Symptoms, stages and treatment of ovarian cancer in women
What is ovarian cancer?
Ovarian cancer is not one, but a whole group of diseases that differ in their origin, clinical manifestation and biological properties. This type of cancer affects precisely these paired organs, which are responsible for the production of estrogen and progesterone. This is a fairly common pathology, which is most often identified among women of retirement age (from 50 to 70 years).
Also, under the definition of ovarian cancer, there is such a description as: a malignant neoplasm affecting the female genital area, which is formed from the epithelial cells of the ovaries. Quite often, the pathology manifests itself as a cyst that grows slowly and, after quite a long time, transforms into a tumor with the appearance of metastases. Particular attention should be paid to such a neoplasm for women who have entered menopause and those girls who have not yet had their periods. Most often these are malignant formations, and they account for up to 80%.
If we refer to the classification of this pathology, then there are such types as: mucinous, serous, clear cell, endometrioid, squamous and transitional cell carcinoma. In the future, oncologists divide these histological types into malignant, benign and intermediate, that is, those whose risk of developing into a malignant is minimal, but still exists.
Ovarian cancer survival
If we talk about the survival rate for cancer that affects the ovaries, then we should turn to such a concept as the survival rate, that is, to the indicator that doctors take as a certain standard. Most often, statistics are used to determine this value, which shows how many patients survived, five years after the problem was discovered. Naturally, blindly relying on these numbers is not worth it, since many die for other reasons. But nevertheless, the statistics are inexorable and directly depend on the stage at which the tumor was detected and adequate treatment started.
If cancer was diagnosed at the first stage of development, then the percentage of women who survived is quite an impressive figure - up to 95% of cases. In the second stage, from 50% to 70% of patients survive, the indicators of the third stage are more sad and amount to 35%. If we talk about a tumor detected at the last fourth stage, then in this case the percentage of survivors is no more than 20%.
Naturally, mortality depends on a number of reasons, and not only on the stage of disease progression, but the earlier the pathology was diagnosed, the more favorable the prognosis will be. In this case, factors such as the patient's age, the presence of concomitant diseases, the state of immunity, the tumor response to treatment, and other indicators should be taken into account.
If we turn to general statistics, then this pathology ranks ninth in the world among oncological diseases of the weaker sex, and is in fifth place in terms of the number of deaths of women. In this case, one and 71 women will fall ill with cancer, and one in 95 will die from it. These are the harsh statistics cited by the WHO.
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Content:
- Ovarian cancer symptoms
- Ovarian Cancer Causes
- Ovarian cancer stages
- Ovarian cancer metastases
- Ovarian Cancer Diagnosis
- Ovarian cancer treatment
- Nutrition for ovarian cancer
Ovarian cancer symptoms
This disease is complicated for diagnosis by the fact that its symptoms at the initial stages are practically absent. This can continue until the tumor reaches a very significant size and begins to "press" on the organs, causing discomfort, or until the first metastases appear.
As symptoms accompanying this stage of the development of the disease, the following can be distinguished:
- Pain in the lower abdomen or in the lumbar region, especially worse after even a slight exercise. Their nature is pulling, acute painful sensations are not typical for this type of disease.
- Quite often, women are worried about dyspareunia - this is the so-called painful sensations after intercourse.
- Sometimes irregularities in the menstrual cycle are observed, discharge appears between periods.
- Ascites is the accumulation of fluid inside the abdominal cavity.
- An increase in the volume of the abdomen, as a result of the growth of a tumor on the ovaries or as a result of the formation of fluid.
- As a result of the progression of the disease, increased pain appears, with parallel weight loss.
- Anemia is a constant companion of ovarian cancer.
- Rarely, but still there is an increase in the lining of the uterus, the growth of the mammary gland and hair. This is due to the fact that the tumor itself produces hormones.
- Uterine bleeding, which is not associated with menstruation, is often the reason for women who have entered menopause to see a doctor.
