Ovarian cancer: how to recognize it early? Causes and how can it be treated?

Ovarian cancer is a malignant disease affecting women. The pain or infertility is negligible. The consequences can be far more frightening. More than one young woman has lost her fight for life.

Initially, it may have an asymptomatic course. Initial symptoms may be common to many diseases. If some of them are underestimated and without regular gynaecological examinations, the consequences can be fatal.

When to think that it may be ovarian cancer, read the article.

What makes ovarian tumours typical?

malignant tumours in the ovaries are very common. They are characterised by their aggressive growth and metastasis. They can grow to large sizes and cause problems by their pressure in a small area of the pelvis.

Expansion (expansion, growth) of the tumour into the abdominal cavity is also common. This results in oppression of tissues and organs in the abdomen and associated further complications.

Basic classification of tumours

Tumors can arise from all the components of the ovary. The sheer complexity of the anatomy of the ovary causes a variety of cancer types. Their classification has changed with scientific advances in the field of medicine.

Classification according to malignancy

1. benign - benign (non-malignant) tumour - in reality a completely different formation (cyst, abscess, subcutaneous fat, myoma, etc.)
2. semimalignant - with borderline malignancy, so-called border line
3. malignant - malignant (true tumour - cancer)

Division according to the site of origin of the tumour

1. primary - the tumour originated directly in the ovary
2. secondary - the tumour has metastasised to the ovary (primary tumour is located in another organ, mainly from the digestive tract - stomach, intestine, pancreas)

Division according to the type of tissue from which the tumour originated

1. Epithelial tumours - form from the superficial epithelium, i.e. the tissue lining the outer and inner surface of the skin, mucous membranes, organs (cystadenoma, cystic adenofibroma, cystadenocarcinoma) - low malignancy
2. germ cell tumours - are from cells involved in the formation of the foetus
3. gonadostromal tumours - arise from a specialised middle layer of sex cells (teratoma, dysgerminoma). These are active tumours that often produce hormones (estrogen, rarely hormones from the adrenal glands)

Why does ovarian cancer arise?

Genetic predisposition plays a big role, improper lifestyle as in many other diseases. Contraceptive pills as such are a risk, but especially their improper use.

The risk increases by 20% with repeated use. According to many experts, it is a carcinogenic (cancer-causing) substance. The composition of contraceptives is the same as that of hormone replacement therapy, but in higher doses.

The difference is that contraception is not a drug and therefore does not need to be taken. As a cancer prevention, therefore, it is also a change in protection against pregnancy. However, the public is not yet sufficiently aware of this important fact.

Interesting:
In June 2015, 21 experts from the International Agency for Research on Cancer met in Paris. They concluded that hormone treatment causes cancer.

When should this serious disease be thought of? How does it manifest itself externally?

The early stages of many diseases are initially asymptomatic, which is also true for ovarian cancer. It can often be detected accidentally during a preventive gynaecological examination.

However, the saddest fact is that up to 80% of these diagnoses are detected at a late stage.

The frequency of symptoms increases with the growth of the tumour itself. The first warning signs include mild pain in the lower abdomen on the affected side (tumours of both ovaries are rare), mild tension that intensifies with physical activity due to blood flow and increased pressure.

The pain is similar to menstrual pain or pain in premenstrual syndrome.

Pain and bleeding

Excruciating pain occurs at a later stage, when the diagnosis of this insidious disease is usually already confirmed. The pain may no longer be localised in the lower abdomen but radiates upwards to the stomach. Sometimes the pain is widespread or radiates to the back.

Degenerative changes such as bleeding from the tumour, strangulation of the tumour pedicle or rupture of the tumour are painful conditions that in many cases warrant a visit to the doctor. The blood vessel next to the tumour that is engorged by the tumour also bleeds.

If the tumour is large or has grown, the abdomen may be harder to feel. It may be possible to feel a hard mass or a hidden mass in the abdomen.

Menstrual cycle disorders, virilisation

Pressure on the ovary by an enlarging tumour causes various disturbances of the menstrual cycle, from weak menstruation to complete absence of menstruation (amenorrhoea). Hormonally active tumours may also manifest themselves (show externally) by heavy menstrual bleeding, i.e. metrorrhagia. They may show typical virilisation (male characteristics such as male pubic hair, thickening of the voice).

The expansion of the tumour with oppression into the abdominal cavity causes a wide range of symptoms such as constipation, bloating, impaired bowel motility, nausea, vomiting. Common symptoms for most cancers are also general weakness, increased fatigue, decreased physical vitality, inappetence, weight loss (usually in the last, terminal stages).

Diagnostic methods

Unlike cervical cancer, there is as yet no screening test for ovarian cancer. As a result, only about 25% of women are diagnosed at an early stage. The remaining 75% are diagnosed at an advanced stage.

The diagnostic approach includes oncomarkers and their positivity in blood serum confirming the tumour without precise localisation. It also includes sonography, laparoscopy, computed tomography (CT), nuclear magnetic resonance imaging (MRI), or tissue collection for histological examination.

Can ovarian cancer be cured?

Surgery by a gynaecological oncologist with tissue collection for histology is the preferred treatment. In young women, partial resection (cutting away) of the affected part of the ovary is preferred to preserve fertility (fecundity), which is not possible in every case.

The other ovary remains fully functional and the woman can become pregnant.

Sometimes a total ovariectomy (removal of the ovaries) is necessary. This is a problem for women who have not yet had children. If both ovaries are removed, fertilisation is not possible. If the tumour grows into the uterus, the whole uterus is removed (hysterectomy).

What is the prognosis?

Chemotherapy is not recommended for all types of ovarian tumours. It is not done for BTO (borderline tumour of ovary). That is, for borderline ovarian tumour or borderline results. Then it is not quite clear whether it is a malignant tumour. Therefore, chemotherapy could do more harm than good.

The prognosis despite the above treatment is unfavourable. Despite all the advances that medicine has made in recent years, only 20% of all patients with malignant ovarian cancer survive 5 years despite aggressive treatment.