
- elderly age;
- hereditary gene mutations (BRCA1/BRCA2 and others, such as MLH1/MSH2 associated with Lynch syndrome);
- heredity, if there was / is cancer in the mother, grandmother, sister;
- the use of estrogen replacement therapy (postmenopausal, long-term, high doses);
- early onset of the menstrual cycle and late onset of menopause;
- no pregnancy, infertility;
- obesity;
- endometriosis.
Symptoms of ovarian cancer
There are several symptoms that may indicate the disease:
- decreased libido;
- weakness, apathy, malaise;
- discomfort in the pelvic area;
- fatigue;
- pulling pains near the navel and inguinal zone;
- change in the menstrual cycle and its duration;
- lack of pregnancy in a young girl;
- uterine bleeding;
- frequent urination;
- pulling dull pain in the lower abdomen;
- lack of appetite;
- feeling inside a foreign body;
- bloating;
- bloody issues
Stages of ovarian cancer
Like other types of cancer, ovarian cancer has four stages:
- first stage – in this case, only the ovaries are affected;
- second stage – the tumor spreads through the pelvis;
- third stage – the disease spreads to the peritoneum, metastases appear in the liver and other organs within the abdominal cavity, damage to the inguinal lymph nodes;
- fourth stage – Distant metastases.
Treatment of ovarian cancer
Treatment for ovarian cancer depends on the stage of the disease. Most often, surgery and chemotherapy are required (in accordance with the data obtained after the operation on the stage and morphology of the tumor).
Surgery includes removal of the uterus with appendages (bilateral salpingo-oophorectomy), removal of the greater omentum, pelvic and para-aortic lymph node dissection. The uterus and one ovary are mostly preserved only for young patients who plan to become pregnant in the future.
If a cytoreductive operation is not possible, a chemotherapy with subsequent operation. “Chemistry” is used in almost all cases of ovarian cancer and combined with targeted therapy.
Also used hormone therapy in the case when there is a recurrence of stromal tumors (low-grade malignancy).
Radiation therapy the first line is practically not used, since there is insufficient evidence for its effectiveness.
Diagnostics
To detect ovarian cancer as early as possible, preventive examinations by a gynecologist should not be missed.
Diagnosis of ovarian cancer is based on the patient’s complaints:
- gynecological examination (palpation of the pelvic organs);
- transvaginal ultrasound (pelvic ultrasound);
- CT scan of the abdomen and/or small pelvis or MRI of the abdomen and/or small pelvis (with contrast);
- general urinalysis, clinical and biochemical blood tests, blood tests for tumor marker CA-125, blood tests for AFP and beta-chorionic gonadotropin, blood tests for inhibin, determination of tumor marker HE4 in blood serum.
If a woman has “family cancer”, that is, there are cases in the family, then genetic counseling and a genetic test to detect mutations in the BRCA, MLH1 / MSH2 genes will be required.
After the oncologist receives all the diagnostic data, he will determine the stage of the disease.
Forecasts depend on many factors – when exactly the diagnosis was made, how the woman feels, whether she has concomitant diseases.
Prevention of ovarian cancer at home
- A woman should monitor her health, visit a gynecologist, do an ultrasound.
- Eat healthy foods: fruits, vegetables, proteins, fats.
- Watch your weight.
- To live an active lifestyle. 30 minutes of exercise 3-4 times a week will reduce the risk of cancer.
- Do not abuse alcohol, it can lead to irreversible destructive processes.
- Refuse to smoke.
Popular questions and answers
Answers Dina Sakaeva, Deputy Head Physician for Oncology, Professor of the Department of Pharmacology with a Course in Clinical Pharmacology, Member of the Board of RUSSCO, Doctor of Medical Sciences:
Factors that increase the risk of developing ovaries?
● hormonal;
● genetic;
● alimentary (ecology, nutrition, social factors).
Epidemiological studies have shown that patients with hormonal risk factors are those who have very early menstruation or late menopause. An increased amount of estrogen is involved in the development of ovarian cancer and breast cancer.
Pregnancy and breastfeeding reduce the number of ovulations in a patient’s life, and related to this is the suggestion that motherhood reduces the risk of developing ovarian cancer.
An important factor in the development of ovarian cancer in recent years is considered genetic. BRCA1 and BRCA2 are genes that are involved in DNA repair and inhibit the development of the tumor process. If there are mutations in the genes, then the mechanism that repairs the damaged DNA does not work, the number of mutations in the DNA accumulates, and malignant tumors appear.
According to statistics, the frequency of mutations in the BRCA gene among patients with ovarian cancer exceeds 15%. These mutations are heritable, often found in families where someone was ill or is ill with oncology, not necessarily ovarian cancer, it can be breast cancer, and prostate cancer, and even stomach cancer.