Recurrent ovarian cancer

Relapse (from the Latin recidere) is a return of the disease that occurs after complete recovery (remission). This process is possible in almost any disease. Often the recurrence of ovarian cancer is also fixed - a serious and life-threatening pathology. In this article, we will try to learn more about the essence of the problem and analyze the possible ways to solve it.

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Frequency of recurrence of ovarian cancer

The return of the disease is typical for almost any type of cancer. But the likelihood of a secondary disease and the nature of its development largely depends on the affected organ, the scale of the disorders in the body, the presence of metastases, the time interval for recognizing the disease and initiating treatment (at what stage of the cancer it was detected and attempts were made to stop it).

For example, as monitoring of the disease shows, the frequency of recurrence of ovarian cancer detected at an early stage is 20 to 50%. Such an impressive run-up in statistics is associated with the characteristics of the patient's body, the level of sensitivity to injected drugs, the correct choice of treatment methods and many more factors, including the woman's attitude toward recovery.

If the talk is about I-IIA stage of ovarian cancer, then the indices of the recurrence-free five-year and ten-year life with adequate treatment are about 27% and 7%, respectively. As the same medical statistics show, the maximum percentage of relapses of the early recognition stage falls on the first three years after the moment of establishment of pathology. At the same time for this period, half of the recurrent ovarian cancers occur. This factor requires urgent and adequate treatment. After passing the therapy, the woman should be under constant supervision of the gynecologist, undergoing regular examinations.

When diagnosing a later stage of the disease, the risk of recurrence of cancer increases.

Causes of recurrence of ovarian cancer

Relapses of malignant damage to the ovaries are quite common. Due to the rapid spread of metastases, the frequency of recurrence of such a disease is great. And it is because of this that in most cases the disease is diagnosed at late stages of development, which leads to a rather high mortality of patients.

Many causes of recurrence of ovarian cancer are still unknown, but a number of them can still be called:

1. For a long time (for more than one year) there was a high level of hormones (especially estrogens) in the body of a woman.
2. Mechanical, chemical or thermal damage to the ovary.
3. Hereditary predisposition to this disease. If close relatives have already been diagnosed with ovarian or breast cancer. This fact significantly increases the risk of recurrent disease.
4. Metastases penetrated the peritoneum and spread to the lymph nodes.
5. Not complete elimination of affected cells or parts of the body. The remaining mutated cells continue to develop and provoke a new coil of the disease.

To prevent or minimize the relapse, physicians tend to resect not only the affected ovary, but also nearby tissues. Such radicalism allows to increase women's chances of full recovery.

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Symptoms of recurrence of ovarian cancer

If, after a certain time after stopping the disease, the woman begins to appear pathological symptoms, you can not delay. As soon as possible, consult your physician for advice. The main thing is not to miss the early stage of development of pathology. In this case, special attention should be paid to a number of factors. Symptoms of recurrence of ovarian cancer are as follows:

1. Increasing malaise.
2. Appearance in the lower abdominal cavity severity and pain symptoms.
3. Feeling of increased fatigue.
4. If the menopause has not yet come or the resection has not been performed during the treatment period, the menstrual cycle may be disturbed.
5. To this discomfort, problems affecting organs localized in the pelvic region can be attached.
6. There may be a violation in urination or defecation.
7. In a number of cases metastatic pleurisy or ascites occur.

The appearance of a symptom of a recurrence of ovarian cancer can manifest itself after many years after the first case of detection of the disease. Therefore, a woman with an increased risk of relapse should be particularly attentive to her health, although approximately 25% of patients at the early stage of the disease do not experience any pathological symptoms, which further increases the risk of the disease.

Recurrence of mucinous ovarian cancer

All the difference of this type of malignant formations from its other species is that this pathology presupposes the presence of mucin in the cytoplasm of cancer cells. At its first manifestation, it is characterized by a high propagation velocity, a sufficiently smooth surface of the neoplasm, and palpable tumor dimensions. Mucinous type of malignant tumor of the ovary is a fairly rare form of the disease, which affects 5-10% of all cancerous pathologies of this organ.

The high rate of development and spread of the disease leads to the fact that the recurrence of mucinous ovarian cancer for a short period of time leads the patient to death.

As medical oncology statistics shows, the five-year survival rate in the case we are considering is quite frightening:

• When diagnosing the first stage of the disease, it is about 84%.
• In the diagnosis of stage II, this indicator is close to 55%.
• Patients with cancer III stage show a five-year survival rate of 21%.
• At the last stage (IV), this figure does not exceed 9%.

Treatment of recurrences of ovarian cancer

After the woman has again addressed to the doctor - the oncologist, the medical worker primary finds out a question on a time interval which has passed from the moment of primary oppression of disease.

For example, if chemotherapy produced by such drugs as cisplatin and carboplatin was carried out at least five months before then treatment of recurrences of ovarian cancer in this case can be carried out with the same drugs. At the same time, the larger this interval, the higher the likelihood that a similar treatment will bring its positive result and, perhaps, still lead to complete recovery.

An antineoplastic agent of carboplatin-CML is entered into the protocol of treatment of the patients examined in this article, prescribing a dosage taken at the rate of 400 mg per each square meter of the body surface of the patient. The drug is administered intravenously. The rate of carboplatin-CML administration should be small and, depending on the dose and condition of the patient, this procedure can take from a quarter to an entire hour. Repeated infusion can be performed no earlier than four weeks, and in the case of a satisfactory patient.

