The ovaries are the most important organ of the reproductive female system, but, unfortunately, they are often exposed to various kinds of diseases. Of the most life-threatening - malignant tumors (ovarian carcinoma). In view of the serious threat posed by such pathologies, any woman should be aware of what this type of oncology is and how its symptoms are manifested.
Causes of Ovarian Carcinoma
Like most varieties of oncological pathologies, ovarian cancer lacks a clearly defined etiology. However, it was found that a number of circumstances may contribute to the occurrence of this disease.
So what triggers the appearance of human ovarian carcinoma?
First of all, we are talking about the number of ovulations. It has been established that women who have never given birth have a much greater chance of contracting this disease. Also at risk are women who have had menstruation early (before 12 years) and menopause has come late, that is, menopause has come after 55-60 years. The theory is widespread that a large number of ovulations exert pressure on the tissues of the ovarian epithelium, which have to endure too many regeneration cycles. This leads to an increase in the likelihood of genetic abnormalities in the cells, which entails the appearance of malignant changes.
Another risk factor for ovarian carcinoma is heredity. As studies show, such cancer is much more often observed in women whose maternal relatives also suffered from this disease.
A fairly important factor that contributes to the development of carcinoma is age. Ovarian cancer is often observed in old age (from fifty to seventy years). This is largely due to the fact that in this period, which is called premenopause, a gradual decrease in hormone levels is observed. Other circumstances that, according to doctors, are universal factors for different types of oncological diseases, cannot be discounted.
These include:
- Regular stress along with reduced immunity.
- Unhealthy diet combined with a lack of dietary fiber, increased amounts of animal fats, and so on.
- The development of vitamin deficiency and bad habits.
- The patient has obesity or diabetes.
- Exposure to a sedentary lifestyle.
- Living in poor environmental conditions.
- Long-term action of carcinogenic components.
Symptoms
With the appearance of ovarian carcinoma in women, urinary retention and its frequency are possible. In addition, the defecation process may be disturbed against the background of an increase in the size of the tumor, which is located in front or behind the uterus. It is not excluded that a change in the psychological state of a woman along with neurological disorders, headaches, indigestion, weight loss, fatigue, apathy, fever, weight loss and swelling of the limbs. However, in most situations, these symptoms may indicate that oncology is already at a late stage.
It is worth noting that such phenomena are very rarely associated in patients with such a formidable disease as ovarian carcinoma. This is mainly associated with fatigue or fatigue. At a later stage, fluid accumulation in the chest area is also possible, which leads to shortness of breath. Among other possible manifestations that are observed with ovarian carcinoma, it should be noted:
- The development of pleurisy and swelling of the extremities.
- The appearance of lymphostasis and intestinal obstruction.
- The presence of elevated ESR levels in the blood.
- The appearance of uterine bleeding that is not associated with menstruation.
Thus, ovarian cancer does not have any specific features at an early stage. And his most likely detection option is a regular diagnostic examination by a gynecologist.
Serous carcinoma
Serous ovarian carcinoma suggests an excessive accumulation of malignant neoplasms developing from the epithelium. That is, a tumor arises from the epithelial tissue that is reborn. To date, the reasons for this process have not yet been found. There are three theories put forward by oncologists:
- Serous ovarian carcinoma is formed from the integumentary epithelium, that is, the tissue that is on the surface of the ovaries is reborn.
- A tumor can form from the vestigial vestiges of the genitals remaining after the standard organs were formed in the woman's body.
- Presence of introduced epithelium entering the ovaries from the fallopian tubes or from the uterus.
Currently, several varieties of such a pathology are distinguished:
- The appearance of serous papillary carcinoma of the ovary.
- The development of adenofibroma.
- The formation of superficial papillary carcinoma.
- The appearance of a serous cystoma of the papillary type.
Various types of serous cancer are treated with special medications.
What is ovarian endometrioid carcinoma?
The occurrence of endometrioid ovarian cancer is mainly associated with endometriosis. This type of carcinoma accounts for 10% of other epithelial tumors. It is usually found in women aged 50-60 years. In 15-20% of cases, endometrioid ovarian cancer is combined with endometrial cancer. The neoplasm consists of a significant number of merging oval and tubular glands, villous structures and proliferation of spindle-shaped cells. Often there are foci of necrosis and hemorrhage. Cancer affects both ovaries in 17% of patients.
Epithelial carcinoma
Epithelial cancer is formed from the mesothelium, that is, from the epithelium located on the surface of the ovary. Usually this type affects only one ovary and can rarely switch to the opposite. The tumor in this case progresses very slowly, and therefore it is very difficult to diagnose. According to statistics, seventy-five percent of patients learn about their disease only at a late stage, when treatment is rather difficult. Epithelial cancer usually develops in patients after fifty years. He acts along with the very common appearance.
Mucinous Ovarian Carcinoma
Such a carcinoma is diagnosed more often among those patients who have or are suffering from uterine fibroids, have an ectopic pregnancy, or have experienced inflammation of the appendages. Usually, against the background of the development of such a tumor, patients do not notice any changes in the menstrual cycle. Among the main symptoms, there are:
- An increase in the abdomen in volume.
- In the abdominal region, pain occurs.
