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What is ovarian cancer?
Ovarian cancer – this is not one, but a whole group of diseases that differ in their origin, clinical manifestations and biological properties. This type of cancer affects precisely these paired organs, which are responsible for the production of estrogen and progesterone. This is a fairly common pathology, which is most often detected among women of retirement age (from 50 to 70 years).
Also under the definition of ovarian cancer is such a description as: a malignant neoplasm affecting the female genital area, which is formed from the epithelial cells of the ovaries. Quite often, the pathology manifests itself as a cyst, which slowly grows and after a rather long time transforms into a tumor with the appearance of metastases. Particular attention to such a neoplasm should be paid to women who have entered menopause and those girls who have not yet had menstruation. Most often, these are malignant tumors, and they account for up to 80%.
If we turn to the classification of this pathology, then there are such types as: mucinous, serous, clear cell, endometrioid, squamous and transitional cell cancer. In the future, oncologists divide these histological types into malignant, benign and intermediate, that is, those whose risk of developing into malignant is minimal, but still exists.
Survival in ovarian cancer
If we talk about survival in cancer that affects the ovaries, then we should refer to such a concept as the survival rate, that is, to the indicator that doctors take as a certain standard. Most often, statistics are used to determine this value, which shows how many patients are still alive, five years after the discovery of the problem. Naturally, one should not blindly rely on these numbers, since many die for other reasons. But nevertheless, the statistics is inexorable and directly depends on the stage at which the tumor was detected and adequate treatment was started.
Naturally, mortality depends on a number of reasons, and not only on the stage of progression of the disease, but the earlier the pathology was diagnosed, the more favorable the prognosis will be. In this case, factors such as the age of the patient, the presence of concomitant diseases, the state of immunity, the response of the tumor to treatment, and other indicators should be taken into account.
If we turn to general statistics, then this pathology ranks ninth in the world among oncological diseases of the weaker sex, and is in fifth place in terms of the number leading to the death of women. At the same time, one in 71 women will fall ill with cancer, and one out of 95 will die from it. These are the harsh statistics given by WHO.
Symptoms of ovarian cancer
This disease is complicated for diagnosis by the fact that its symptoms at the initial stages are practically absent. This can continue until the tumor reaches a very large size and begins to “press” on the organs, causing discomfort, or until the first metastases appear.
As accompanying this stage of the development of the disease, the following symptoms can be distinguished:
Pain in the lower abdomen or in the lumbar region, especially aggravated after even minor physical exertion. Their character is pulling, acute painful sensations are not typical for this type of disease.
Quite often, women are concerned about dyspareunia – these are the so-called painful sensations after intercourse.
Sometimes there are irregularities in the menstrual cycle, there are discharge between periods.
Ascites is the accumulation of fluid inside the abdominal cavity.
An increase in the volume of the abdomen, as a result of the growth of a tumor on the ovaries or as a result of the formation of fluid.
As a result of the progression of the disease, increased pain appears, with parallel weight loss.
Anemia is a constant companion of ovarian cancer.
Rarely, but still there is an increase in the uterine mucosa, growth of the mammary gland and hair. This is due to the fact that the tumor itself produces hormones.
Uterine bleeding that is not associated with menstruation, often they are the reason for women who have entered menopause to consult a doctor.
Loss of appetite, stool disorders, unreasonable nausea.
Frequent urination.
Excessive satiety during meals.
Increased fatigue, irritability weakness.
A blood test will show a high ESR, since there is a focus of inflammation in the body.
When the tumor has given metastases that have spread to other organs, then patients feel pain in the bones, headaches. Convulsive seizures, cough with hemoptysis may occur. Often there is a proliferation of secondary foci of the tumor, which are located on nearby organs and tissues.
The first signs of ovarian cancer
The first signs of this pathology are quite blurred, which is why the disease remains undetected for a long time. However, there are a number of certain features that you should pay attention to and inform your doctor about it.
The following signs will help to suspect ovarian cancer:
Discomfort in the abdomen. They may not even be painful, but similar to those that occur with diarrhea.
Slight malaise and weakness against the background of general well-being.
Sensation of something foreign in the lower abdomen, this feeling intensifies when the body is tilted, after going to the toilet and after eating. Similar sensations are described by up to 60% of women who have had ovarian cancer.
Deviations in the leukocyte balance and a jump in ESR can be observed during a blood test.
These are the signs of the disease at the initial stage. Since they are very non-specific, if similar sensations occur, it is advisable to undergo a general examination.
Causes of ovarian cancer
As the main causes of ovarian cancer, it is customary to single out several fundamental factors.
