Ovarian Cancer

Ovarian cancer is a malignant tumor that begins to develop from the epithelium of this female organ. According to statistics, in 5% of cases, cancer patients die precisely because of the development of this education. The peak age of the disease. Usually a large number of patients are already 70 years of age. As a rule, the cancer develops from benign formations that can grow in this part of the body. Often, ovarian cancer occurs in women who have stimulated ovulation, have had abortions, or have been ill with infertility.

[1], [2], [3], [4]

Epidemiology

If you believe statistics, every woman has a risk of getting sick on ovarian cancer. The percentage here is 1:71, and the mortality from this disease throughout life has a percentage of 1:95. As already mentioned above, malignant tumors of this type more often affect the elderly patients. As a rule, at the time of diagnosing cancer patients from 60 to 70 years. An interesting fact is that Caucasian women suffer from ovarian cancer at times more often than patients with dark skin. Recently, a positive trend in this disease is noticeable: over 20 years it has been diagnosed in fewer women. In addition, of the four patients, one must be cured within a year.

Within five years among patients who had ovarian cancer diagnosed, 45% remained alive. Also interesting is the fact that elderly patients (after age 65) are more amenable to treatment. Unfortunately, to date, this malignant tumor is detected in only 20% of cases.

[5], [6], [7], [8], [9], [10], [11], [12],

Causes of the ovarian cancer

To date, doctors can not give an exact reason why ovarian cancer occurs. But there are special factors that make women susceptible to malignant education in this body. Also, many theories are used, which, unfortunately, have not yet received full medical confirmation. For example, women who have often become pregnant or have taken oral contraceptives have less risk of contracting ovarian cancer. Some doctors believe that carcinogens can enter the ovaries through the vagina, so it is recommended to do a ligation of the fallopian tubes. There is also a theory that a malignant tumor is formed if there are too many male hormones in the female body, in particular, androgens. It is believed that ovarian cancer can develop because of genetic predisposition.

[13]

Risk factors

Risks of ovarian cancer development are as follows:

• Age-related changes in the body - the elderly are more often diagnosed with a malignant tumor. This disease is strongly influenced by menopause.
• Some studies have proven the relationship between obesity and ovarian cancer.
• Women who have not had children can become ill with this type of cancer, while those who often become pregnant are usually considered more protected.
• To reduce the risk of developing ovarian cancer make a ligation of the fallopian tubes or hysterectomy (removal of the uterus with preservation of the ovaries).
• Some studies have shown that taking Clomid from infertility for more than a year can lead to the appearance of a tumor.
• A large number of androgens (male hormones) in the female body.
• When taking estrogen after the onset of menopause can develop ovarian cancer.
• If a woman is already more on breast cancer.
• Improper diet - consuming more than 4 years of low fat foods.
• Those who consume alcohol and smoke increase the risk of developing cancer.
• The use of paracetamol and aspirin can, on the contrary, reduce this risk.

[14], [15], [16],

Calculation of the risk of ovarian cancer

Since in the initial stage of the development of the disease there are no symptoms or are so insignificant that few women decide to go to see a doctor, it is quite difficult to diagnose ovarian cancer. There is a special calculation of the risk of this disease. At the same time today several types of it are distinguished:

1. Calculation of PI (or prognostic index).
2. Calculation of ROMA.

Usually, during the diagnosis, a serum marker is studied, which carries the Ca 125 number. Studies have shown that its amount was increased in 80% of all patients who were sick for ovarian cancer. It should be noted that in the first two stages of the disease, its index practically does not change. Therefore, for the first stage, another marker (NOT 4) is used. For more accurate diagnosis, these two markers are usually combined.

[17], [18], [19], [20],

The ROMA Index

The ROMA index is considered the best option for the diagnosis of ovarian cancer at stage 1. Thanks to him it is possible to estimate what kind of woman is likely that a malignant tumor develops in the pelvic organs. The ROMA index consists of these tests:

1. Number 143 Ca 125.
2. Number 1281 is not 4.
3. Calculated indices of ROMA1 - for women before menopause and ROMA2 - for women after menopause.

This index allows you to see how many women in the body have two main markers.

Hereditary cancer of the ovaries

According to statistics, in 5-10% of cases, the disease with ovarian cancer is hereditary. The main feature of this type of disease is the fact that the patient can be at a younger age (before the onset of menopause). Also usually her parents or next of kin were ill for this disease or other types of cancer. To date, special programs have been opened for the prevention of hereditary ovarian cancer. They have a very important negative side. In some cases, during this program, it is necessary to delay pregnancy (taking oral contraceptives) or even to refuse to become pregnant (then the removal of the uterus or ligation of the fallopian tubes). That is why it is very important to diagnose a genetic predisposition to this type of malignant tumors beforehand so that young couples can think about the possibility of having children before the program begins.

