WHO recognizes ovarian cancer as one of the most dangerous oncopathologies of the female reproductive system. The disease is the second most common after carcinoma of the cervix. However, it is much worse diagnosed, and poorly treatable. It is characterized by an aggressive course and a tendency to relapse. Tumors are detected in patients of different ages but are most common in older women.
Reasons for the development of the disease
The mechanism of the formation of ovarian tumors is similar to the development of oncopathologies of other organs. Under the influence of a mutation, the process of cell division and death is disrupted.
Malignant formations begin to grow uncontrollably, gradually replacing healthy structures.
Reliably the causes of the onset of pathological changes have not been identified. Experts are inclined to believe that ovarian cancer is hormonal, more often developing in women with constant failures in the synthesis of hormones of the reproductive system. So, the absence of pregnancy, and childbirth significantly increases the likelihood of malignancy. In this case, ovulatory cycles are continuous, causing accelerated regeneration of ovarian epithelial cells, which eventually provokes malignant mutations.
Other risk factors for ovarian cancer include:
- congenital genetic mutations (for example, provoked by Lynch syndrome);
- early menstruation;
- transferred venereal diseases;
- polycystic;
- obesity;
- late menopause or childbirth;
- endometriosis;
- chronic inflammation of the reproductive organs;
- smoking;
- irregular sex life;
- living in a region with poor ecology;
- numerous abortions.
The main group of patients who are diagnosed with ovarian cancer in women aged 40–69 years who suffer from infertility. The hereditary predisposition to oncopathologies of the reproductive system significantly increases the risk of developing pathology.
Types of ovarian cancer
Tumors of this category are more often unilateral (grow in one ovary), and less often – bilateral.
Innovations are divided into:
epithelial – are formed in the epithelium lining the outer or inner surface of organs;
stromal – grow from cells of a specific connective tissue (stroma), responsible for the synthesis of estrogens, androgens, and progestins. These neoplasms account for about 7% of the total number of cases of diagnosed ovarian cancer. They are slow-growing, easier to detect in the early stages;
carcinogenic – are formed from primary, immature cells, are introduced into any tissues of organs. They are rare, usually in young girls.
Up to 90% of ovarian cancers are of the epithelial type. They are difficult to diagnose and treat.
There are several histological types of such tumors:
- mucinous;
- endometrioid;
- complex;
- clear cell;
- serous;
- mixed;
- carcinomas;
- Brener neoplasms.
By origin, tumors are:
- primary – are formed directly from the cells of the ovaries;
- secondary – are reborn from benign formations (cysts);
- metastatic – appear as a result of the introduction of altered cells with a blood or lymph flow from other parts of the body.
Neoplasms of the latter variety are the most dangerous, characterized by rapid growth, and rapid spread to neighboring organs.
Stages of disease development
Like other types of cancer, ovarian tumors go through four stages of development:
I – the neoplasm is localized in one organ, rarely begins to spread to the pair;
II – one ovary is completely affected, the process extends to the uterus, tubes;
III – cancer cells are found in the inguinal, retroperitoneal lymph nodes;
IV – metastasis is observed in internal organs distant from the primary focus.
The earlier tissue malignancy is detected, the greater the chance of a patient recovering.
Characteristic features
The danger of ovarian cancer is that in 75-80% of cases (according to WHO statistics) it is detected already at the stage of aggressive metastasis to distant organs and systems.
Symptoms of the early stages are nonspecific, they are signs of many diseases. Among them:
- bloating;
- pain in the lower abdomen;
- frequent urination;
- a feeling of heaviness in the stomach, satiety with a small amount of food;
- sudden, unreasonable weight loss.
- As the tumor grows, the clinical picture of the pathology is replenished with such manifestations as:
- constant fatigue;
- heartburn;
- decrease in working capacity;
- skin rash;
- back pain;
- menstrual irregularities;
- muscle weakness;
- constipation;
- backache;
- discomfort during intercourse.
It is impossible to establish pathology according to these characteristics. A complete examination is required to identify the tumor process.
Diagnostics
A visit to a medical institution begins with an anamnesis, gynecological examination, and palpation of the pelvic organs. To detect a tumor, determine its type, localization, degree of development, the patient is carried out:
- transvaginal ultrasound;
- chest x-ray;
- MRI;
- general, biochemical blood tests;
- mammography;
- CT scan of the abdomen;
- genetic tests to detect mutations;
- positron emission tomography;
- diagnostic curettage of the uterine cavity (if endometrial cancer is suspected).
A blood test for the presence of the CA-125 tumor marker is not specific, therefore, it is more often used not to detect ovarian cancer at an early stage, but to monitor the dynamics during the treatment of the patient, to prevent relapses.
The final diagnosis is made only after a biopsy with a histological examination of the biomaterial.
Treatment
The main treatment for ovarian cancer is the surgical removal of the tumor. Oncologists practice several methods of intervention:
- total hysterectomy – complete removal of a woman’s reproductive organs;
- cytoreduction – cutting off part of the neoplasm if chemotherapy is ineffective;
- partial hysterectomy – removal of the tumor with the capture of surrounding tissues;
- palliative surgery – resection of a part of an inoperable neoplasm, aimed not at treatment, but at improving the patient’s quality of life.
The type of intervention is chosen by the attending physician, based on the characteristics of a particular case, and the state of health of the patient. The operation is complemented by chemotherapy.
She happens:
neoadjuvant – performed before resection to reduce the size of the neoplasm or when surgical intervention is impossible;
adjuvant – is indicated for patients in the postoperative period to consolidate the result, and prevent relapse.
If it is possible to detect “target” cells in the tumor, chemotherapy is combined with targeted chemotherapy.
Hormonal treatment is justified in the recurrence of stromal tumors. Separately, it is rarely used due to the low effectiveness of the impact on malignant cells.
Forecast
As a rule, the prognosis for ovarian cancer is poor. This is because these neoplasms are more often diagnosed in the later stages. In addition, this type of neoplasm is prone to recurrence.
The five-year survival threshold is overcome by 10 to 80% of women, depending on the degree of spread of the tumor. Subject to the removal of all altered tissues, about 60% of patients recover.
Prevention
There is no way to completely ensure against the development of ovarian cancer. However, to reduce the risk of a tumor, it is enough to follow several simple rules:
- balance the diet;
- do sport;
- stop smoking, alcoholic beverages;
- protect the skin from ultraviolet radiation.
Girls whose close relatives had ovarian cancer need to carefully monitor their health. Undergo regular gynecological examinations. Annual screenings are recommended for all women over 40 years of age.
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