Ovarian cancer

Ovarian cancer treatment

Ovarian cancer (female gonads) is a malignant tumor that develops in the ovaries and affects their tissues. Like other forms of cancer, ovarian cancer is a serious and dangerous disease.

Causes of ovarian cancer

The causes of ovarian cancer are not yet fully understood, but risk factors that may affect the appearance of a malignant tumor include the following:

  • Genetic predisposition. Having a relative who has been diagnosed with ovarian cancer or breast cancer increases the risk. Mutations in the BRCA1 or BRCA2 genes are responsible for this.
  • The period of the beginning and end of menstruation. It is believed that early onset of menstruation and late onset of menopause in a woman increases the likelihood of developing ovarian cancer.

To a lesser extent, the risk of developing a malignant ovarian tumor increases in the presence of the following factors:

  • age over 50;
  • taking hormones, oral contraceptives;
  • tubal ligation;
  • breastfeeding

The development of ovarian cancer can also provoke inflammatory processes in the pelvic organs, STDs, and hormonal disorders.

Types of ovarian cancer

By origin, malignant ovarian tumors can be divided into:

  • Primary tumors - they form in the cells of the ovary. The most common variant of primary ovarian cancer is carcinoma, a tumor that is formed due to gene mutations in epithelial cells. Carcinomas can be divided into:
    • serous - most common, in about half of the cases;
    • endometrioid - they account for 10% of ovarian cancers;
    • mucinous - 6% of cases;
    • clear cell cancer is also 6%.
    Less commonly, ovarian cancer develops in germ cells (germ cell tumors) or stromal cells (stromal tumors).
  • Secondary - these are metastases of oncological diseases of other organs that have entered the ovaries with blood or lymph.

Stages of ovarian cancer

The most common classification of stages of ovarian cancer identifies four stages of its development:

  • Stage 1 - the tumor does not extend beyond the ovary;
  • Stage 2 - cancer affects neighboring organs and tissues of the small pelvis;
  • Stage 3 - ovarian cancer metastasizes to the abdominal organs and nearby (regional) lymph nodes;
  • Stage 4 - there are distant metastases in other organs and tissues of the body.

Ovarian cancer symptoms

In the early stages, ovarian cancer is usually asymptomatic. Early signs of the presence of malignant tumors may not cause a woman special problems and may not attract her attention. Unfortunately, the symptoms that begin to bother appear already in the later stages of ovarian cancer (stage 3 or 4). The most common symptoms of this cancer are:

Pain in the lower abdomen and/or back. They may not be strong, aching, usually one-sided, with long periods of calm. Pain can be accompanied by a feeling of heaviness in the lower abdomen, the appearance of more solid areas in it.

Changes in the functioning of the bladder (frequent urge to urinate) and intestines. This is due to the fact that ovarian tumors put pressure on the bladder and / or rectum, which manifests itself in constipation and frequent urination, a feeling of incomplete emptying.

Abdominal enlargement due to ovarian tumors and their metastases in the peritoneum and other organs of the small pelvis. Neoplasms lead to the fact that fluid accumulates in the abdominal cavity (ascites). This condition worsens the state of health, shortness of breath, loss of appetite may appear.

In the last stages of ovarian cancer, symptoms characteristic of any oncology appear: weight loss, exhaustion, weakness, etc.

If there are any of the signs of ovarian cancer, you should urgently be examined by a gynecological oncologist, as the prognosis for the treatment of advanced disease is very pessimistic.

Ovarian cancer treatment

Ovarian cancer diagnosis

The examination of the patient begins with palpation of the abdominal organs, mammary glands, lymph nodes, rectal and rectovaginal examination.

As a primary diagnosis of ovarian cancer, the most effective methods are: the method of transvaginal ultrasound examination of the abdominal cavity and small pelvis in combination with an analysis for the CA 125 tumor marker. The CA 125 marker is an antigen that is produced in the serous membranes of many organs of the small pelvis and abdominal cavity and therefore has low specificity for ovarian cancer, especially in the early stages of the development of a malignant tumor. Normally, its content is less than 35 IU / ml. In the presence of ovarian cancer, this figure increases significantly. But the level of CA 125 in the blood serum also increases due to other oncological diseases, as well as due to some non-tumor processes (menstruation, inflammation in the abdominal cavity or small pelvis, benign ovarian tumors, ovarian cysts, etc.). Therefore, additional methods for diagnosing ovarian cancer are needed. These include magnetic resonance imaging of the abdominal cavity and positron emission tomography, which allow you to clarify the parameters of the ovarian tumor, their nature (benign or malignant).

To make a final diagnosis, a biopsy with a histological examination of tumor cells is mandatory.

Ovarian cancer treatment

The choice of treatment for ovarian cancer depends on many factors. From the stage of the disease, the type of tumor, its size, the general condition of the patient and concomitant diseases. In the treatment of ovarian cancer, one of the following methods or a combination of them is used:

Surgical intervention

Surgical treatment of ovarian cancer is the main method of treatment and in the early stages of the disease may be the only necessary method of therapy. Its goal is the complete removal of affected ovarian tissues and metastases. The most effective is the extirpation of the uterus with appendages and resection of the greater omentum - that is, the removal of all organs of the reproductive system: ovaries, fallopian tubes and uterus. In some cases, it is possible to preserve fertility and remove only one affected ovary and fallopian tube. But at the same time, there must be confidence that the second ovary is completely healthy.

