Ovarian cancer

Ovarian cancer is a malignant tumor that begins to develop from the epithelium of this female organ. According to statistics, in 5% of cases, cancer patients die precisely because of the development of this formation. The peak of the disease is considered to be old age. Usually, a large number of patients have already reached the age of 70. As a rule, cancer develops from benign formations that can grow in this part of the body. Most often, ovarian cancer develops in women who have stimulated ovulation, had abortions, or are sick with infertility.

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Epidemiology

According to statistics, every woman has a risk of getting ovarian cancer. The percentage here is 1:71, and the mortality rate from this disease throughout life is 1:95. As mentioned above, malignant tumors of this type most often affect elderly patients. As a rule, at the time of cancer diagnosis, patients are 60 to 70 years old. It is interesting that white women get ovarian cancer many times more often than patients with dark skin. Recently, positive dynamics in this disease have been noticeable: over 20 years, it has been diagnosed in fewer women. In addition, one out of four patients is necessarily cured within a year.

Within five years, 45% of patients diagnosed with ovarian cancer survive. It is also interesting that older patients (over 65) respond better to treatment. Unfortunately, this malignant tumor is detected in only 20% of cases today.

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Causes ovarian cancer

To date, doctors cannot name the exact reason why ovarian cancer occurs. But there are specific factors that make women susceptible to malignant tumors in this organ. There are also many theories that, unfortunately, have not yet received full medical confirmation. For example, women who have often become pregnant or taken oral contraceptives have a lower risk of developing ovarian cancer. Some doctors believe that carcinogenic substances can enter the ovaries through the vagina, so they recommend ligation of the fallopian tubes. There is also a theory that a malignant tumor is formed if too many male hormones, in particular androgens, are released in the female body. It is believed that ovarian cancer can develop due to genetic predisposition.

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Risk factors

The risks of developing ovarian cancer are as follows:

• Age-related changes in the body – malignant tumors are more often diagnosed in older people. Menopause has a strong influence on this disease.
• Some studies have shown a link between obesity and ovarian cancer.
• Women who have not had children are more likely to develop this type of cancer, while those who have had frequent pregnancies are generally considered to be more protected.
• To reduce the risk of developing ovarian cancer, tubal ligation or hysterectomy (removal of the uterus while preserving the ovaries) is performed.
• Some studies have shown that taking the infertility drug Clomid for more than a year can lead to the development of a tumor.
• A large amount of androgens (male hormones) in the female body.
• Taking estrogen after menopause may increase the risk of ovarian cancer.
• If a woman is already more likely to have breast cancer.
• Poor nutrition – consumption of low-fat foods for more than 4 years.
• Those who drink alcohol and smoke increase their risk of developing cancer.
• Taking paracetamol and aspirin may, on the contrary, reduce this risk.

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Calculating the risk of ovarian cancer

Since at the initial stage of the disease there are no symptoms or they are so subtle that few women will decide to see a doctor, diagnosing ovarian cancer is quite difficult. There is a special calculation of the risk of this disease. At the same time, today there are several types of it:

1. Calculation of PI (or prognostic index).
2. ROMA calculation.

Usually, during diagnostics, a serum marker called Ca 125 is studied. Studies have shown that its amount was increased in 80% of all patients who were sick with ovarian cancer. It is worth noting that in the first two stages of the disease, its index practically does not change. Therefore, another marker (НЕ 4) is used for the first stage. For more accurate diagnostics, these two markers are usually combined.

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ROMA Index

The ROMA index is considered the best option for diagnosing ovarian cancer at stage 1. It can be used to assess the likelihood of a woman developing a malignant tumor in her pelvic organs. The ROMA index consists of the following tests:

1. Number 143 Sa 125.
2. Number 1281 NOT 4.
3. The calculated indices are ROMA1 for women before menopause and ROMA2 for women after menopause.

This index allows you to see in what quantities two main markers are present in a woman’s body.

Hereditary ovarian cancer

According to statistics, 5-10% of cases of ovarian cancer are hereditary. The main feature of this type of disease is the fact that the patient may be at a younger age (before menopause). Also, usually her parents or close relatives suffered from this disease or other types of cancer. Today, special programs have been opened for the prevention of hereditary ovarian cancer. They have a very important negative side. In some cases, during such a program, it is necessary to postpone pregnancy (by taking oral contraceptives) or even refuse the opportunity to become pregnant (then the uterus is removed or the fallopian tubes are ligated). That is why it is very important to diagnose a genetic predisposition to this type of malignant tumor in advance, so that young couples can think about the possibility of having children before the start of the program.

