Ovarian cancer is a common oncological disease in gynecology. Every year, more than 220 thousand women hear a disappointing diagnosis, with most of the cases ending in death. Carcinoma is usually discovered very late, because there are no specific symptoms, and metastases appear quite early. It is for this reason that disease awareness and regular check-ups are important.
Tumor features
More than 70% of ovarian tumors are benign neoplasms that can go unnoticed for many years and practically do not pose a danger to the patient's he alth. But sometimes benign formations can degenerate into malignant ones. 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 mostcommon tumors of the female gonads of a malignant nature. It develops from cells of the glandular epithelium, can affect both ovaries or only one. The tumor is a multi-chamber node with septa. It can break the ovarian capsule when it reaches a significant size, and neighboring organs. This type of cancer is diagnosed at any age, but is more common in women over forty.
Ovarian adenocarcinoma is characterized by rapid growth. It can move to neighboring tissues and is prone to early metastasis. The tumor secretes toxins that worsen the patient's condition and suppress immune defenses. With the help of a special mechanism, a malignant tumor can hide from the body's immunological control.
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 of 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.
Reason for development
Modern medicine does not know the exact causes of 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. It won't help to eat a lot of fat,poor nutrition, poor environmental conditions, exposure to various types of radiation, excess weight, weak immunity, alcohol consumption and smoking. If the ovaries are significantly enlarged, this may indicate the development of a tumor or be a predisposing factor.
Causes of enlarged ovaries in women are usually as follows:
- taking hormonal drugs (oral contraceptives);
- hormonal imbalance;
- lactation period (due to natural increase in prolactin concentration);
- prolonged stress or depression;
- dramatic change in body weight;
- diseases of the endocrine system;
- neoplasms of a malignant or benign nature.
Ovarian enlargement is possible in girls at 12-13 years old - this is a normal phenomenon that does not require treatment. The causes of ovarian enlargement in women are pathogenic microflora, cervical erosion or inflammation of the appendix.
Provoke the development of adenocarcinoma can:
- uterine fibroids;
- infertility or frequent pregnancies and childbirth;
- ovarian dysfunction;
- diseases of the endocrine system and hormonal disorders;
- uterine bleeding;
- menstrual irregularities;
- abortions and genital surgery;
- menopause too early or too late.
The risk of developing tumors increases with age. It is believed that girls who have not given birth are more susceptible to cancer. And some even think thatcauses of ovarian cancer are the use of talc-based cosmetics.
Disease classification
Different types of tumors are classified according to the histotype. The most common form of cancer is serous ovarian adenocarcinoma, which is diagnosed in 80% of cases. This is an aggressive type of cancer. The tumor reaches a large size and often affects both ovaries. Metastases in the abdominal organs are observed already in the early stages. Serous adenocarcinoma has a high mortality rate.
Approximately 10% of cases are diagnosed with endometrioid adenocarcinoma. 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 affects only one of the ovaries.
Pale cell adenocarcinoma is rare (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. Isolate undifferentiated adenocarcinoma.
Depending on the complexity of the course of the disease, poorly differentiated adenocarcinoma is isolated. In this case, a large number of cancer cells are detected, which are very different fromhe althy. 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, adenocarcinoma borderline, 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 beginning 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 to the pelvic organs and fluid accumulation. The disease is detected in 13% of patients.
- At the third stage, metastases up to two centimeters in diameter are diagnosed in the abdominal cavity, 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. Found in 17% of cases.
If the disease is diagnosed in the first stage, the survival rate reaches 85-90%, in the second - 70-73%, the third - approximately 20-30%. At the last stage, the survival rate reaches only 1-5%. Most patients die due to metastases in the brain, lungs, bones and liver.
Clinical picture
In the early stages of symptomseven with poorly differentiated adenocarcinoma may be absent. Signs of cancer are mistaken for other disorders, so doctors misdiagnose.
The main symptoms of a gonadal tumor are:
- heavy bleeding during menstruation and soreness;
- disorders of the digestive tract;
- pain in the lower abdomen, which intensifies as the tumor grows;
- enlarged lymph nodes;
- pain after sex;
- fatigue and a general feeling of weakness.