Pathogenesis

According to the latest statistics, in 80% of cases, ovarian cancer develops as malignant tumors that are formed from the epithelial tissues of the organ itself. All other tumors develop from embryonic or stromal cells.

It is believed that it is the cysts that are the source of all such epithelial structures. Cysts usually occur after the invaginated cover mesothelium begins to be unscrewed. Cells in cysts can be transformed into tubal or endocervical epithelium. Most doctors are sure that it is almost impossible to determine when the cancer began to germinate.

[21], [22], [23], [24], [25], [26], [27], [28], [29]

Symptoms of the ovarian cancer

Symptoms of ovarian cancer are quite diverse and not always a woman can determine that she needs to undergo an examination. Among the most frequent are:

• Indigestion.
• An increased frequency of urination, which becomes quite painful.
• Nausea and vomiting.
• Discharge in the form of blood from the vagina.
• Constipation.
• The waist is enlarged in diameter.
• Frequent pain in the lower back and lower abdomen.
• Violated menstrual cycle.
• Frequent sensation of swelling or overeating.
• Appetite worsens.
• Sexual contact is painful.
• Weight changes rapidly.

The most important symptom is spotting not in menstrual days. Usually a malignant tumor is difficult to see. Since it is located inside the ovary, then in 1 or 2 stages, it is almost invisible.

First signs

Almost all patients diagnosed with ovarian cancer experienced the first signs of this disease:

1. Pain syndrome in the abdomen.
2. Bloating, involuntary triggering of gases.
3. Too fast saturation during meals.
4. Dyspepsia.
5. Pain in the lower back.

Subfebrile temperature for ovarian cancer is a fairly common symptom. Usually, in patients with this disease, the body temperature is constantly elevated (37-38 degrees). But often, irregular temperature fluctuations are also noticeable, which can be explained by the fact that the decay products of a tumor are absorbed by the body. Usually, despite the fact that the body temperature rises, the general well-being of the woman remains at a satisfactory level.

Severe pain in ovarian cancer occurs when the leg of the mobile tumor is twisted. The so-called "acute abdomen" is accompanied not only by strong pain sensations, but also by frequent vomiting, nausea, a frequent pulse. In addition, pain can occur at the last stages of the disease, when the tumor is already so large that it presses on neighboring organs.

Bloody discharge from the vagina is an alarm, which requires a compulsory examination of the doctor. Usually this kind of secretions is considered rare for ovarian cancer, it appears only in 20% of cases. In addition, it is necessary to pay attention to the fact that such a symptom is manifested only in women of sufficiently advanced age (after 65 years). Allocations in ovarian cancer can be either bloody or brown in color. The number of secretions is small, they last from a few days to a week.

More details about the symptoms of ovarian cancer can be read here.

[30], [31]

Cancer of the right ovary

Malignant formation in the right ovary is called cancer. Usually the tumor is affected only by the right side of this female organ. Often the cancer of the right ovary is formed from the tissues of the epithelium. Often the cause is cysts (benign tumors). Patients on cancer of the right ovary notice in themselves not strong pulling pains from the right side in the bottom of the abdomen.

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Cancer of the left ovary

Usually the tumor grows out of the cyst (a benign formation filled with liquid or mucus). It can also develop from epithelial cells. It affects only the left ovary, for which it got its name. Usually, the patients quickly get a sense of satiety, there may be drawing light pains from the left side of the abdomen.

See also: Types of ovarian cancer

[33], [34]

Stages

The stages of ovarian cancer are as follows:

Stage 1: Malignant tumor is located in one or two ovaries, without going beyond them.

Stage 1A: Cancer occurs in one of the ovaries (right or left), without going beyond it. The tumor grows only inside. There are no cancer cells in the abdominal cavity and pelvic organs.

Stage 1B: The tumor is common in both ovaries, but only inside them. Cancer cells in the pelvic organs and abdominal cavity are not diagnosed.

Stage 1C: There is a tumor in two ovaries. Also:

• There may be a rupture of its wall, if there was a tumor of the cystic type.
• In the abdominal fluid, the analysis showed the presence of cancer cells.
• The cells came out at least one ovary.

Stage 2: The tumor is diagnosed in one or two ovaries, but it also developed into the pelvic organs, but did not spread into the abdominal cavity, lymph nodes, or other organs.

Stage 2A: If the cancer has spread to the fallopian tubes or uterus. In the abdominal cavity cancer cells are still absent.

