Compared to other gynecological cancers, ovarian cancers in the early stages do not show any preliminary symptoms. Routine ultrasound examinations play a major role in the diagnosis of ovarian cancer, where early diagnosis is important.
What is Ovarian Cancer?
Epithelial cells form the main structure of the ovaries, the tissue of which contains many different cells. Ovarian cancer occurs as a result of uncontrolled division and proliferation in epithelial or embryonic cells. 80% of ovarian cancers occur in epithelial tissue, which is mostly seen after menopause. Embryonic tumors are seen in 60% of ovarian cancers observed under the age of 20.
What are the Symptoms of Ovarian Cancer?
Ovarian cancer symptoms usually do not show themselves very well, although most of the symptoms are specific to the patient, they do not have a typical finding. Within the scope of ovarian cancer symptoms, it can be said as a symptom of many diseases; Abdominal pain, bloating and stomach ailments are possible.
The biggest symptom of ovarian cancer is a palpable mass in the abdomen in its advanced stages, a feeling of downward pressure, fluid accumulation in the abdomen, abdominal swelling, urinary and intestinal complaints due to pressure on the surrounding organs.
In some types of ovarian cancer, it is possible to see hormone irregularities. As a result, it is possible to see menstrual irregularities, hair growth due to increased male hormone secretion, and male pattern hair loss. Many ovarian cancer complaints are related to abdominal distension.
We can list the general symptoms of ovarian cancer as follows;
- Change in bowel habits, especially the appearance of constipation,
- Change in bladder habits, the need to urinate frequently,
- Loss of appetite or feeling full quickly
- vaginal bleeding,
- weight loss,
- Feeling of pressure and bloating in the abdomen,
- Fullness or pain in the groin,
- Prolonged indigestion, gas or nausea.
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What Causes Ovarian Cancer?
Although the causes of ovarian cancer are not clearly known, it can be said that some risk factors cause this disease. Genetic, environmental and hormonal factors can be counted among the causes of ovarian cancer. We can list the causes of ovarian cancer as follows;
- Those with a family history of breast or ovarian cancer are at increased risk.
- In recent years, changes in some genes have led to an increased risk of ovarian cancer.
- The risk of ovarian cancer increases in those who use drugs that increase ovulation.
- The use of birth control pills reduces the risk of ovarian cancer.
- The risk of ovarian cancer is higher in those who have never been pregnant. The risk is reduced in those who have given birth.
How Is Ovarian Cancer Diagnosed?
As with other types of cancer, early diagnosis is very important in ovarian cancer. It is recommended that women do not delay their annual routine gynecological controls for early diagnosis. A palpable mass in a gynecological examination or a mass seen in the ovaries during an ultrasound gives the chance to intervene early in cancer.
Not every cyst in the ovaries means cancer. Most cysts seen in women of reproductive age are simple and harmless. These cysts, which disappear spontaneously over time, do not carry the risk of cancer. For this reason, it is determined whether the cysts observed on ultrasound by the specialist doctor are harmful or do not have any negative effects on the body. In addition, all types of cysts in menopausal women and premenstrual young girls are susceptible to tumor risk and must be evaluated in this respect.
In advanced stages of ovarian cysts and masses with tumor features, tumor markers should be checked in the blood. Some tumor markers (especially CA 125) are elevated in some types of ovarian tumors. However, high levels of CA125 and other tumor markers do not always indicate that the mass is cancer, and low tumor markers do not exclude cancer. Apart from tumor markers, Doppler ultrasonography also shows blood flow changes and can help distinguish between benign and malignant tumors. All these methods are auxiliary techniques. None of them is sufficient to make a definitive diagnosis. In cases that cannot be differentiated from cysts and masses that are thought to be tumoral (whether benign or malignant), performing surgery and taking a pathological sample biopsy during the operation provides a definitive diagnosis.