With a significant size of the tumor, the abdomen may increase. Some symptoms are similar to the onset of menopause, which is why women mistakenly attribute them to menopause, missing out on 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 enlargements. If cancer is suspected, they will be referred for a 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 the disease with enlarged ovaries. This can be confirmed by ultrasound. The patient can decipher the data of the study on her own. The normal sizes of the ovaries in women are 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.
Sizes may vary depending on the phase of the cycle and the state of the organism as a whole. Deviation from the norm in the size of the ovaries in women does not always directly indicate oncology.
MRI and CT scans are performed to obtain images to identify metastases in other organs. A biopsy is performed under CT guidance. 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 a study for tumor markers.
A biopsy will help to accurately determine the nature of the neoplasm. During the procedure, a sample is taken and then examined under a microscope.
Laparoscopy involves examining the peritoneum through a special device that is inserted through an incision in the abdomen. The image is transferred to the monitor. The method allows you to assess the prevalence of the tumor, the stage, the situation as a whole.
Lifespan
With early detection of ovarian adenocarcinoma, the prognosis can be favorable. In the early stages, removal of the tumor is indicated, while it has not yet metastasized. Removal of the ovaries in women is carried out so that the disease does not spread. In the second stage, life expectancy is significantly reduced. After the appearance of metastases within five yearsonly 10% of patients survive, and those patients for whom it is decided to refuse surgery live from one to three years.
Treatment of adenocarcinoma
Therapy is mainly indicated by surgery. During the intervention, the removal of the ovaries in women is performed. They can cut out the uterus and appendages if they are also affected. But usually surgeons try to remove only the neoplasm so that the woman can have children in the future. Before the intervention, a course of chemotherapy is prescribed to reduce the tumor. The same method is used after surgery if cancer cells remain.
The essence of the method is the use of toxins and poisons that have a detrimental effect on 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, procedures are not needed, but only help with the appointment of an operation. With a well-differentiated adenoma, for example, the survival rate after the intervention is 95%. The tactics of treatment depends 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, constant monitoring is required. To prevent recurrence, ultrasound and blood tests for cancer markers are regularly performed.
Additionally, the doctor gives the patient recommendations on lifestyle. You should give up bad habits and carefully monitor your he alth, because the body is greatly weakened. Timely treatment of all concomitant diseases is important. Nutrition for adenocarcinoma of the ovaries should be complete. A predominantly vegetarian menu is recommended for women.
Surgical treatment
In most cases, the tumor is detected when it has already grown. In this case, removal of the ovaries is indicated, possibly together with the uterus and appendages. Sometimes only part of the tumor is removed to reduce its volume. If no more than 1 cm of neoplasm remains after the intervention, then the intervention is called optimal. Sometimes oncology affects neighboring organs, such as the gallbladder, part of the stomach or liver. In this case, these organs must also be removed.
After the removal of the internal genital organs, a woman will no longer be able to have children in the future. With a unilateral lesion, detected in the early stages, it is possible to preserve the childbearing function. Less traumatic laparoscopic surgery. 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 at the initial stages of development. Otherwise, extensive surgery is needed.
Proper nutrition for oncology
To reduce the adverse effects of cancer therapy on the body, the patient must eat well. To restore strength, you can introduce honey into the diet (if there is no allergy to bee products), nuts, take vitamin complexes.
It is necessary to exclude from the menu toofatty and meat foods, smoked meats, spices and marinades, refined oils. Sugar and s alt intake should be limited.
Useful fresh fruits and vegetables, grains, lean meats, legumes, fish dishes. It is equally important to normalize weight, give up bad habits, ensure the absence of stress factors and good rest, and follow the regime.
Disease prevention
Prevention of any type of cancer involves the exclusion of the influence of factors that may affect the development of the disease. It is necessary to normalize weight, give up all bad habits, avoid stress and eat right. Exposure should be avoided whenever possible.
It is important to monitor your he alth and treat all pathologies in a timely manner. If you have any alarming symptoms (it must be remembered that the early signs of cancer are very similar to the onset of menopause), you should immediately consult a doctor, without postponing 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.