Stage 2B: The tumor spreads to other organs that are located in the pelvis. There are no cancer cells in the abdominal cavity.

Stage 2C: Cancer cells are found in the abdominal cavity, the tumor spreads to other organs of the small pelvis.

Stage 3: One or two ovaries are affected by a tumor. Besides:

• Spread of the tumor into the lymph nodes.
• The spread of cancer cells to the abdominal cavity, especially its shell.

Stage 3A: During the operation it is found that the tumor has spread to both ovaries. Metastases in the abdominal cavity are not visible. In the lymph nodes there is no tumor.

Stage 3B: With the naked eye, it can be seen that metastases have spread to the abdominal cavity. The affected area is both ovaries. There are no cancer cells in the lymph nodes.

Stage 3C: In addition to the fact that the cancer affects both ovaries, it is also noted:

• Distribution of cancer cells into lymph nodes.
• Metastases larger than 2 cm are seen in the abdominal region.

Stage 4: Very common degree. Cancer cells through the bloodstream fall into other, even distant, organs.

Read more about the stages of ovarian cancer in this article.

Remission of ovarian cancer

The remission of ovarian cancer is a long period of time when the disease did not develop, remaining at the same level. Recently, German doctors have noted that patients who took the drug "Pazopanib" even in the last stages of the disease were able to prolong remission for up to six months. Approving such a drug will be a huge step forward, as patients can make periods between chemotherapy much longer. According to statistics, in advanced stages ovarian cancer is considered a complex disease, which often leads to death. The survival rate here is only 20-25%.

[35], [36], [37], [38]

Complications and consequences

The most effective way to overcome ovarian cancer is surgery. But if we talk about the consequences of such a disease, we must, first of all, pay attention to its stage, size and appearance. Of course, no doctor can give a 100% result, because much depends on the patient himself.

Read also: Complications of ovarian cancer

It is worthwhile to understand that surgical operations do not pass without a trace to the human body. If you have moved the removal of the ovaries or another organ, such as the uterus, to fight cancer, you should be prepared for changes in your body.

First, if at least one ovary is removed, it sharply reduces the amount of hormones produced. When you remove both organs, the hormonal background changes very seriously. Although somehow you can stabilize your condition with the help of special courses. But remember that after the operation the patient will be forced to constantly artificially maintain the hormonal background. If this is not done, the disease may return again.

Secondly, sometimes during surgery the doctor also removes the uterus. This leads to the formation of emptiness. Of course, it affects the general state negatively. After such an operation, it is forbidden to lift any weights, engage in sports or active sex life.

Do not forget to constantly undergo examinations, which will allow you to see the relapse of the illness in time .

[39], [40], [41], [42]

Diagnostics of the ovarian cancer

To date, the diagnosis of ovarian cancer is carried out using two main methods:

1. Transvaginal ultrasound.
2. Marker CA 125 through serum.

To get more accurate results, doctors prefer to combine these two methods. In addition, there are additional diagnostic methods: magnetic resonance imaging, positron emission tomography, morphological study. Remember, the doctor will be able to determine the final diagnosis only after the last method.

[43], [44], [45], [46], [47]

Differential diagnosis

Differential diagnosis in ovarian cancer includes the analysis of the main cancer markers. Thanks to this technique, in 80% of cases it is possible to determine the development of the tumor and to prescribe the correct treatment.

Treatment of the ovarian cancer

The main role in this process is given to surgical intervention. But for different stages of treatment of ovarian cancer can differ. What are the most common methods of treating ovarian cancer today?

At the last stages of the disease, when surgical methods are already of little help, chemotherapy is used. Thanks to the use of various chemical preparations, it is possible not only to stop the development of the tumor, but also to reduce it in size.

Medications

Cisplatinum. Available in the form of a yellowish powder. Due to its composition, the drug takes part in cell death. As a rule, it is used for ovarian cancer and other small pelvic organs. Among the main contraindications for use is: severe impairment of kidney function, high sensitivity, bone marrow hypoplasia. Can not be used during pregnancy. Must be used only under examination of an experienced oncologist.

Adriablastin. This drug is an antibiotic that is part of the anthracyclines group. Its main activity is antitumor activity. Usually used in combination with other drugs. Actively used in ovarian cancer. The drug is contraindicated in patients with acute violations in the liver, myocarditis, tuberculosis. It is also forbidden to use during pregnancy.

Vincristine. It has a vegetable origin. It is used for various tumors, especially for ovarian cancer. Available in the form of a snow-white or slightly yellowish powder. Do not take during pregnancy, with jaundice, the elderly.