It is them who characterizes them as most often leading to a pathological state of the body:
hereditary predisposition. This means that if there have been cases of ovarian cancer in the family, as well as breast cancer or other pathologies of the reproductive system that lead to tumors, then every woman in the family should be extremely attentive to her health. This fact is explained by the fact that mutations in the genes responsible for the onset and development of a tumor can be hereditary in approximately 10% of cases. That is why it is so important to know the family history.
Women’s age after 45 years and older. That is, from the moment a woman enters menopause, there is a real risk of ovarian cancer, especially against the background of hormone therapy.
Polyposis symptoms that take place in a family history.
Hormonal disruptions in the body, in particular an increase in the number of androgens. Violations in the work of the adrenal glands, pituitary gland, or severe ovarian dysfunction.
Excess body weight is one of the common causes of this pathology. It should also be noted that the mortality from tumors among such women is higher than among those whose body weight does not exceed normal.
Early puberty.
It is generally accepted that hormonal contraceptives reduce the risk of developing a malignant tumor on the ovaries, but violations of the regimen can, on the contrary, provoke its growth.
Prophylactic oophorectomy.
Abortions and promiscuity, which leads to frequent STDs. All of these can lead to the development of ovarian cancer.
Infectious diseases of the ovaries, which are inflammatory in nature and occur in a chronic form.
Smoking and alcohol abuse, as well as malnutrition.
radiation exposure.
Stages of ovarian cancer
It is customary to distinguish four stages in the development of this pathology. They are numbered depending on the progression of the disease:
In the first stage, the ovary is directly affected. The process can include either one or both organs.
At the next stage, the disease begins to capture more and more “territories”: the uterus and adjacent organs.
The third stage is characterized by damage to the lymph nodes, as well as the peritoneum.
The last stage is the least amenable to therapy and is characterized by the fact that the tumor spreads its metastases to organs located far away. The liver and lungs may be affected.
First stage ovarian cancer
The first stage is the very beginning of the process, when the tumor is located directly inside one or a pair of ovaries and does not go beyond it.
It has its own characteristics, and doctors assign the corresponding abbreviations to the disease, under the first number (1a, 1c, 1c):
In the first case, the tumor is localized in one ovary, malignant cells are not detected. When conducting a laboratory flush from the pelvis, cancer cells are not detected.
In the second case, the process affects both organs, but there is no evidence that the neoplasm is malignant.
In the third case, the process affects both ovaries, the malignant process goes outside the organ, and during washings, cancer cells can be diagnosed. Sometimes there is a rupture of the capsule of the neoplasm.
The first stage of the development of the disease is very difficult to diagnose, therefore, as a rule, the process is detected at later stages.
Stage II ovarian cancer
If left untreated, ovarian cancer continues to progress and moves to the next stage of its development. It is characterized by the fact that the tumor, in addition to what is located on both ovaries, also involves other organs located in the small pelvis in the pathological process. The rectum, sigmoid colon, uterus and tubes, and bladder are often involved. This is what causes certain symptoms associated with the appearance of discomfort in the abdomen.
Doctors also classify the second stage according to severity (2a, 2c, 2c):
The first is characterized by the spread of the tumor to the body of the uterus and to the fallopian tubes.
In stage 2b, the tumor has spread further and may involve the rectum and bladder.
At the final stage of the second stage, the formation, as well as in the two previous ones, affects the pelvic organs, but at the same time, during laboratory washings, tumor cells are detected. Unlike steps 2a and 2c.
As for the symptoms, the majority of women who were diagnosed with the disease during this period indicate that they felt painful tingling and pulling in the lower abdomen, and also periodically experienced pain in the hypochondrium and simply in the abdominal cavity, localized in different places. If the pelvic organs are affected, then, depending on the nature of the damage, there is a frequent urge to urinate or an intestinal disorder is observed. Sometimes a hard area is found on palpation.
Stage III ovarian cancer
It is at the third stage of the development of ovarian cancer that women most often seek help. Approximately 70% of all cases are detected in this period. The process has already gone quite far, but it is still reversible. The tumor affects not only the pelvic organs, but also affects the abdominal cavity and lymph nodes.
Just like the two previous stages, oncologists divide the third stage into several similar subgroups (3a, 3c, 3c):
The first abbreviation is characterized by the absence of visible metastases in the abdominal cavity and lymph nodes, but microscopic examination reveals the smallest malignant cancer cells in biopsy specimens of the abdominal cavity.
If we talk about the next stage, then the lesions of the abdominal cavity are already becoming visible to the naked eye, during the operation. But metastases do not exceed a size of more than 2 cm, while the lymph nodes remain unaffected.
