The ovaries are the most important organ of the female reproductive 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 manifest.
Causes of ovarian carcinoma
As with most types of oncological pathologies, ovarian cancer does not have a clearly established etiology. However, it has been found that a number of circumstances can contribute to the occurrence of this disease.
So what causes 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 are much more likely to get this disease. Women are also included in the risk groupwho had early menstruation (up to 12 years) and late menopause, that is, menopause came after 55-60 years. There is a widespread theory that a large number of ovulations puts a strain 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. Studies show that this cancer is much more common 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). In many ways, this is directly related to the fact that during this period, which is called premenopause, a gradual decrease in hormone levels is observed. You can not discount other circumstances that, according to doctors, are universal factors for different types of oncological ailments.
These include:
- Regular stress along with reduced immunity.
- Unhe althy diet combined with a lack of plant fiber in the diet, an increased amount of animal fats and so on.
- Development of beriberi and bad habits.
- The patient is obese or diabetic.
- Exposuresedentary lifestyle.
- Live in a bad environment.
- Prolonged action of carcinogenic components.
Symptoms
When ovarian carcinoma appears in women, urinary retention and its increase 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 also possible 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 extremities. However, in most situations, these symptoms may indicate that the cancer is already at an advanced 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 overwork. At a later stage, fluid accumulation in the chest area is also not ruled out, which leads to shortness of breath. Among other possible manifestations that are observed in ovarian carcinoma, it should be noted:
- Development of pleurisy and swelling of the extremities.
- The appearance of lymphostasis and intestinal obstruction.
- The presence of an increased level of ESR in the blood.
- Appearance of uterine bleeding not related to menstruation.
Thus, ovarian cancer at an early stage does not have any specific features. And its most likely detection option is regulardiagnostic examination by a gynecologist.
Serous carcinoma
Serous ovarian carcinoma involves an excessive accumulation of malignant neoplasms that develop from the epithelium. That is, the tumor arises from the epithelial tissue that has been 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 rudimentary remnants of the genital organs left after standard organs formed in a woman's body.
- Presence of invaded epithelium entering the ovaries from the fallopian tubes or from the uterus.
Currently, there are several varieties of this pathology:
- Appearance of serous papillary ovarian carcinoma.
- Development of adenofibroma.
- Formation of superficial papillary carcinoma.
- The occurrence of papillary-type serous cystoma.
Various types of serous cancer are treated with special medications.
What is endometrioid ovarian carcinoma?
The occurrence of endometrioid ovarian cancer is associated mainly 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 cancerassociated with endometrial cancer. The neoplasm consists of a significant number of confluent oval and tubular glands, villous structures, and proliferation of spindle 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 species affects only one ovary and very rarely can switch to the opposite one. The tumor in this case progresses very slowly and is therefore very difficult to diagnose. According to statistics, seventy-five percent of patients learn about their disease only at a late stage, when treatment is quite difficult. Epithelial cancer usually develops in patients over the age of fifty. He acts along with the most common look.
Mucinous carcinoma of the ovary
Such a carcinoma is diagnosed more often among those patients who were ill or are ill with uterine fibroids, had an ectopic pregnancy, or 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 are:
- Increased belly volume.
- Pain in the abdominal region.
- Urine may become noticeably more frequent.
Depending on the stage of the disease, 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 don't know exactly what causes clear cell carcinoma of the ovary, but they suggest that this type of disease usually develops from Müllerian epithelium. Usually, cancer of this form affects only one ovary. In appearance, the tumor may resemble a cyst. It is able to metastasize quite quickly, in connection with this, the prognosis for cancer therapy is gloomy. Clear cell carcinoma often develops along with adenofibroma.
Diagnosis
A set of methods for diagnosing ovarian carcinoma includes performing a physical, as well as instrumental and gynecological examination. Recognition of the tumor can be carried out already in the process of palpation of the abdomen. Conducting a gynecological examination makes it possible to detect the presence of a bilateral ovarian neoplasm, but does not provide a clear understanding of the degree of goodness. By means of a rectovaginal examination, the invasion of ovarian cancer is determined. Ovarian carcinoma can also be seen on ultrasound.
Thanks to transvaginal echography and computed tomography of the small pelvis, a volumetric neoplasm of irregular shape without clear capsules with a tuberous contour and an unequal structure is detected. Thanks to this study, its size is also estimated with the degree of prevalence. Performing a diagnostic laparoscopy for ovarian carcinoma is necessary for biopsy anddetermination of the histotype of the tumor formation. Also, this technique is used to collect peritoneal washings in order to perform a cytological study. In some situations, obtaining ascitic fluid becomes possible due to the puncture of the vaginal fornix.
In case of suspicion of ovarian cancer, a study of tumor and associated markers is prescribed. To exclude primary foci or metastases of carcinoma in distant organs, the following types of examinations are carried out:
- Perform mammography and lung x-rays.
- Irrigoscopy and ultrasound examination of the abdominal region, pleural cavity and thyroid gland.
- Sigmoidoscopy, cystoscopy.
Treatment
The choice of therapeutic tactics in the presence of papillary ovarian carcinoma 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 chemotherapy. Ovarian cancer therapy combines a surgical approach (i.e. panhysterectomy) with radiotherapy and polychemotherapy.
Surgical treatment of ovarian carcinoma of the first and second degree is to perform removal of the uterus with resection of the greater omentum and adnexectomy. In elderly and debilitated patients, it is possible to resort to supravaginal amputation of the uterus, and, in addition, to subtotal resection of the omentum. During the operation, it is necessary to conduct a revision of the paraortal lymph node with its operational histologicalresearch. If the patient has the third or fourth stage, cytoreductive intervention is performed, which is directed to the maximum removal of the tumor mass before chemotherapy. In the presence of an inoperable process, doctors usually limit themselves 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 (with the help of platinum preparations, chlorethylamines 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 hematopoietic depression. Radiation treatment for ovarian cancer is only marginally effective.
Forecast
The prognosis for ovarian carcinoma largely depends not only on the stage of the pathology, but also on the histological type of cancer. In addition, it also depends on the age of the patient. True, it should be emphasized that, in comparison with other oncological diseases of the female reproductive system, ovarian malignancies are highly aggressive, and the prognosis in the presence of this disease is relatively unfavorable. Even with adequate therapy at a late stage, the overall survival rate is not more than ten percent.
If we take the effectiveness of surgical intervention for all stages andtypes of ovarian cancer, it is worth saying that the one-year survival rate is sixty-three percent. The three-year survival rate is forty-one percent. The five-year survival rate is thirty-five percent. Regarding the five-year survival rate for different stages, the statistics are as follows:
- In the initial stage - seventy-five percent.
- In the second stage - sixty percent.
- Third stage - twenty-five percent.
- At the fourth stage - ten percent.
Besides the stage of pathology, the prognosis also depends on the type of carcinoma. Serous and mucinous variants are usually easier to treat and have a better prognosis than undifferentiated ones. In the presence of a stromal tumor, the prognosis for the first stage of the disease is usually ninety-five percent, and in the presence of germ cell carcinomas, ninety-eight. For the third stage of the disease with stromal tumors, the survival rate will be above sixty-five percent. Also, the prognosis is associated with the complications present in the patient. For example, the presence of ascites significantly reduces the overall survival rate.
Reviews
In reviews, people write that ovarian cancer (carcinoma) is an extremely serious disease in women, representing a great danger to their lives. 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.
Specialists emphasize that ovarian carcinoma is not to be trifled with. It is extremely important for every woman to be regularly examined by a gynecologist,to minimize the risks of suffering from this disease. This is especially true for women over the age of forty-five.