- Loss of appetite, stool disturbances, unreasonable nausea.
- Frequent urination.
- Excessive satiety during meals.
- Increased fatigue, irritability, weakness.
- A blood test will show a high ESR, since there is a focus of inflammation in the body.
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When the tumor has metastases, spreading to other organs, then patients feel pain in the bones, headaches. Convulsive seizures, cough with hemoptysis may occur. Often there is a proliferation of secondary tumor foci, which are located on nearby organs and tissues.
The first signs of ovarian cancer
The first signs of this pathology are quite blurred, which is why the disease remains undetected for a long time. However, there are a number of certain features that you should pay attention to and inform your doctor about it.
The following signs can help you suspect ovarian cancer:
- Unpleasant sensations in the abdomen. They may not even be painful, but similar to those that occur with diarrhea.
- Slight malaise and weakness against the background of general well-being.
- The feeling of something foreign in the lower abdomen, this feeling is enhanced when the body bends, after going to the toilet and after eating. Up to 60% of women who have had ovarian cancer describe similar feelings.
- Deviations in the leukocyte balance and a jump in ESR can be observed during a blood test.
These are the signs of the disease at the initial stage. Since they are very nonspecific, then if similar sensations arise, it is advisable to undergo a general examination.
Ovarian Cancer Causes
As the main causes of ovarian cancer, it is customary to single out several underlying factors.
It is their WHO that characterizes them as the most often leading to a pathological state of the body:
- Hereditary predisposition. This means that if there were cases of ovarian cancer in the family, as well as of the breast or other pathologies of the reproductive system leading to the appearance of tumors, then every woman in the family should be extremely attentive to her health. This fact is explained by the fact that mutations in the genes responsible for the emergence and development of tumors, in about 10% of cases, can be hereditary. This is why it is so important to know your family history.
- The woman's age is after 45 years and older. That is, from the moment a woman enters menopause, there is a real risk of ovarian cancer, especially against the background of hormone therapy.
- Family history of polyposis symptoms.
- Hormonal disruptions in the body, in particular an increase in the number of androgens. Disorders in the adrenal glands, pituitary gland, or severe ovarian dysfunction.
- Overweight is one of the common causes of this pathology. It should also be noted that the death rate from tumors among such women is higher than among those whose body weight does not exceed normal.
- Early puberty.
- It is generally accepted that hormonal contraceptives reduce the risk of developing a malignant tumor on the ovaries, but violations of the dosage regimen can, on the contrary, provoke its growth.
- Prophylactic oophorectomy.
- Abortion and promiscuous sex that leads to frequent STDs. All this can provoke the development of ovarian cancer.
- Infectious diseases of the ovaries, which are inflammatory in nature and occurring in a chronic form.
- Smoking and alcohol abuse, as well as unhealthy diet.
- Radiation exposure.
See also: Other Cancer Causes and Risk Factors
Ovarian cancer stages
It is customary to distinguish four stages in the development of this pathology. They are numbered depending on the progression of the disease:
- In the first stage, the ovary is directly affected. The process can include either one or both organs.
- At the next stage, the disease begins to capture more and more "territories": the uterus and nearby organs.
- The third stage is characterized by damage to the lymph nodes, as well as the peritoneum.
- The last stage is the worst amenable to therapy and is characterized by the fact that the tumor spreads its metastases to organs located in the distance. The liver and lungs may be affected.
Stage 1 ovarian cancer
The first stage is the very beginning of the process, when the tumor is located directly inside one or a pair of ovaries and does not go beyond it.
It has its own characteristics, and doctors assign the disease the corresponding abbreviations, under the first number (1a, 1b, 1c):
- In the first case, the tumor is localized in one ovary, malignant cells are not detected. When performing a laboratory washout from the pelvis, cancer cells are not detected.
- In the second case, the process affects both organs, but there is no confirmation that the neoplasm is malignant.