Paclitaxel. The drug is based on alkaloids, which stand out with yew bark. It has the shape of a white powder. It differs in cytotoxic antimitotic action. The drug should not be taken to patients with Kaposi's sarcoma, neutropenia, during pregnancy.

Alternative treatment

Alternative medicine offers its own methods of treating ovarian cancer. But remember that they were not tested, so do not always give a 100% result. In addition, alternative treatment is usually quite individual, so it can help one, but harm others. For example, many patients try to treat a tumor in the ovaries with a decoction of pine needles. In order to cook it, you need to take about three tablespoons of needles and put them in a liter of boiling water. This infusion is consumed in one day. The second process repeats itself. The course of treatment consists of one month.

[48], [49]

Herbal Treatment

Some believe that with ovarian cancer can be controlled with the help of poisonous grasses, in particular, celandine, aconite, hemlock. Many try to cure themselves by taking fly agarics. Herbs need to be properly insisted that they stop being so toxic to the human body. It is also worth taking just a few drops of such tinctures.

According to statistics, about 51% of all patients after receiving a terrible diagnosis began to take a variety of herbs. Many have paid attention to the fact that a substance called trifolirizine copes well with the growth and development of tumors. It can be found in the root of Sophora yellowing. A small activity in this area is seen in curcumin. Thanks to the flavonoids that are in the hops, you can block the development of ovarian cancer. One of the popular recipes in the treatment of herbs is this: take two teaspoons of cones of hops, pour one cup of boiling water and insist for about two to three hours. After this, the drink is well filtered and taken before meals three times a day.

Homeopathy

Homeopathy is also widely used by patients who have been diagnosed with ovarian cancer. Among the popular drugs are:

1. Argentum metallicum. Used to improve the general condition of the body. In some cases, inhibition of the development of cancer and a decrease in the size of the tumor were noticeable.
2. Asafoetida. The medicine is indispensable if the patient exhibits the main symptoms of ovarian cancer.

Operative treatment

Operative treatment of ovarian cancer usually sets two main goals. First, during the operation, the doctor can learn in more detail how far the tumor has spread. Secondly, the cleaning of the organs is carried out so that a more effective result can be obtained. During surgery, the surgeon usually removes both ovaries, and sometimes the uterus with uterine tubes is also removed. Sometimes the surgeon can also decide to remove some or all of the omentum. If cancer cells have spread to the lymph nodes, then some of them are excised. Parts of tissues, as well as a small amount of fluid are taken during the operation and then sent to the study.

Life after ovarian cancer

First of all, it is worth to be ready to the fact that in some cases the cancerous tumor never disappears. Therefore, such patients have been attending chemotherapy courses for many years. But, if you are cured yet managed, then the patient begins life full of anxiety for the future. It is very difficult to be 100% sure that the cancer will not return again. After all, relapses are common.

After the course of treatment is completed, the attending physician will have to constantly examine you. It is very important not to miss a single meeting with him. During such meetings, a survey is conducted, new tests are submitted. It is also worth noting that antitumor treatment often leads to side effects. At what some of them will remain with you for life. Many start to play sports, try to eat healthier.

Prevention

The risk of contracting the cancer of the ovaries is, according to a common account, every woman. That's why you need to think about the methods of prevention that are used today:

1. Use oral contraceptives. If you no longer plan to have children with your sexual partner, you should consider taking oral contraceptives, which are selected individually.
2. Conducting a gynecological operation. In order to reduce the chances of developing a tumor in the ovaries, remove the uterus and ligation of the fallopian tubes.

[50], [51], [52]

Forecast

Like any other diseases associated with tumors, ovarian cancer is predicted depending on which stage was diagnosed in the patient. In addition, it is worthwhile to understand if the disease was seen earlier, then the forecast for effective and positive treatment will be much more positive. If the patient was diagnosed with the first degree of ovarian cancer and the operation was performed, in 90% of cases, such patients live 5 more years. To speak about the same result in the later stages, of course, is stupid. Here, the rate drops sharply to 75%. Among patients with grade 4 tumors, only 15% survive.

Read more: Prognosis of ovarian cancer

[53], [54], [55], [56], [57], [58]

Disability

In ovarian cancer, the following types of labor are contraindicated:

1. Heavy work with physical exertion.
2. Work in an unfavorable microclimate.
3. Work that is associated with harmful substances and factors.

With effective treatment of ovarian cancer 1 and 2 stages, patients are given moderate limitation of vital activity. Therefore, the patient can return to work without problems, if it is not included in the list of contraindicated. At 1,2,3 stages, if tumor treatment is impossible, a pronounced limitation of vital activity (the second group of disability) is put. The first group of disability is assigned to those patients who have been diagnosed with ovarian cancer of the 4th stage.

[59], [60]