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Treatment of ovarian cancer abroad

Ovarian cancer is a deadly malignant oncologic disease resulting in patients’ high mortality rate. Only one third of sufferers have the tumor identified at stage 1 or 2. Others have it detected only at stage 3 or 4.

 

By incidence, this pathology is only lower than cervical cancer among all those of gynecologic oncology. But, mortality rate is on the first place as far as process is diagnosed at the advanced stages, grows fast and has early metastases.

 

Ovarian cancer

 

Causes of ovarian cancer

Ovarian cancer can be primary, secondary, and metastatic. Secondary type of cancer counts for the majority of cases (85%). Cancer develops as a result of other oncological pathologies (serous papillary or mucinous cystadenomas).

 

Risk factors of the ovarian cancer:

  • Early or late onset of menopause
  • Early periods
  • Reproductive function disorders
  • Hereditary background
  • Absence of childbirth in the medical history
  • Long absence of sexual life
  • Age of 50-60

 

Metastatic ovarian cancer forms as a resultof malignant tumor in other organs. Mostly, it can be uterine, digestive tract, mammary gland or thyroid gland.

 

Ovarian cancer symptoms

 

Symptoms of ovarian cancer

There are no symptoms at the early stages;or they are non-specific which worsens the diagnostics. Tumor cannot be always detected during bimanual pelvic exam. Patients don’t have any complaints and thus, don’t make any doctor’s appointments.

 

Possible symptoms of ovarian cancer are:

  • Acute pain syndrome (22% of patients) similar to “acute abdomen”
  • Ascites (60% cases) - fluid accumulates in the peritoneal cavity
  • Uterine bleeding (30-35% of women) are caused by abnormalfunction of the ovaries

 

Most patients have an obvious intoxication syndrome. It is expressed by:

  • Weight loss
  • Weakness
  • General fatigue
  • Fever
  • Nausea
  • Appetite loss

 

When tumor has large size and metastases, symptoms of organs compression in pelvic and abdominal cavity can appear. Constipation or urinary retention can also develop.

 

Ovarian cancer treatment

 

Tumor can produce hormones. In this case, a woman has disorders in her menstrual cycle, increased libido, late onset of the menopause. If ovarian cancer has started developing in childhood, then it leads to the premature puberty and early formation of secondary sexual characteristics.

 

Ovarian cancer can develop from the cells that produce androgens (androgenoblastoma). In this case, symptoms of defemenization step to the foreground like male type hair growth, absence of periods, gruff voice, decreased libido, and changed face features.

 

Ovarian cancer diagnostics

 

Diagnostics of ovarian cancer

Vaginal examination and ultrasound (transvaginal ultrasonography,colourDoppler sonography) are used for screening diagnostics. Additional methods of visualization are CT and MRI.

 

The diagnosis is confirmed only after laparoscopy. It allows to take the biopsy material from the tumor formation and to define the prevalence of the oncological process.

 

Cancer stages are:

  • Stage 1 is when tumor is limited to just one ovary
  • Stage 2 is when tumor has spread to the pelvic cavity
  • Stage 3 is when there are regional metastases off the pelvic cavity limits
  • Stage 4 is when there are distant metastases present

 

Laboratory tests are used to determine ovarian cancer indicators. They are not that informative for the early diagnostics, but help to evaluate the prognosis and effectiveness of the therapy held. CA-125 marker has the highest diagnostic value.

 

Ovarian cancer treatment abroad

 

Treatment of ovarian cancer abroad

Surgery is a basic treatment technique of ovarian cancer. Volume of intervention is determined by the stage of the pathological process, though its prevalence can be fully determinedonly during surgery. Laparotomy gives a chance to thoroughly examine abdominal cavity.

 

Usually, they remove uterine with appendages, lymph nodes and also a small omentum to prevent the development of ascites in the future. If necessary, the volume of operation is expanded.

 

Following organs can be removed:

  • A fragment of sigmoid colon
  • Large omentum
  • Small intestine loops
  • Appendix

 

At the beginning stage of the illness and if tumor is highly differentiated, it is possible to perform laparoscopy with removal of one ovary and a fallopian tube. It is done if a woman wants to preserve the reproductive function. Necessarily, they do a biopsy of the other ovary.

 

If tumor process is extensive, then hyperthermic intraperitoneal chemotherapy is indicated. During this procedure they wash the abdominal cavity with warm chemical solution. It helps to destroy the micrometastases of ovarian cancer in case of peritoneal dissemination.

 

Additional treatment can be performed such as:

  • Radiation therapy
  • Chemotherapy

 

Ovarian cancer new treatment methods

 

New treatment methods are being constantly implemented that increase life expectancy of the patients with ovarian cancer:

 

Targeted therapy. Medicines that block tumor growth but don’t damage healthy tissues are used. Bevacizumab is used in ovarian cancer treatment.

 

Other drugs are still on the stage of clinical trials:

  • Pazopanib – angiogenesis inhibitors that block tumor blood vessels formation what violate sits trophics and slows down its growth
  • PARP-1 inhibitors – olaparib medicine
  • Medicines that are targeted at the folic acid receptors

 

Immune therapy. Effectiveness of the monoclonal antibodies focused against the protein molecules on the surface of cancerous cells (farletuzumab and catumaxomab drugs).

 

Ovarian cancer prognosis

 

Ovarian cancer - Prognosis

Prognosis for the patients having ovarian cancer significantly varies at each stage. In the developing countries five-year survival of patients with ovarian cancer at the stage 3 is about 20%, and at the stage 4 is only 5%. Thanks to higher level of healthcare systems, patients’ life expectancy is increased to much higher numbers.

 

Five-year survival indicators depending on the stage are:

  • Stage 1 – 90%
  • Stage 2 – 70%
  • Stage 3 – 39%
  • Stage 4 – 17%

 

As we can see, five-year survival of patients with ovarian cancer of the first stage is high enough. However, illness is detected at the beginning stage only among 15% of patients. That’s why general five-year survival of sufferers having ovarian cancer is about 45%.

 


 

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