- In the third case, the process affects both ovaries, the malignant process goes outside the organ, and when the washings are carried out, the cancer cells can be diagnosed. Sometimes there is a rupture of the capsule of the neoplasm.
The first stage of the development of the disease is very difficult to diagnose, therefore, as a rule, the process is detected at later stages.
Stage II ovarian cancer
If untreated, ovarian cancer continues to progress and enters the next stage of its development. It is characterized by the fact that the tumor, in addition to being located on both ovaries, also involves other organs in the small pelvis in the pathological process. The rectum and sigmoid colon, uterus and tubes, and the bladder are often involved. This is what causes certain symptoms associated with the appearance of abdominal discomfort.
Doctors also classify the second stage according to the severity (2a, 2b, 2c):
- The first is characterized by the spread of the tumor to the body of the uterus and to the fallopian tubes.
- In stage 2c, the tumor spreads further and can invade the rectum and bladder.
- At the final stage of the second stage, the formation, as in the previous two, affects the pelvic organs, but during laboratory washings, tumor cells are detected. In contrast to stages 2a and 2c.
As for the symptoms, most of the women who were diagnosed with the disease during this period indicate that they felt painful tingling and stretching in the lower abdomen, as well as periodically there were pains in the hypochondrium and just in the abdominal cavity, localized in different places. If the pelvic organs are affected, then, depending on the nature of the damage, there is a frequent urge to urinate or an intestinal disorder is observed. Sometimes a hard area is found on palpation.
Stage III ovarian cancer
It is at the third stage of the development of ovarian cancer that women most often seek help. Up to about 70% of all cases are identified in this particular period. The process is already going quite far, but it is still reversible. The tumor affects not only the pelvic organs, but also affects the abdominal cavity and lymph nodes.
Just like the two previous stages, oncologists divide the third into several similar subgroups (3a, 3b, 3c):
- The first abbreviation is characterized by the absence of visible metastases in the abdominal cavity and lymph nodes, but microscopic examination reveals the smallest malignant cancer cells in the abdominal biopsies.
- If we talk about the next stage, then the lesions of the abdominal cavity are already becoming visible to the naked eye, during the operation. But metastases do not exceed a size of more than 2 cm, while the lymph nodes remain unaffected.
- In the final subgroup of the third stage, in addition to the presence of metastases in the abdominal cavity, which reach 2 cm or more in diameter, cancer cells can be found in the lymph nodes.
Stage 4 ovarian cancer
This is the last stage in the development of the oncological process, when metastases have spread beyond the abdominal cavity and reached distant organs. The lungs and liver are often affected. The presence of pleural fluid in the peri-pulmonary space is often observed. The pain practically does not recede and the patients are prescribed potent drugs.
In such cases, the symptoms become more pronounced, a woman turns to doctors with complaints of abdominal pain, which are intense, sometimes it increases significantly in size. A disease that has come this far is extremely difficult to treat and the prognosis is usually poor.
Ovarian cancer metastases
Regardless of what type of cancer affects a woman's ovaries, each of them can metastasize. Their presence or absence, as well as the degree and nature of proliferation, is of enormous importance for determining the treatment regimen. Most often, they begin to appear in the case when the disease has gone quite far and therefore the pathological process captures many organs.
If we talk about germination, then metastases capture those organs that are located in the immediate vicinity of the ovaries. Quite often, both the uterus and the tubes (fallopids) are affected. When it comes to migration, this process is the separation of tumor cells and penetration into the abdominal cavity with the capture of organs located there. In medical language, this concept is referred to as "seeding". As for the spread, this is the "journey" of malignant cells through the lymph nodes to any other organs, regardless of their location. Remote systems such as the pulmonary or cardiovascular systems are sometimes affected. In this case, the tumor, which is located in the ovary, is called primary, and if, as a result of its spread, neoplasms have arisen, for example, in the lungs,then oncologists call them metastases of ovarian cancer.
