Ovarian cancer is a common cancer in gynecology. Each year, more than 220 thousand women hear a disappointing diagnosis, with most of the cases ending in death. Carcinoma is usually detected very late, because there are no specific symptoms, and metastases appear quite early. It is for this reason that disease awareness and regular testing play an important role.
Tumor features
More than 70% of ovarian tumors are benign tumors, which for many years can go unnoticed and practically do not pose a threat to the patient’s health. But sometimes benign formations can degenerate into malignant. The difference between such a tumor is that it spreads throughout the body and leads to death.
It is important to know that adenocarcinoma is one of the most common malignant female genital tumors. It develops from the cells of the glandular epithelium, can affect both ovaries or only one. The tumor is a multi-chamber node with partitions. She can break the capsule of the ovary when it reaches a significant size, and neighboring organs. This type of cancer is diagnosed at any age, but more often appears in women older than forty years.
Ovarian adenocarcinoma is characterized by rapid growth. It can pass to neighboring tissues and is prone to early metastasis. The tumor secretes toxins, which worsen the condition of the patient and suppress the immune defense. Using a special mechanism, a malignant tumor can hide from the immunological control of the body.
It should also be mentioned that adenocarcinoma is an oncological disease that is difficult to recognize due to the complex structure of the organs of the reproductive system. Complicating the diagnosis is that in the early stages, cancer symptoms may be completely absent. The disease begins to develop early, but spreads to the abdominal organs and lymph nodes rather quickly. The prognosis for ovarian adenocarcinoma depends on the timeliness of treatment.
Development reasons
Modern medicine does not know the exact reasons for the development of cancer, but doctors identify several factors that affect the development of pathology. An important role is played by unfavorable heredity and genetic predisposition. The use of large amounts of fats, poor nutrition, poor environmental conditions, exposure to various types of radiation, the presence of excess weight, poor immunity, alcohol consumption and smoking will not benefit. If the ovaries are significantly enlarged, this may indicate the development of a tumor or be a predisposing factor.
The causes of enlarged ovaries in women are usually as follows:
- taking hormonal drugs (oral contraceptives);
- hormonal imbalance;
- lactation (due to a natural increase in prolactin concentration);
- prolonged stress or depression;
- a sharp change in body weight;
- endocrine system diseases;
- neoplasms of a malignant or benign nature.
Ovarian enlargement is possible in girls aged 12-13 years - this is a normal phenomenon that does not require treatment. The causes of ovarian enlargement in women are pathogenic microflora, cervical erosion, or appendix inflammation.
Provoke the development of adenocarcinoma can:
- uterine fibroids;
- infertility or frequent pregnancy and childbirth;
- ovarian dysfunction;
- endocrine system diseases and hormonal disorders;
- uterine bleeding;
- menstrual irregularities;
- abortion and genital surgery;
- menopause is too soon or too late.
The risk of tumors increases with age. It is believed that girls who did not give birth are more prone to cancer. And some even believe that the causes of ovarian cancer are the use of talc-based cosmetics.
Disease classification
Different types of tumors are classified according to histotype. The most common form of cancer is serous ovarian adenocarcinoma, which is diagnosed in 80% of cases. This is an aggressive type of oncology. The tumor is large and often affects both ovaries. Metastases in the abdominal organs are already observed in the early stages. Serous adenocarcinoma has a high mortality rate.
In approximately 10% of cases, endometrioid adenocarcinoma is diagnosed. The course of the disease is slow, the pathology is relatively well treatable. The same prevalence is observed in the case of mucinous adenocarcinoma. The tumor is characterized by large size and rapid growth. Usually only one of the ovaries is affected.
Rarely, clear cell adenocarcinoma (diagnosed in less than 1% of cases). This is a highly malignant tumor that reaches a large size and is prone to early metastasis. This type of neoplasm is difficult to diagnose. Most often, a clear cell tumor affects only one ovary. There is also a mixed type in which several types of education are combined. Undifferentiated adenocarcinoma is isolated.
Depending on the complexity of the course of the disease, low-grade adenocarcinoma is isolated. In this case, a large number of cancer cells are detected, which are very different from healthy ones. This is an unfavorable factor in the development of the disease. With highly differentiated ovarian adenocarcinoma, cancer cells practically do not differ from normal ones. A moderately differentiated tumor is also distinguished.
According to the degree of differentiation, there are malignant carcinomas, borderline adenocarcinoma, ovarian sarcoma, and mesodermal tumors.
Stages of Adenocarcinoma
The stage of cancer is determined during diagnosis and surgery. There are four stages in total:
- The first involves the onset of tumor development. In this case, only the ovaries are affected, there is no accumulation of fluid. At the initial stage, the disease is diagnosed in 23% of patients.
- The second stage is characterized by metastases of ovarian cancer in the pelvic organs and fluid accumulation. The disease is detected in 13% of patients.
- At the third stage, metastases with a diameter of up to two centimeters in the abdominal cavity are diagnosed, and lymph nodes are also affected. Most often, ovarian adenocarcinoma is diagnosed just at the third stage (in 47% of cases).
- The fourth stage is characterized by metastases throughout the body. It is found in 17% of cases.
If the disease is diagnosed in the first stage, survival reaches 85-90%, in the second - 70-73%, in the third - approximately 20-30%. At the last stage, the survival rate reaches only 1-5%. More often, patients die due to metastases in the brain, lungs, bones and liver.
Clinical picture
At the initial stage, symptoms may be absent even with low-grade adenocarcinoma. The signs of oncology are mistaken for other disorders, so that doctors make the wrong diagnosis.