Pathogenesis

According to the latest statistics, in 80% of cases ovarian cancer develops as malignant tumors that form from the epithelial tissues of the organ itself. All other tumors develop from germ or stromal cells.

Cysts are believed to be the source of all such epithelial formations. Cysts usually occur after the invaginated covering mesothelium begins to slough off. The cells in the cysts can transform into tubal or endocervical epithelium. Most doctors are confident that it is almost impossible to determine when exactly cancer began to develop.

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Symptoms ovarian cancer

Symptoms of ovarian cancer are quite varied and a woman may not always be able to determine that she needs to undergo an examination. Among the most common are:

• Indigestion.
• Increased frequency of urination, which becomes quite painful.
• Nausea and vomiting.
• Bloody discharge from the vagina.
• Constipation.
• The waist increases in diameter.
• Frequent pain in the lower back and lower abdomen.
• Irregular menstrual cycle.
• Frequent feeling of bloating or overeating.
• Appetite is getting worse.
• Sexual intercourse is characterized by pain.
• Weight changes rapidly.

The most important symptom is considered to be bloody discharge not on menstrual days. Usually, a malignant tumor is quite difficult to see. Since it is located inside the ovary, then at stages 1 or 2, it is practically invisible.

First signs

Almost all patients diagnosed with ovarian cancer have experienced the following early signs of the disease:

1. Pain in the abdominal area.
2. Bloating, involuntary gas.
3. Feeling full too quickly during meals.
4. Dyspepsia.
5. Pain in the lumbar region.

Subfebrile temperature in ovarian cancer is a fairly common symptom. Usually, patients with this disease have a constantly elevated body temperature (37-38 degrees). But often, abnormal temperature jumps are also noticeable, which can be explained by the fact that the tumor decay products are absorbed by the body. Usually, despite the fact that the body temperature rises, the woman's general well-being remains satisfactory.

Severe pain in ovarian cancer occurs when the pedicle of a mobile tumor twists. The so-called "acute abdomen" is accompanied not only by severe pain, but also by frequent vomiting, nausea, and rapid pulse. In addition, pain can occur in the last stages of the disease, when the tumor is already so large that it presses on neighboring organs.

Bloody vaginal discharge is an alarming signal that requires a mandatory medical examination. Usually, this type of discharge is considered rare for ovarian cancer, it appears only in 20% of cases. In addition, it is necessary to note that such a sign appears only in women of a fairly old age (after 65 years). Discharge in ovarian cancer can be either bloody or brown. The amount of discharge is small, they last from several days to a week.

You can read more about the symptoms of ovarian cancer here.

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Cancer of the right ovary

A malignant tumor in the right ovary is called cancer. Usually, the tumor affects only the right side of this female organ. Often, cancer of the right ovary is formed from epithelial tissue. Cysts (benign tumors) are often the cause. Patients with cancer of the right ovary notice mild pulling pains on the right side of the lower abdomen.

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Left ovarian cancer

Usually the tumor grows from a cyst (a benign formation filled with fluid or mucus). It can also develop from epithelial cells. It affects only the left ovary, which is why it got its name. Usually, patients quickly feel full, and there may be nagging light pain on the left side of the lower abdomen.

Read also: Types of ovarian cancer

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Stages

The stages of ovarian cancer are as follows:

Stage 1: The cancer is located in one or both ovaries, but does not extend beyond them.

Stage 1A: Cancer occurs in one of the ovaries (right or left), without spreading beyond it. The tumor grows only internally. There are no cancer cells in the abdominal cavity or pelvic organs.

Stage 1B: The tumor has spread to both ovaries, but only within them. Cancer cells have not been detected in the pelvic or abdominal organs.

Stage 1C: The tumor is in both ovaries. Also:

• There may be a rupture of its own wall if the tumor was of a cystic type.
• Analysis of the abdominal fluid showed the presence of cancer cells.
• The cells have come out of at least one ovary.

Stage 2: The tumor is diagnosed in one or both ovaries, and it has also grown into the pelvic organs, but has not spread to the abdominal cavity, lymph nodes, or other organs.

Stage 2A: If the cancer has begun to spread to the fallopian tubes or uterus. There are still no cancer cells in the abdomen.

Stage 2B: The tumor has spread to other organs located in the pelvis. There are no cancer cells in the abdominal cavity.