If we consider the sequence of spread of metastases from the ovary to other organs, then the following pattern is most often traced: first, the peritoneum is affected, then the lymph nodes, through which cells are transferred to the liver, pleura and diaphragm. Often, the intestines and fallopian tubes are affected. But this sequence is rather arbitrary, and depends on the characteristics of the course of the disease.
Ovarian cancer is the most dangerous of the possible tumors that arise in the female body, since it gives the most metastases, which incredibly quickly cover new territories. Naturally, the type of tumor depends on the characteristics of their growth. The most dangerous is epithelial neoplasms, which quickly affect the peritoneum, the greater omentum and the lymphatic system. The peculiarity of metastatic tumors is that they are practically insensitive to the effects of chemotherapy and to radiation exposure. That is why their removal is possible only by surgery.
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Ovarian Cancer Diagnosis
Diagnosis of this disease in most cases is rather difficult. This is justified by the fact that the symptoms of the disease are rather blurred and overlap with similar manifestations of other pathologies that are considered less dangerous.
In case of suspicion of the presence of education in the ovaries, the doctor prescribes either an ultrasound or computed tomography. Based on the data obtained, one can judge the size of the tumor and make some assumptions about its nature.
Also, the doctor will need to collect and analyze the anamnesis of complaints and diseases, the nature of the pain, to study the previous gynecological diseases, operations, the number of pregnancies and other information. Information about the onset of menstruation, its nature and cycle duration is important. Naturally, a gynecological examination with bimanual follow-up is required.
Sometimes diagnostics is carried out using a special device - a laparoscope. After making a small incision, the doctor inserts the machine into the peritoneum and uses it to examine the ovaries. If it is established that the organ has been struck by a benign cyst, then its removal is not required, it is enough, only periodic observations by a gynecologist. If, as a result of the data obtained, there is a suspicion of ovarian cancer, then surgical intervention is necessary, which allows you to determine what the neoplasm is and stop its spread. In the event that fluid accumulates inside the abdominal cavity, the doctor makes a small puncture and takes it for examination to make sure the presence or absence of malignant cells.
The complete list of methods that are used to diagnose ovarian cancer consists of the following studies: computed and magnetic resonance imaging, laparoscopy, ultrasound of the pelvic organs. In addition, biopsy and microscopic examination may be required.
Ovarian cancer treatment
When such a diagnosis is made, there can be no other options: surgical intervention is clearly indicated. The immediate scope of the operation will depend on the nature of the tumor: malignant or benign, as well as the stage of its development. If the disease has struck an organ, then only its removal is possible. The fallopian tube will also have to be removed. When the disease has progressed, then removal of both ovaries and the uterus is most often required. Nearby lymph nodes, as well as soft tissues, are subject to elimination. This is done to remove metastases.
Sometimes surgical intervention is delayed in time. This is done in cases where it is impossible to fulfill its technical side, It should be noted that in the early stages of detecting the disease, surgical intervention gives very good results, and women even manage to preserve their fertility. This applies when the tumor affects one organ.
After the operation is performed, the patient is required to be prescribed radiation and chemical therapy. The purpose of these procedures is to destroy those possible cancer cells and foci that have not been surgically removed.
Chemotherapy for ovarian cancer
The most pronounced effect during chemotherapy is exerted by ethyleneimine derivatives (etymidine, cyclophosphamide and other drugs), but they must be combined with agents belonging to the group of alkalizing compounds. Indications for the use of chemotherapy in patients are ovarian cancer at any stage. But medical withdrawals are also possible, which are prescribed in cases when a woman's general condition is assessed as severe, the disease is at the terminal stage, there are concomitant diseases, such as tuberculosis, parenchymal hepatitis, glomerulonephritis and other indications.
