Ovarian cancer: prevention, diagnosis and treatment

This type of malignancy is formed from mutated cells in the ovarian tissue. Like many other oncological pathologies, ovarian cancer initially does not have clearly defined symptoms, which makes diagnosis much more difficult. Signs of neoplasm development are usually nonspecific. This could be weakness, slight bloating, or weight loss, which many people mistakenly attribute to stress, poor diet, or a variety of other reasons. As a result, the diagnosis is made at a late stage in 80% of cases. In order to timely determine the presence of a neoplasm and apply adequate therapy, it is recommended to attend preventive appointments with specialized specialists, as well as periodically undergo a full examination.

Ovarian cancer: symptoms and causes of development

The exact reasons for the mutation of ovarian cells have not been established, however, there is a known list of factors that can lead to the formation of a malignant tumor:

• the risk group includes women over 40 years of age, with more than half of the cases diagnosed after 60 years of age;
• late birth after 35 years or no birth;
• excess weight: this parameter affects the increase in estrogen levels, which leads to the development of tumors;
• taking certain drugs based on pure estrogens during the postmenopausal period;
• the use of hormonal stimulation of the organ to achieve pregnancy: this negatively affects the ratio of hormones and affects the formation of functional changes in the ovaries;
• heredity: at risk are women whose relatives have been diagnosed with breast cancer, ovarian cancer or Lynch syndrome.

Signs of oncology in a woman’s body are nonspecific and are often mistakenly identified as the consequences of other diseases. In the initial stages, ovarian cancer has no obvious symptoms, and its development can take quite a long time. As a result, when a diagnosis is made, the third or fourth stage is determined.

First signs and symptoms ovarian cancer among women:

• bloating and increase in its volume;
• nausea, loss of appetite;
• faster onset of satiety;
• pain syndrome in the lower abdomen;
• more frequent urination;
• constipation or diarrhea;
• pronounced weakness;
• sharp weight loss;
• appearance of shortness of breath.

Types and stages of ovarian cancer

The type of neoplasm is determined depending on the type of cells from which it is formed. The type of tumor is determined by a specialist pathologist who studies organ tissue under a microscope. This study allows you to accurately determine the type of formation, as well as determine the rate of tumor spread.

There are more than a hundred types of ovarian cancer, but epithelial cancer is most often diagnosed. It is diagnosed in more than 80% of cases. Below are the most common types:

• serous carcinoma:
  • low grade;
  • high grade;
• endometrioid carcinoma;
• gray mucinous carcinoma;
• mucinous carcinoma;
• clear cell carcinoma;
• malignant Brenner tumor;
• undifferentiated carcinoma;
• mixed epithelial carcinoma.

Two main methods are used to determine the stage: FIGO and TNM classification.

There are four stages of this type of cancer:

• I with additional letter division depending on the location of the tumor. At this stage, the formation is localized in the area of one or two ovaries, and can also have both an intact capsule and one damaged during the operation.
• II with additional letter division depending on the spread of the tumor. Thus, the tumor can spread or metastasize to the uterus or fallopian tube, other pelvic tissues and its structures.
• III with an additional letter designation depending on the number and location of metastases. Thus, metastases can be localized in retroperitoneal lymph nodes, have a size of up to 10 mm or more than 10 mm, and also be located in distant systems of the body. This stage also includes metastases larger than 2 cm.
• IV: intraperitoneal and distant metastases were detected.

The stage of cancer is determined both before and after surgery.

Modern methods of diagnosis and treatment

It is not always possible to determine the presence of a tumor by symptoms. In some cases, removal of the ovarian cyst leads to its detection. In order to confirm the diagnosis and determine adequate tactics, it is necessary to undergo a comprehensive examination.

What methods are used for diagnosis:

• CT scan of the chest, abdominal cavity and pelvis with contrast allows you to determine the presence of metastases in distant systems of the body, as well as establish the localization of the tumor;
• positron emission computed tomography also allows you to reliably determine the location and size of the tumor;
• MRI of the pelvis provides visualization of the primary tumor and the presence of metastases of the disease;
• esophagogastroscopy allows you to differentiate ovarian cancer from metastases, which stomach cancer often gives to this organ;
• colonoscopy is used to determine the presence of metastases or other types of neoplasms;
• the level of tumor markers (Ca125, HE 4, ROMA index, Ca19-9, CEA) is also determined.
• Women under 40 years of age undergo an ultrasound of the mammary glands in the first phase of the menstrual cycle, if present; women over 40 years of age are recommended to undergo mammography in the first phase of the menstrual cycle, if present.
• Diagnostic laparoscopy is recommended to assess resectability, extent and morphological verification of the process, or, if it is impossible to perform optimal cytoreductive surgery for staging the process

Ultrasound is not used as an independent diagnostic method, as it is not sufficiently informative.

The most commonly used therapy methods are:

• Surgical treatment is performed in all cases of suspected ovarian cancer. During surgery, the uterus, ovaries, fallopian tubes and greater omentum are removed. If the tumor spreads to neighboring organs, they can also be removed completely or partially.
• Chemotherapy is often used before surgery to shrink the size of the tumor as well as completely eliminate any remaining cancer cells.
• Targeted and immunotherapy are widely used. The first type of treatment attacks cancer cells without affecting healthy tissue in the body. The second one activates the body’s own defense system.

Any type of cancer is more successfully treated if detected early.

Professional diagnostics and consultation

There is no effective method for preventing ovarian cancer. Although risk factors are known, their absence does not guarantee that a tumor will not develop. In this regard, it is important to be extremely attentive to your health, even if, at first glance, nothing bothers you.

Consultation with a doctor is recommended for any discomfort. In addition, it is important to conduct preventive examinations that will allow cancer to be diagnosed at an early stage. You can make an appointment for a consultation and examination with a specialist on a day convenient for you by phone.