In the final subgroup of the third stage, in addition to the presence of metastases in the abdominal cavity, which reach a diameter of 2 cm or more, cancer cells can be found in the lymph nodes.
Stage XNUMX ovarian cancer
This is the last stage in the development of the oncological process, when metastases have spread beyond the abdominal cavity and reached distant organs. The lungs and liver are often affected. The presence of pleural fluid in the peripulmonary space is often observed. The pain practically does not recede and patients are prescribed potent drugs.
In such cases, the symptoms become more pronounced, the woman turns to the doctors with complaints of abdominal pain, which is intense, sometimes it increases significantly in size. The disease, which has gone so far, is extremely difficult to treat and the prognosis is usually unfavorable.
Metastases of ovarian cancer
Regardless of which type of cancer affects a woman’s ovaries, each of them can metastasize. Their presence or absence, as well as the degree and nature of growth is of great importance for determining the treatment regimen. Most often, they begin to appear when the disease has gone quite far and therefore the pathological process captures many organs.
If we talk about germination, then metastases capture those organs that are located in close proximity to the ovaries. Quite often, both the uterus and the fallopian tubes are affected. When it comes to migration, this process is the separation of tumor cells and penetration into the abdominal cavity with the capture of the organs located there. In medical language, this concept is referred to as “sowing”. As for spread, this is the “journey” of malignant cells through the lymph nodes to any other organs, regardless of their location. Sometimes remote systems such as the pulmonary or cardiovascular systems are affected. In this case, the tumor, which is located in the ovary, is called primary, and if, as a result of its spread, neoplasms have arisen, for example, in the lungs, then oncologists call them metastases of ovarian cancer.
If we consider the sequence of spread of metastases from the ovary to other organs, then the following pattern is most often observed: first, the peritoneum is affected, then the lymph nodes, through which the cells are transferred to the liver, pleura and diaphragm. Often the intestines and fallopian tubes are affected. But this sequence is rather conditional, and depends on the characteristics of the course of the disease.
Ovarian cancer is the most dangerous of the possible tumors that occur in the female body, as it gives the most metastases, which incredibly quickly capture new territories. Naturally, the type of tumor depends on the features of their growth. The most dangerous is epithelial neoplasms, which quickly affect the peritoneum, the greater omentum and the lymphatic system. A feature of metastatic tumors is that they are practically insensitive to the effects of chemotherapy and radiation exposure. That is why their removal is possible only surgically.
Diagnosis of ovarian cancer
Diagnosis of this disease in most cases is quite difficult. This is justified by the fact that the symptoms of the disease are rather vague and echo similar manifestations of other pathologies that are considered less dangerous.
If there is a suspicion of the presence of education in the ovaries, the doctor prescribes either an ultrasound or computed tomography. Based on the data obtained, it is possible to judge the size of the tumor and make some assumptions about its nature.
Also, the doctor will need to collect and analyze the anamnesis of complaints and diseases, the nature of pain, to study previously transferred gynecological diseases, operations, the number of pregnancies and other information. Important information about the onset of menstruation, its nature and duration of the cycle. Naturally, a gynecological examination with bimanual follow-up is mandatory.
Sometimes the diagnosis is carried out using a special device – a laparoscope. After making a small incision, the doctor inserts the device into the peritoneum and with its help examines the ovaries. If it is established that the organ was affected by a benign cyst, then its removal is not required, it is enough, only periodic observations by a gynecologist. If, as a result of the data obtained, a suspicion of ovarian cancer remains, then surgical intervention is necessary, which allows you to determine what the neoplasm is and stop its spread. In the event that fluid accumulates inside the abdominal cavity, the doctor makes a small puncture and takes it for examination to make sure the presence or absence of malignant cells.
A complete list of techniques that are used to diagnose ovarian cancer consists of the following studies: computed and magnetic resonance imaging, laparoscopy, ultrasound of the pelvic organs. Biopsy and microscopic examination may also be required.
Treatment of ovarian cancer
When making such a diagnosis, there can be no other options: surgical intervention is clearly indicated. The immediate volume of the operation will depend on the nature of the tumor: malignant or benign, as well as what stage of its development. If the disease has affected the organ, then only its removal is possible. The fallopian tube will also have to be removed. When the disease has progressed, then most often the removal of both ovaries and the uterus is required. Nearby lymph nodes, as well as soft tissues, are subject to liquidation. This is done to remove metastases.
Sometimes surgery is delayed in time. This is done in cases where it is impossible to fulfill its technical side,
It should be noted that in the early stages of the detection of the disease, surgical intervention gives very good results, and women even manage to maintain their reproductive function. This applies to cases where the tumor affects one organ.