Stage 2C: Cancer cells are found in the abdominal cavity, the tumor has spread to other organs in the pelvis.

Stage 3: One or both ovaries are affected by the tumor. In addition:

• Spread of the tumor to the lymph nodes.
• The spread of cancer cells to the abdominal cavity, especially its lining.

Stage 3A: During surgery, it is discovered that the tumor has spread to both ovaries. No metastases are visible in the abdominal cavity. There is no tumor in the lymph nodes.

Stage 3B: It is obvious to the naked eye that the metastases have spread to the abdominal cavity. The affected area is both ovaries. There are no cancer cells in the lymph nodes.

Stage 3C: In addition to the cancer affecting both ovaries, there is also:

• Spread of cancer cells to the lymph nodes.
• Metastases larger than 2 cm are visible in the abdominal region.

Stage 4: Very widespread stage. Cancer cells spread through the bloodstream to other, even distant, organs.

Read more about the stages of ovarian cancer in this article.

Ovarian cancer remission

Remission of ovarian cancer is a long period of time when the disease has not progressed, remaining at the same level. Recently, German doctors have noted that patients who took the drug "Pazopanib" even in the last stages of the disease were able to extend the remission for up to six months. The approval of such a drug will be a huge step forward, since patients will be able to make the periods between chemotherapy much longer. According to statistics, in the late stages, ovarian cancer is considered a complex disease that often leads to death. The survival rate here is only 20-25%.

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Complications and consequences

The most effective way to fight ovarian cancer is surgery. But if we talk about the consequences of such a disease, then we must first of all pay attention to its stage, size and type. Of course, no doctor can give a 100% result, because much depends on the patient.

Read also: Complications of ovarian cancer

It is important to understand that surgical operations do not pass without leaving a trace for the human body. If you have undergone removal of the ovaries or another organ, such as the uterus, to fight cancer, you should be prepared for changes to occur in your body.

Firstly, if at least one ovary is removed, this dramatically reduces the amount of hormones produced. When both organs are removed, the hormonal background changes very seriously. At least somehow you can stabilize your condition with the help of special courses. But remember that after the operation the patient will have to constantly artificially maintain the hormonal background. If you do not do this, the disease may return again.

Secondly, sometimes during the operation the doctor also removes the uterus. This leads to the formation of a void. It, of course, has a negative effect on the general condition. After such an operation, it is forbidden to lift any weights, play sports or have an active sex life.

Do not forget to undergo regular check-ups, which will allow you to detect a relapse of the disease in time.

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Diagnostics ovarian cancer

Today, ovarian cancer is diagnosed using two main methods:

1. Transvaginal ultrasound examination.
2. CA 125 marker via blood serum.

To obtain more accurate results, doctors prefer to combine these two methods. In addition, there are additional diagnostic methods: magnetic resonance imaging, positron emission tomography, morphological examination. Remember that the doctor will be able to make a final diagnosis only after the last method.

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Differential diagnosis

Differential diagnostics for ovarian cancer includes testing for the main tumor markers. Thanks to this method, in 80% of cases it is possible to determine the development of a tumor and prescribe the correct treatment.

Treatment ovarian cancer

The main role in this process is given to surgical intervention. But for different stages, the treatment of ovarian cancer may differ. What methods of treating ovarian cancer are considered the most common today?

In the last stages of the disease, when surgical methods can do little to help, chemotherapy is used. Thanks to the use of various chemicals, it is possible not only to stop the development of the tumor, but also to reduce its size.

Medicines

Cisplatin. It is produced in the form of a yellowish powder. Due to its composition, the drug takes part in cell death. As a rule, it is used for ovarian cancer and other pelvic organs. Among the main contraindications for use are: severe renal dysfunction, high sensitivity, bone marrow hypoplasia. Cannot be used during pregnancy. Should be used only under the supervision of an experienced oncologist.

Adriablastin. This drug is an antibiotic that belongs to the anthracycline group. Its main activity is antitumor. It is usually used in combination with other drugs. It is actively used for ovarian cancer. The drug is contraindicated for patients with acute liver dysfunction, myocarditis, tuberculosis. It is also prohibited to use during pregnancy.

Vincristine. Of plant origin. Used for various tumors, especially ovarian cancer. Available in the form of snow-white or slightly yellowish powder. Should not be taken during pregnancy, with jaundice, or by the elderly.