In the presence of a cyst, if tumor markers and Doppler examinations are normal, there are no findings suggesting a tumor on ultrasound and examination, and if the cyst is smaller than 8 cm, it can be followed for a while. If there is no shrinkage or disappearance during follow-up, surgery should be preferred.
How Is Ovarian Cancer Treated?
Ovarian cancer treatment is surgical, not only the uterus and ovaries, but also all tissues that are likely to be retained in the body are removed and chemotherapy is given after surgical treatment. Surgical technique is used in all stages of ovarian cancer. In the treatment of ovarian cancer, if removal of the mass carries the risk of damaging vital organs, it is aimed to reduce the mass with chemotherapy first. Then, cancerous masses and tissues are intervened with surgical method. After ovarian cancer surgery, chemotherapy may not be required if the cancer does not spread throughout the body. If ovarian cancer has spread, chemotherapy or radiotherapy should be administered. Although chemotherapy varies according to the stage of the disease, 6-9 cycles are applied after surgery.
New treatment alternatives in ovarian cancer are now frequently applied in our country. Treatments with targeted agents increase the likelihood of cure, prolong survival, and provide significant symptomatic relief. In the treatment of ovarian cancers, great care is taken to protect reproduction. In germ cell ovarian cancers and borderline type ovarian cancers seen at an early age, only the cancerous tissue or cancerous ovary is removed, the uterus and contralateral ovary are protected and conception is made possible.
Frequently asked Questions
The response of ovarian cancer to treatment is directly related to how far the tumor has spread. When ovarian cancer is diagnosed at an early stage, it can be eliminated by 80 percent with appropriate treatments. The cure rate for advanced ovarian cancers is 40-50%. After ovarian cancer surgery and chemotherapy, it should be checked regularly against the possibility of recurrence of the disease.
Ovarian cancer (ovary) is a very important disease that can seriously threaten women’s health and life and can be seen at any age. It is the most lethal among female genital organ cancers. Compared to other gynecological cancers, ovarian cancers in the early stages can be diagnosed very late, as they do not show any preliminary symptoms. Therefore, routine gynecological USG is important in early diagnosis.
Ovarian cancer is divided into two depending on the type of tissue it originates from, the type of the disease changes the probability of occurrence and the age of onset. People who have never given birth and have a family history of breast and ovarian cancer are at higher risk of developing the disease. However, the most important risk factor is considered to be advanced age. Estrogen hormone support alone, especially after menopause, is among the factors that trigger ovarian cancer.
CA125 is a protein on the surface of many ovarian cancer cells. It may be significantly higher in the blood of women with ovarian cancer. Small amounts of this protein can also be produced in some other cancers.
Values between 0 and 35 in the CA 125 test are normal values. If there is a figure between 35-50, this patient should be under control. At values above 50, ovarian cancer is suspected, but CA 125 may not be high in every ovarian cancer.
Ovarian cancer is likely to spread to various organs in advanced stages. In the treatment, it should be known whether it spreads around the ovary and to the surrounding organs. The most important feature of this cancer is the spread to the intra-abdominal organs. Patients are usually diagnosed at an advanced stage, as there is a rapid spread to the intra-abdominal organs. Ovarian cancer can spread to the small and large intestines and may metastasize to the peritoneum, pelvis, lung and liver.
Since symptoms such as digestive complaints, pain in the groin area and constipation can be seen in ovarian cancer, patients may go to gastroenterology or internal medicine services and lose time to see if there is a problem in the digestive system. Sometimes the diagnosis can even be made by these doctors. If there is a digestive system problem in the advanced age group, it is absolutely necessary to apply to the gynecology department.
If there is fluid collection in the abdomen and tumor spread in the advanced stage, open surgery is performed. In some cases, it is looked at and observed by laparoscopy. If there is no large spread, tumors seen in the same session can be removed. In these patients, the uterus, ovaries, lymph nodes can also be removed by laparoscopic or robotic surgery, as well as appendicitis in the needed group. Chemotherapy is planned according to the pathology.