If a woman enters a risk zone with an increased suppression of bone marrow hematopoiesis, the amount of medication allowed for administration is reduced. Also, a lower dose of the drug is acceptable in combination with other antitumor drugs.

Carboplatin-CML is not used in its pure form, immediately before infusion, the drug is diluted with 0.9% sodium chloride solution or 5% glucose solution. This is done to maintain the recommended injected drug concentration to a concentration of no more than 0.5 mg / ml.

Contraindications for the introduction of the treatment protocol in carboplatin-CML include severe myelosuppression, serious malfunctioning of the kidneys, as well as individual intolerance to the components that make up the drug, including platinum.

If the interval between the completion of treatment and complete recovery is less than five months, or during the process of arresting the problem, further progression of the disease (refractory cancer) was noted, in this case, many oncologists turn their attention to paclitaxel (Taxol), which in most cases shows a positive result of treatment.

Antitumor agents of plant origin paclitaxel (Paclitaxel) is dripped intravenously in the form of a three-hour or twenty-four-hour infusion. The use of this preparation in concentrated form is not allowed, so dilute it to the required concentration with a 0.9% solution of sodium chloride or 5% glucose solution before use. The recommended content of the drug is from 0.3 to 1.2 mg / ml.

Contraindications for the introduction of the treatment protocol for paclitaxel include a severe form of neutropenia, the presence in the patient's history of Kaposi's sarcoma, as well as the individual intolerance of the components that make up the drug.

The volumes of prescription drugs are highly individual and selected based on the results of primary chemotherapy (or lack thereof) and the state of the hematopoietic system.

With a refractory cancer new growth, another drug of this pharmacological group can be prescribed. It can be epirubicin (pharmorubicin), fluorouracil with calcium folinate (leucovorin), ifosfamide, altretamine (hexamethylmelamine), etoposide, tamoxifen.

To date, new medications have been received to help the oncologist, who has already shown his high effectiveness in the field of relief of the problem discussed in this article: docetaxel, vinorelbine, topotecan, gemcitabine (gemzar), liposomal doxorubicin, irinotecan (campto), oxaliplatin ( eloxatin), cycloplates.

These drugs are used in the treatment protocol as a monotherapy, and as one of the drugs of complex treatment.

For example, as a basic element of monotherapy, altretamine (hexamethylmelamine) is prescribed by the patient at a rate of 6 to 8 mg per kilogram of the patient's weight orally, every day for three to four weeks.

The dosage of cisplatin is calculated from 75 to 100 mg per square meter of the patient's body surface area. The drug is injected into the vein. The procedure takes place with hydration and forced diuresis once. The next invasion is allowed after three weeks.

One of the numerous variants of combined treatment (chemotherapy) is the administration of such antitumor drugs as paclitaxel (dosage of 175 mg per square meter infusion diluted with special pharmacological substances) with premedication. The second drug of this treatment protocol is cisplatin, administered at a rate of 75 mg per square meter, administered by dropwise hydration at three weeks.

Repeated operation for recurrent ovarian cancer

It is often enough when diagnosing a malignant neoplasm in the ovarian region - a doctor - an oncologist raises the question of a complete resection of a diseased ovary, including nearby tissues. If this has not been done, or the operation has not been carried out to the proper level, or, for whatever reason, all mutated cells have not been removed, the probability of disease return is high. Therefore, repeated surgery for recurrence of ovarian cancer is a very real therapeutic course.

Many women, in order to preserve childbearing functions, force the oncologist surgeon to perform an organ-saving operation. When it is removed, mutated tissues are exposed. But in this case the risk of recurrence of the disease remains high enough. Therefore, if the disease returned, the doctor insists on carrying out hysterectomy, that is, complete removal of the uterus, appendages and testicles. This approach, especially in the light of the relapse that has arisen, is often the only way to save a woman's life and lead to a full recovery, even if she has lost a woman's genital organ or just give a woman a few extra years or months.

Survival in the recurrence of ovarian cancer

As monitoring and medical statistics show, survival in the recurrence of ovarian cancer is low, since this pathology is considered incurable diseases. With the return of cancer progression of the tumor, localized in the ovarian region, patients' lifespan is usually invested between eight and fifteen months. Physicians in most cases resort to re-chemotherapy, which allows prolonging the life of such patients. Although, as experience shows, with repeated treatment, the effectiveness of this technique is slightly lower than when the primary relief of the problem.

Complex timely and adequate treatment is able in seven patients out of ten to increase life expectancy by an average of six months. This indicator depends on many factors, including the patient's desire for life.

Of course, get used to the idea that the genital organs will be removed for any woman is very difficult. And not only on the physical, but also on the emotional level, but if the woman does not plan to give birth in the future, it will be right to agree to an operation. In this case, recurrence of ovarian cancer with a high probability can only become a phantom fear. But if there was no surgical intervention, or an organ-saving operation was performed, or for any other reason, the risk of returning the disease remains very high. Such a woman should be more attentive to her health. Regular visits to a doctor - an oncologist, with a periodic full examination, an appeal to the doctor even with minor discomfort. Only in this way it is possible, if not to be saved, then considerably prolong the life of such a patient. Be more attentive to yourself, fight! We wish that the pathology considered in this article does not affect you or your loved ones!