If chemotherapy is performed, and it gives a positive result, cytoreduction can be performed - a decrease in the volume of the ovarian tumor. There are several types of this operation: optimal cytoreduction - reduction of the tumor so that no more than 1 cm of malignant neoplasm remains, non-optimal cytoreductive operation - when more than 1 cm of tumor remains after it.

Chemotherapy for ovarian cancer

There are different chemotherapy options that are applicable to the treatment of ovarian cancer:

Neoadjuvant chemotherapy is given before surgery to shrink the tumor and make it operable during subsequent surgery.

Adjuvant chemotherapy is given after surgery to remove the remnants of the tumor that could not be removed surgically or to make sure that even small amounts of cancer cells do not remain after the operation. This is necessary to prevent the recurrence of ovarian cancer.

Therapeutic chemotherapy is an independent method of treating ovarian cancer, which is prescribed in cases where surgery is not possible.

If platinum-based chemotherapy has relapsed after treatment for ovarian cancer, the time between treatment and recurrence is important. If this period is less than six months, then the tumor is platinum-resistant, i. not sensitive to this drug. In this case, chemotherapy a second time will not be effective. If the period is more than six months, the tumor is platinum-sensitive, and chemotherapy can again be prescribed to treat recurrence.

Radiation therapy is ineffective in the treatment of ovarian cancer, so it is usually not used. It is prescribed in combination with chemotherapy when surgery and chemotherapy have failed.

Our clinic treats all pathologies of the female reproductive system, including during pregnancy.

Examinations after ovarian cancer treatment

After surgery to remove an ovarian tumor or other type of treatment for ovarian cancer, it is imperative that you have regular examinations with an oncologist in order to detect a possible recurrence in time.

For the first two years after ovarian cancer treatment, screening should be done quarterly. Further, at the direction of the doctor, the frequency can be reduced to once every four months in the third year after treatment and to once every six months in the fourth and fifth years after treatment.

The mandatory examination should include ultrasound of the pelvic organs, ultrasound of the abdominal organs, a blood test for the concentration of CA 125.

Survival forecast

Five-year survival is the percentage of patients who are alive five years after diagnosis. When ovarian cancer is detected in the first stage of development, treatment in most cases gives good results, and the five-year survival rate is 90% or more. In the second stage of ovarian cancer, this figure is around 70%, in the third stage - 15–20%. Very pessimistic survival prognosis if ovarian cancer is detected at an advanced stage. In this case, the indicator is less than 2%.

You can undergo treatment for cancer of the ovaries, cervix, mammary glands and other organs of the genitourinary system at our K + 31 centers in Moscow. Our doctors have extensive experience in working with oncological diseases, constantly improve their skills, and study the latest clinical studies. We carry out diagnostics and treatment of cancer of the stomach, liver, lungs and other organs, as well as any pathology of the body. For more information about our range of services, please call. And make an appointment for a doctor's consultation - by phone or online.

Service record



Specialists

All specialists
Merkulov
Igor Alexandrovich

Deputy chief physician for oncology, oncologist

Doctor of Sciences, PhD


Academician, professor, Doctor of Sciences, PhD

Petrov
Dmitry Yurevich

Deputy chief physician for oncology, surgeon

PhD, Docent

Ershova
Ksenia Igorevna

Head of department, oncologist

PhD

Rasner
Pavel Ilyich

Consultant in urology, urologist

Doctor of Sciences, PhD, professor

Malygin
Sergey Evgenyevich

Oncologist-mammologist, surgeon

Pshikhachev
Ahmed Mukhamedovich

Urologist, Oncologist

Doctor of Sciences, PhD

Shevchuk
Alexei Sergeyevich

Oncogynecology consultant, obstetrician-gynecologist

PhD

Chichkanova
Tatyana Vladimirovna

Oncologist-mammologist, radiologist

Katz
Ksenia Vladimirovna

Dermatovenerologist, oncologist

Rakova
Elena Sergeevna

Oncologist, chemotherapist

Udin
Oleg Ivanovich

Deputy chief physician for surgery, surgeon

PhD

Kogonia
Lali Mikhailovna

Chemotherapist

Doctor of Sciences, PhD

Ushenina
Maria Valerievna

Oncologist-chemotherapist

PhD

Stepura
Yulia Evgenievna

Head of the department of antitumor drug therapy, oncologist, chemotherapist

Volkova
Daria Mikhailovna

Head of the radiation therapy department

Gomov
Mikhail Alexandrovich

Consultant in oncogynecology, obstetrician-gynecologist

Grishin
Igor Igorevich

Obstetrician-gynecologist

Doctor of Sciences, PhD, professor

Achba
Maya Otarovna

Radiologist, ultrasound diagnostician, oncologist-mammologist