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 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:
Metastatic ovarian cancer forms as a resultof malignant tumor in other organs. Mostly, it can be uterine, digestive tract, mammary gland or thyroid gland.
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:
Most patients have an obvious intoxication syndrome. It is expressed by:
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.
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.
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:
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.
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:
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:
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:
Immune therapy. Effectiveness of the monoclonal antibodies focused against the protein molecules on the surface of cancerous cells (farletuzumab and catumaxomab drugs).
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:
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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