Paclitaxel. The drug is based on alkaloids that are secreted by yew bark. It is a white powder. It has cytotoxic antimitotic action. The drug should not be taken by patients with Kaposi's sarcoma, neutropenia, or during pregnancy.

Folk remedies

Traditional medicine offers its own methods of treating ovarian cancer. But remember that they have not been tested, so they do not always give a 100% result. In addition, traditional treatment is usually quite individual, so it can help some, but harm others. For example, many patients try to treat ovarian tumors with a decoction of pine needles. To prepare it, you need to take about three tablespoons of needles and place them in a liter of boiling water. This infusion is drunk in one day. On the second, the whole process is repeated. The course of treatment is one month.

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Herbal treatment

Some people believe that ovarian cancer can be treated with poisonous herbs, in particular, celandine, aconite, hemlock. Many try to cure themselves by taking fly agarics. The herbs must be properly infused so that they stop being so toxic to the human body. It is also worth taking just a few drops of such tinctures.

According to statistics, about 51% of all patients after receiving a terrible diagnosis began to take various herbs. Many have paid attention to the fact that a substance called trifolirizin copes well with the growth and development of tumors. It can be found in the root of Sophora lutea. A small activity in this area is also noted in curcumin. Thanks to the flavonoids found in hops, it is possible to block the development of ovarian cancer. One of the popular recipes in herbal treatment is this: take two teaspoons of hop cones, pour one glass of boiling water and leave for about two to three hours. After this, strain the drink well and take it before meals three times a day.

Homeopathy

Homeopathy is also widely used by patients diagnosed with ovarian cancer. Popular remedies include:

1. Argentum metallicum. Used to improve the general condition of the body. In some cases, inhibition of cancer development and reduction in tumor size have been noted.
2. Asafoetida. The drug is irreplaceable if the patient exhibits the main symptoms of ovarian cancer.

Surgical treatment

Surgery for ovarian cancer usually has two main goals. First, the operation allows the doctor to learn more about how far the cancer has spread. Second, it cleans out the organs to achieve a more effective outcome. During surgery, the surgeon usually removes both ovaries, and sometimes the uterus and fallopian tubes are also removed. Sometimes the surgeon may also decide to remove part or all of the omentum. If the cancer has spread to the lymph nodes, some of these are removed as well. Tissue samples and a small amount of fluid are removed during surgery and sent for testing.

Life after ovarian cancer

First of all, you should be prepared for the fact that in some cases, the cancerous tumor never disappears. Therefore, such patients undergo chemotherapy for many years. But if you do manage to get cured, then the patient begins a life full of worries about the future. It is very difficult to be 100% sure that the cancer will not return again. After all, relapses are common.

After the course of treatment is completed, the attending physician will have to examine you regularly. It is very important not to miss a single appointment with him. During such appointments, an examination is carried out, new tests are taken. It is also worth understanding that antitumor treatment often leads to side effects. Moreover, some of them will remain with you for life. Many people start doing sports, try to eat healthier.

Prevention

Generally speaking, every woman is at risk of developing ovarian cancer. That is why it is necessary to think about the prevention methods that are used today:

1. Use oral contraceptives. If you no longer plan to have children with your sexual partner, you should consider taking oral contraceptives, which are selected individually.
2. Conducting a gynecological operation. In order to reduce the chances of developing a tumor in the ovaries, the uterus is removed and the fallopian tubes are tied.

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Forecast

Like any other tumor-related disease, ovarian cancer is predicted depending on what stage the patient was diagnosed with. In addition, it is worth understanding that if the disease was noticed earlier, then the prognosis for effective and positive treatment will be much more positive. If the patient was diagnosed with stage 1 ovarian cancer and an operation was performed, then in 90% of cases such patients live another 5 years. Of course, it is stupid to talk about the same result at later stages. Here the indicator drops sharply to 75%. Among patients with stage 4 tumors, only 15% survive.

Read more: Ovarian Cancer Prognosis

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Disability

The following types of work are contraindicated in ovarian cancer:

1. Hard work with physical exertion.
2. Work in an unfavorable microclimate.
3. Work that involves harmful substances and factors.

With effective treatment of ovarian cancer of stages 1 and 2, patients are given moderate restrictions on life activities. Therefore, the patient can return to work without problems, if it is not included in the list of contraindications. At stages 1, 2, 3, if tumor treatment is impossible, a significant restriction of life activities is given (the second group of disability). The first group of disability is given to those patients who have been diagnosed with ovarian cancer of stage 4.

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