- Urination can be noticeably more frequent.
Depending on the stage of the disease, the symptoms may appear or disappear, as well as intensify.
Clear cell carcinoma
This type of cancer is quite rare. Usually a malignant tumor is combined with the presence of endometriosis in a woman. Doctors do not exactly know the cause of the appearance of clear cell carcinoma of the ovaries, but suggest that this type of disease usually develops from the Müller epithelium. Usually only one ovary can be affected by this form of cancer. In appearance, the tumor may resemble a cyst. It is capable of metastasizing quickly enough, and in this regard, the prognosis for cancer therapy is not good. Often, clear cell cancer forms with adenofibroma.
Diagnostics
A set of methods for the diagnosis of ovarian carcinoma includes a physical, but also instrumental and gynecological examination. Tumor recognition can be carried out already in the process of abdominal palpation. Gynecological examination reveals the presence of bilateral ovarian neoplasm, but does not provide a clear understanding of the degree of benignity. By rectovaginal examination, the invasion of ovarian cancer is determined. Ovarian carcinoma can also be seen on an ultrasound scan.
Thanks to transvaginal ultrasound imaging and computed tomography of the pelvis, a volumetric neoplasm of irregular shape without clear capsules with a bumpy contour and uneven structure is revealed. Thanks to this study, its size is also estimated with a degree of prevalence. Performing diagnostic laparoscopy for ovarian carcinoma is necessary for biopsy and determination of the histotype of tumor formation. Also, this technique is used to collect peritoneal swabs in order to perform a cytological examination. In some situations, obtaining ascitic fluid becomes possible due to puncture of the vaginal fornix.
If ovarian cancer is suspected, a study of tumor and associated markers is prescribed. To exclude primary foci or metastases of carcinoma in distant organs, the following examinations are performed:
- Mammography and radiography of the lungs.
- Irrigoscopy and ultrasound of the abdominal region, pleural cavity and thyroid gland.
- Sigmoidoscopy, cystoscopy.
Treatment
The choice of therapeutic tactics in the presence of papillary carcinoma of the ovaries is decided taking into account the stage of the pathological process, the structure of the tumor and the sensitivity of the existing histiotype to radiation and chemotherapeutic effects. In the treatment of ovarian cancer, a surgical approach (i.e., panhisterectomy) is combined with radiotherapy and polychemotherapy.
Surgical treatment of ovarian carcinoma of the first and second degree consists in performing the removal of the uterus with resection of the greater omentum and adnexectomy. In elderly and debilitated patients, it is possible to resort to performing supravaginal amputation of the uterus, and, in addition, to a subtotal omentum resection. During the operation, a revision of the paraortal lymph node with its operative histological examination is mandatory. If the patient has a third or fourth stage, a cytoreductive intervention is performed, which is aimed at the maximum removal of the tumor mass before chemotherapy. In the presence of an inoperable process, doctors are limited, as a rule, to a biopsy of tumor tissues.
Polychemotherapy for ovarian carcinoma is carried out at the postoperative or preoperative stage. Often this approach is an independent treatment against the background of a widespread malignant process. Conducting polychemotherapy (using drugs of platinum, chloroethylamines and taxanes) makes it possible to suppress the mitosis of tumor cells. The main side effects of cytostatics are nausea along with vomiting, nephrotoxicity and inhibition of hematopoietic functions. Radiation treatment for ovarian cancer is only slightly effective.
Forecast
The prognosis for ovarian carcinoma largely depends not only on the stage of the pathology, but also on which histological type the cancer belongs to. In addition, it depends on the age of the patient. True, it should be emphasized that in comparison with other oncological diseases of the reproductive female system, ovarian malignancies are very aggressive, and the prognosis in the presence of this disease is relatively unfavorable. Even with adequate late-stage therapy, the overall survival rate is not more than ten percent.
If we take the effectiveness of surgical intervention for all stages and types of ovarian oncology, then it is worth saying that the one-year survival rate is sixty-three percent. Three-year survival is forty-one percent. Five-year survival is thirty-five percent. Regarding the five-year survival rate for different stages, the statistics are as follows:
- At the initial stage, seventy-five percent.
- In the second stage, sixty percent.
- The third stage is twenty-five percent.
- In the fourth stage, ten percent.
In addition to the stage of pathology, the prognosis also depends on the type of carcinoma. Serous and mucinous variants are usually treated easier and have a better prognosis compared to undifferentiated ones. In the presence of a stromal tumor for the first stage of the disease, the prognosis, as a rule, is ninety-five percent, and in the presence of germinogenic carcinomas, ninety-eight. For the third stage of the disease with stromal tumors, survival will be above sixty-five percent. Also, the prognosis is associated with complications present in the patient. For example, the presence of ascites significantly reduces the overall survival rate.
Reviews
In the reviews, people write that ovarian cancer (carcinoma) is an extremely serious disease in women, which poses a great danger to their life. As doctors comment on the pathology, treatment largely depends on the stage of the disease and the characteristics of the body of a particular patient.
Experts focus on the fact that ovarian carcinoma cannot be joked. It is extremely important for each woman to be regularly examined by a gynecologist in order to minimize the risks of suffering from this disease. This is especially true for women after the age of forty-five.