In line with its mission, the Editorial Board of MedTvoiLokony makes every effort to provide reliable medical content supported by the latest scientific knowledge. The additional flag “Checked Content” indicates that the article has been reviewed by or written directly by a physician. This two-step verification: a medical journalist and a doctor allows us to provide the highest quality content in line with current medical knowledge.
Our commitment in this area has been appreciated, among others, by by the Association of Journalists for Health, which awarded the Editorial Board of MedTvoiLokony with the honorary title of the Great Educator.
– This cancer gives very subtle symptoms, mainly – up to 80% of gastric problems – says prof. dr hab. n. med. Mariusz Bidziński, head of the Gynecological Oncology Clinic of the Oncology Center – Institute of M Skłodowskiej – Curie in Warsaw. In Poland, it is still a disease with poor prognosis.
Edyta Kolasińska – Bazan, Medonet: At this year’s “Urooncology” conference, you said that although the five-year survival rate has improved, ovarian cancer is still a cancer with a poor prognosis. Why is this happening?
The reason is the late diagnosis of the disease. This, in turn, is influenced by the lack of both characteristic symptoms and screening programs for detection. Ovarian cancer does not cause any symptoms, and the pain that occurs is a sign of a significant advancement of the disease. This cancer has very subtle symptoms, mostly gastrointestinal problems. As much as 80 percent symptoms are gastric.
And there is no vaginal bleeding ?!
Less frequently than in other gynecological neoplasms.
These subtle symptoms probably worsen during your period?
Nie.
The gastric symptoms you mentioned are stomach pains?
No, most often it is flatulence, bloating, enlargement of the abdominal circumference. If the treatment with a family doctor or gastroenterologist is ineffective, e.g. it lasts several weeks or months, it is worth visiting a gynecologist who will perform a gynecological examination, conduct a family history and offer an ultrasound examination of the reproductive organ.
What can be worrying about ultrasound?
Ovarian changes, their size, or free fluid in Douglas sinus, i.e. the lowest located recess of the small pelvis peritoneum. Ascites and tumors testify to the advanced stage of the disease. The doctor should additionally order markers – a ROMA test (blood test) when he notices something disturbing, especially if there has been a case of breast or ovarian cancer in the family. The family burden of cancer is not insignificant – in approx. 15 percent. patients have gene mutations responsible for the disease.
However, 85 percent remains. without the so-called burdens, so what is considered a risk factor?
The age of the woman is such a factor – ovarian cancer is most often activated at the time of the menopause, after the age of 55. Obesity is considered a risk factor for all types of cancer. Hormone replacement therapy (HRT) increases the risk of breast cancer. For example, talc (used in sanitary napkins) or active smoking (but also passive smoking – inhaling tobacco smoke) are harmful, which also pose a risk of cervical and lung cancer. However, I appeal to everyone – BE AWARE, cancer does not only affect women.
Contact your doctor without leaving home Link to Partner
Can we also appeal to doctors?
Yes, because maybe in a given patient we are dealing, for example, with a predisposition to cancer, e.g. Lynch’s syndrome (hereditary cancer of the large intestine)? Therefore, it is extremely important for the doctor to conduct a detailed interview with the patient. This is an appeal to doctors, because I know that the current health care system does not provide convenient opportunities to conduct comprehensive interviews. If any disturbing symptoms persist, let’s not get over it – let’s look for the cause! I am alerting you to increase medical awareness, because it is said that ignorance of the law is harmful, but ignorance of the basics of medicine is also harmful.
What reduces the risk of ovarian cancer?
Ovulation blocking: pregnancy (before 35 years of age), adnexectomy, tubal ligation, oral contraception.
How is this cancer treated?
It is difficult to treat. The problem is the lack of a diagnostic tool to help detect cancer early, so most cancers are diagnosed at an advanced stage. About 30 percent. are early neoplasms (first and second stage, the curability of which is approx. 70-80%), but approx. 70%. patients are diagnosed in the highly advanced stage – the third and the fourth, where the curability fluctuates only in the range of 30-40 percent. I must say that the treatment of ovarian cancer is surgically complicated (often involving the entire abdominal cavity), requiring specialized medical teams: surgeons, anesthesiologists.
What about checking markers?
The OVA-1 test, which is a combination of five markers, is not yet accepted for general use in Poland.
What can improve the situation?
The current education of doctors in the field of oncology is still insufficient and ineffective, therefore I believe that reference centers for the treatment of ovarian cancer should be selected in Poland. Primary care physicians, gynecologists-obstetricians should not be afraid to consult patients there. I believe that patients who are treated from the beginning in specialized centers with experienced staff and comprehensive technologies for the treatment of this cancer have the greatest chances for longer survival.
You said that “Personalized medicine is probably a recipe for treating ovarian cancer.” This is probably the future of all medicine?
In any system, individualization is very important, which does not mean that we run away from standardization, but we know that each disease entity (including cancer) also differs in terms of the host in which the disease develops.
So the same cancer will develop differently in each patient?
Exactly! A seed that falls on the soil will take root in one place, but not in another. It’s the same with disease, which is why personalization is so important. Today we are looking for the fingerprints of the disease, but also the host – we are looking for an individual and safe therapy, and therefore adapted to the disease and the specific patient. We cannot sew a suit for everyone – tall and short. Like a cold – one aspirin tablet is enough for one, another 1, and another – can have dangerous complications after taking it. That is why it is worth asking the patient and listening to her carefully, because we are treating a specific Mrs. Kowalska who comes to us with a specific story, her own story.
Why don’t Polish women come regularly for preventive examinations?
This question has been bothering me for a long time. I talked to sociologists and found out that we – both Polish and Polish (there is no difference in terms of gender, although women, however, test more often than men) believe that … they will not get sick. Yes – a neighbor or a neighbor will get sick, because … “they were weak”. But me? – I will definitely not get sick! We are a nation with a low level of education in the field of cancer prevention. There is another group that thinks, “I will go for a test, but if they find cancer, what will happen then? So it’s better not to know. ” People are terribly afraid of being diagnosed with cancer!
- Breast and ovarian cancer – genetic testing of the most common mutations can be purchased at Medonet Market.
And they are right?
Yes, because our health care system can nail the proverbial nail in their coffin. This system is not working! If it worked well, a person would be sure that by systematically carrying out preventive examinations, he would be confident that even if a tumor was detected, it would be an early stage of the disease and with a chance of a complete cure. I would like to add that the referentiality in obstetrics and perinatology resulted in a significant decrease in neonatal mortality. It can also be transferred to other areas, but it has to be done systemically, starting with the form of “invitations” to such research – it will be different for an older person (letter), and another for a young person (text message, email, or info on a social networking site).
Pure Marketing?
All over the world there is a group of people who think how to effectively reach the addressee. The American population is neither Polish nor Mongolian. You have to know that we are a perverse nation, and for each community of people you should choose the right tools – then you can think about being successful.
Will it be a success?
Fall in mortality.
Prof. dr hab. n. med. Mariusz Bidziński, head of the Gynecological Oncology Clinic of the Oncology Center – Institute of M Skłodowskiej – Curie.