The main symptoms of a genital tumor are:
- heavy bleeding during menstruation and soreness;
- violations of the digestive tract;
- pain in the lower abdomen, which intensifies as the tumor grows;
- swollen lymph nodes;
- pain after sex;
- fatigue and a general feeling of weakness.
With significant tumor sizes, the abdomen may enlarge. Some symptoms are similar to the onset of menopause, so women mistakenly attribute them to menopause, missing valuable time when treatment is most effective.
Diagnostic Methods
Diagnosis begins with a gynecological examination. A gynecologist can visually determine the condition of the organs of the reproductive system, feel them for signs of enlargement. If cancer is suspected, they will be referred for consultation with an oncogynecologist.
To clarify the diagnosis, ultrasound diagnostics is shown, which is performed using a special sensor through the vagina. The method will determine the size and nature of the tumor, but will not confirm its malignancy.
You can suspect a disease with enlarged ovaries. This can confirm the ultrasound. The patient can independently decrypt the research data. The size of the ovaries in women is normal as follows:
- depth - from 1.6 to 2.2 cm;
- length - from 2 to 3.7 cm;
- volume - from 4 to 10 cubic centimeters;
- height - from 1.8 to 3 cm.
Dimensions may vary depending on the phase of the cycle and the state of the organism as a whole. Deviation from the norm in terms of ovarian size in women does not always directly indicate oncology.
MRI and CT are performed to obtain images in order to determine metastases in other organs. Under the control of CT, a biopsy is performed. The disadvantage of the methods is the need to introduce contrast, which can cause adverse effects.
Histology, laparoscopy, tissue biopsy, and fluid puncture from the abdominal cavity are also indicated for diagnostic purposes. The doctor will prescribe a general blood test and examination for tumor markers.
A biopsy will help to accurately determine the nature of the tumor. During the procedure, a sample is taken, which is then examined under a microscope.
Laparoscopy involves examining the peritoneum through a special device that is inserted through an incision on the abdomen. The image is transmitted to the monitor. The method allows you to assess the prevalence of the tumor, stage, the situation as a whole.
Life span
With early detection of ovarian adenocarcinoma, the prognosis may be favorable. In the early stages, removal of the tumor is indicated before it has metastasized. The ovaries are removed in women so that the disease does not spread. In the second stage, life expectancy is significantly reduced. After the onset of metastasis, only 10% of patients survive for five years, and those patients in respect of whom it was decided to abandon the operation live from one to three years.
Adenocarcinoma Treatment
Therapy is mainly indicated by surgery. During the intervention, ovaries are removed in women. They can cut the uterus and appendages if they are also affected. But usually surgeons try to remove only the neoplasm, so that a woman can have children in the future. A chemotherapy course is prescribed before the intervention so that the tumor shrinks. The same method is used after surgical treatment if cancer cells remain.
The essence of the method is the use of toxins and poisons, which are detrimental to malignant cells. Of course, along with education, the whole organism suffers.
Surgery may be contraindicated. In this case, chemotherapy is used as the main one. In some cases, the procedures are not needed, but only help with the appointment of the operation. With a highly differentiated adenoma, for example, survival after surgery is 95%. The tactics of treatment depend on many factors: the current condition of the patient and the age, stage and size of the tumor, the presence of metastases. After the operation, you need constant monitoring. Ultrasound and blood tests for markers of cancer are regularly performed to prevent relapse.
Additionally, the doctor gives the patient lifestyle recommendations. You should abandon bad habits and carefully monitor your health, because the body is greatly weakened. Timely treatment of all concomitant diseases is important. Nutrition for ovarian adenocarcinoma should be complete. A woman is recommended mainly a vegetarian menu.
Surgery
In most cases, a tumor is detected when it already has time to grow. In this case, removal of the ovaries is shown, possibly together with the uterus and appendages. Sometimes only part of the tumor is removed to reduce its volume. If after the intervention there is no more than 1 cm of the neoplasm, then the intervention is called optimal. Oncology sometimes affects neighboring organs, such as the gall bladder, part of the stomach or liver. In this case, these bodies are also subject to removal.
After removal of the internal genital organs, a woman will no longer be able to have children in the future. With a unilateral lesion identified in the early stages, it is possible to maintain reproductive function. Laparoscopic surgery is less traumatic. During such an intervention, blood loss is minimal, the rehabilitation period after is quite short, and there will not be a large scar on the body. But this method is used only if the tumor is detected in the initial stages of development. Otherwise, extensive surgical intervention is necessary.
Proper nutrition in oncology
To reduce the adverse effects of cancer therapy on the body, the patient should eat well. To restore strength, you can introduce honey into the diet (if there is no allergy to beekeeping products), nuts, take vitamin complexes.
It is necessary to exclude from the menu too fatty and meaty foods, smoked meats, spices and marinades, refined oils. Sugar and salt intake should be limited.
Useful fresh fruits and vegetables, cereals, lean meat, legumes, fish dishes. It is equally important to normalize weight, abandon bad habits, ensure the absence of stress factors and proper rest, observe the regimen.
Disease prevention
Prevention of any type of cancer eliminates the influence of factors that may affect the development of the disease. It is necessary to normalize weight, abandon all bad habits, avoid stress and eat right. If possible, exposure should be avoided.
It is important to monitor the health and timely treat all pathologies. If you have any alarming symptoms (you need to remember that the early signs of cancer are very similar to the onset of menopause), you should immediately consult a doctor without delaying the visit for later. An equally important role is played by the choice of a specialist who already has successful experience working with similar diagnoses. It is important that the doctor can perform the operation with a positive result.