After the operation is performed, the patient is prescribed radiation and chemical therapy without fail. The purpose of these procedures is to destroy those possible cancer cells and foci that have not been removed surgically.
Chemotherapy for ovarian cancer
The most pronounced effect during chemotherapy is provided by ethyleneimine derivatives (etimidine, cyclophosphamide and other drugs), but they must be combined with agents that are part of the group of alkalizing compounds. Indications for the use of chemotherapy in patients is ovarian cancer at any stage. But medical withdrawals are also possible, which are prescribed in cases where a woman’s general condition is assessed as serious, the disease is at the terminal stage, there are concomitant diseases, such as: tuberculosis, parenchymal hepatitis, glomerulonephritis and other indications.
The drugs are administered in courses, the timing and duration of which depends on the severity of the course of the disease, as well as on the indicators of the effectiveness of treatment. At the first stages of therapy, doctors try to create the maximum concentration of the therapeutic agent in the body, the next stage of administration is most often prescribed after 6 weeks, and then, depending on the indications.
Methods of administration of drugs are best combined, but the main one is intravenous, as it is considered the most effective. The dosage is chosen on a strictly individual basis, based on the obtained blood tests.
Diet for ovarian cancer
It should be understood that no single diet or specific eating pattern will help cure ovarian cancer. This is a disease that can only be treated with drugs and a surgical scalpel. However, in the postoperative period and after several courses of chemotherapy, you can help your body recover. To do this, you can adhere to a certain diet, the dishes in which for the most part should consist of grain products, as well as be rich in fiber. Naturally, this includes any fruits and vegetables. You should, if not completely refuse, then if possible avoid the presence of fatty meat, sausages, as well as sugar and refined oils on your table. Almost under a complete ban falls alcohol.
A sample menu for the week might look like this:
On Monday, you can drink any juice for breakfast, citrus nectar is perfect. As an awakening dish, you can eat an egg omelette and bread with butter. For lunch, a vegetable soup is suitable, the basis of which should be carrots and celery, with a small piece of black bread; as a second course, you can put peppers stuffed with any vegetables on the table. For dinner, boil buckwheat porridge with butter, make a salad of fresh cucumbers and radishes. Wash it all down with weak tea. If you want to have a snack late in the evening, you can drink a glass of milk.
On Tuesday, you can start your day with fresh carrot juice, stewed zucchini and rye bread. For lunch, let there be soup with semolina dumplings and pumpkin cutlets, you can diversify the menu with baked fish. For dessert, fruits and jelly are perfect. For dinner, you can cook a salad with vegetables and boiled rice. Before going to bed, a glass of low-fat yogurt is allowed.
You can start Wednesday morning with grapefruit juice and Chinese cabbage salad. At lunch, there will be such dishes on the table as cabbage soup, eggplant caviar and turkey, either boiled or steamed. You can complement the dishes with fresh fruits and compote. Dinner should consist of boiled buckwheat with any stewed vegetables, green tea and subsequently kefir.
Thursday should be met with apple, bean and greens salad. For lunch, you can eat onion soup, salad with cabbage and apples, and tea with milk. Dinner may consist of millet porridge with any nuts and tea. Before going to bed, you can drink a glass of yogurt.
On the last working day of the week, grape juice is perfect in the morning; boiled potatoes with any greens can be used as a hearty breakfast. For lunch, you should cook lentil soup, a couple of carrot and apple salads, as well as cabbage and celery with prunes. You can complement the dishes with fruit drinks and pears. For dinner, you can stew beets, seasoning them with walnuts and drinking black tea with a slice of the same bread. The last snack should be yogurt.
Weekend morning should start with blackcurrant juice and friendship porridge. For lunch, you can treat yourself to a noodle soup and a salad with cheese and an egg, complemented by steamed fish; you can drink compote with lunch. For dinner, you should cook a radish with cucumber and a sandwich with zucchini caviar and tea. Before going to bed, you can drink a glass of milk.
The last day of the week should start with pear juice, rice porridge and dried fruits. For lunch, tomato soup, a salad of cottage cheese and parsley, as well as chicken fillet baked in the oven, are perfect. As a dessert, you can eat fruit and drink jelly. Dinner should consist of steamed green beans, stewed eggplant and tea. Before going to bed, you can drink a glass of kefir.
This diet is very conditional, dishes can be combined and complicated depending on your preferences. But, nevertheless, a meal consisting of an abundance of vegetables, fruits and cereals will help the body spend energy on fighting the disease, and not on digesting food.