The drugs are administered in courses, the timing and duration of which depends on the severity of the course of the disease, as well as on the indicators of the effectiveness of treatment. At the first stages of the initiation of therapy, doctors try to create the maximum concentration of the therapeutic agent in the body, the next stage of administration is most often prescribed after 6 weeks, and then, depending on the indications.
The methods of drug administration are best combined, but the main one is intravenous, since it is considered the most effective. The dosage is chosen on a strictly individual basis, based on the blood tests received.
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Nutrition for ovarian cancer
It should be understood that no diet or dietary regimen will help cure ovarian cancer. This is a disease that is susceptible only to drugs and a surgical scalpel. Nevertheless, in the postoperative period and after several courses of chemotherapy, you can help your body recover. To do this, you can adhere to a certain dietary scheme, in which dishes for the most part should consist of grain products, and also be rich in fiber. Naturally, this includes any fruits and vegetables. If you do not completely refuse, then, if possible, avoid the presence of fatty meat, sausages, as well as sugar and refined oils on your table. Alcohol is almost completely banned.
A sample menu for a week might look like this:
- On Monday, you can drink any juice for breakfast, citrus nectar is perfect. For an awakening meal, you can eat an egg omelet and bread with butter. For lunch, a vegetable soup is suitable, the basis of which should be carrots and celery, with a small slice of black bread; as a second course, you can put pepper stuffed with any vegetables on the table. For dinner, you should boil buckwheat porridge with butter, make a salad of fresh cucumbers and radishes. Wash it all down with weak tea. If you want to have a snack in the late evening, you can drink a glass of milk.
- On Tuesday you can start your day with fresh carrot juice, stewed zucchini and rye bread. For lunch, let there be soup with semolina dumplings and pumpkin cutlets, you can diversify the menu with baked fish. Fruit and jelly are perfect for dessert. For dinner, you can prepare a salad with vegetables and boiled rice. A glass of low-fat yogurt is allowed before bed.
- Start Wednesday morning with grapefruit juice and Peking cabbage salad. At lunchtime, the table will feature dishes such as cabbage soup, eggplant caviar and turkey either boiled or steamed. You can supplement the dishes with fresh fruits and compote. Dinner should consist of boiled buckwheat with any stewed vegetables, green tea and subsequently kefir.
- Thursday is worth celebrating with apple, bean and greens salad. For lunch you can eat onion soup, salad with cabbage and apples, and tea with milk. Dinner can consist of millet porridge with any nuts and tea. Before going to bed, you can drink a glass of yogurt.
- On the last working day of the week in the morning, grape juice is perfect; boiled potatoes with any greens can be used as a hearty breakfast. For lunch, you should cook lentil soup, a couple of carrot and apple salads, as well as cabbage and celery with prunes. You can supplement the dishes with fruit drink and pears. For dinner, you can stew beets, season them with walnuts and wash them down with black tea and a slice of the same bread. The last snack should be yogurt.
- Weekend morning needs to start with blackcurrant juice and porridge friendship. At lunchtime, you can indulge yourself with noodle soup and salad with cheese and eggs, supplemented with steamed fish; you can drink compote for lunch. For dinner, prepare a radish with a cucumber and a sandwich with squash caviar and tea. Before going to bed, you can drink a glass of milk.
- Start the last day of the week with pear juice, rice porridge and dried fruits. For lunch, tomato soup, a salad of cottage cheese and parsley, as well as chicken fillet baked in the oven are perfect. As a dessert, you can eat fruit and drink jelly. Dinner should consist of steamed green beans, eggplant stew, and tea. Before going to bed, you can drink a glass of kefir.
This diet is very conditional, dishes can be combined and complicated depending on your preferences. But, nevertheless, food, consisting of an abundance of vegetables, fruits and cereals, will help the body to spend energy fighting disease, and not digesting food.
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The author of the article: Bykov Evgeny Pavlovich | Oncologist, surgeon
Education: graduated from residency at the Russian Scientific Oncological Center. N. N. Blokhin "and received a diploma in the specialty" Oncologist"
