Ovary cancer

Definition

Ovarian cancer, or ovarian cancer, is a gynecological neoplasm that affects the ovaries. The ovaries are female glands responsible for the production of female hormones (estrogen and progesterone), the hormone testosterone and eggs for fertilization. Every woman has 2 ovaries located at the end of the uterine tubes.
Ovarian cancer usually originates in the surface cells of the ovary (epithelial cells) and this type of tumor is called epithelial carcinoma. Another common type of tumor is the malignant tumor of the germ cells, which give rise to oocytes. Stromal tumors affect cells that produce female hormones and testosterone.

Epidemiology

Ovarian cancer is the most difficult neoplasm to be diagnosed in the preliminary stages and, therefore, it is a very serious disease with little chance of cure when diagnosed in advanced cases. Epidemiological data show that about 75% of cases of ovarian cancer are at an advanced stage when the first diagnosis is made.

Ovarian cancer accounts for about 6% of all cancers that affect women and the risk that a woman will have this type of cancer throughout her life is 1 case in every 69 women. Apparently, the incidence of ovarian cancer is higher in industrialized countries such as the United States, Western European countries, Israel and Canada. The medical age of incidence of the disease is between 50 and 59 years.

According to the Vaudois University Hospital Center in Switzerland, most patients with advanced-stage cancer relapse within two years and die within five years. That same center has been developing a vaccine against ovarian cancer.

In Brazil, according to data from the National Cancer Institute (INCA) in 2010 there were 2979 deaths from the disease and it is estimated that in 2012 there will be 6190 new cases.

Causes

The causes of ovarian cancer are still uncertain. It is believed that the BRCA1 and BRCA2 genes (related to breast cancer ) have a great influence on the appearance of ovarian cancer. Data estimates that carriers of the BRCA1 gene have a 45% chance of developing the disease and patients who have BRCA2 have about a 25% chance.

Another factor suggested as a possible cause of ovarian cancer is female hormonal activity. Women who never breastfed or had children and women who experienced late menopause are at increased risk of ovarian cancer.

Other possible causes are:

– Breast cancer .

– Colorectal cancer .

– Heredity (family members with breast or ovarian cancer – responsible for 10% of cases).

– Contact with ionizing radiation or chemical solvents, as they cause genetic mutations.

– I smoke .

– Excessive consumption of alcoholic beverages.

– Diet high in fat.

– Use of anti-infertility drugs.

– Hormone replacement therapy (HRT) leads to an increased risk of developing ovarian cancer. Even when prescribed for just a few years, the likelihood of developing cancer is higher, according to a study published on February 13, 2015 in the British medical journal “The Lancet”.

To reach these results, the British researchers analyzed nearly 50 epidemiological studies, involving a total of 21,488 American, European and Australian women who developed ovarian cancer. They showed that those who received HRT had a 40% increased risk of ovarian cancer than women who never received such treatment.

In this study, British researchers noted that the increased risk of ovarian cancer is “significant” over the duration of treatment. It gradually disappears after discontinuation, but persists even longer as treatment is longer.

If it is not longer than 5 years, the risk completely disappears after a few years, which is not the case for treatments with a longer duration.

Groups of risk

The main risk groups for ovarian cancer are:

– Women over 50 years old.

– Women who have never been pregnant or breastfed.

– Women who had late menopause .

– Patients who have used infertility treatments.

– Patients with the presence of the BRCA1 and BRCA2 genes.

– Women with genetic mutation in the HNPCC gene (responsible for colorectal cancer ).

– Women who have had breast or colorectal cancer or who have a family history of one of these types of cancer.

– Smokers .

– Overweight or obese women .

– Women who have taken hormonal treatment for menopause.

Symptoms

Ovarian cancer is extremely dangerous, as in the early stages of the disease it does not have specific symptoms of the disease and many of them are similar to other common diseases such as digestive problems and bladder problems. As the tumor grows, some symptoms begin to appear, such as:

– Abdominal bloating.

– Sensation of abdominal pressure.

– Pain in the abdomen, back, pelvis and legs.

– Nausea and vomiting.

– Loss of appetite and indisposition.

– Intestinal problems such as indigestion, gas, diarrhea or constipation .

– Changes in urinary habits, such as frequent need to urinate.

– Presence of blood when urinating.

Many of these symptoms are nonspecific. If you have any risk factors for the disease and have the symptoms described above, see a doctor.

Diagnosis

In the suspicion of ovarian cancer, the doctor will analyze the symptoms presented by the patient and perform some tests, such as:

– Transvaginal ultrasound.

– Pelvic examination, to assess whether there are any abnormalities in the vaginal cavity or ovaries.

Another common type of examination that the doctor can perform is the search for tumor markers, including:

– CA 125 levels (most women with ovarian cancer have elevated CA 125 levels).

– Alpha-fetoprotein levels.

– Levels of beta-HCG.

Once the tumor is diagnosed, the doctor will take a biopsy (removal of a small part of the tumor tissue) to see what stage the tumor is at. Depending on the degree of evolution, the tumor may fall into one of the following categories:

Internship IThe tumor is confined to one of the two ovaries.
Stage IIThe tumor has spread elsewhere in the pelvis, such as the fallopian tubes or uterus.
Stage IIIThe tumor has spread to places other than the pelvis, such as lymph nodes.
Stage IVThe tumor has spread to organs other than the abdomen, such as the lung and liver (metastasis).

Complications

Ovarian cancer can cause some changes in the female body. Initially, there may be alterations in the hormone production profile, since the tumor can reach the stromal cells, responsible for the production of progesterone, estrogen and testosterone. This can lead to menstrual changes and even post-menopausal bleeding (less frequent). Other complications are common to other types of cancer, such as loss of appetite, fatigue , body aches and weight loss.

Certainly the worst complication of ovarian cancer is metastasis. Ovarian cancer is very difficult to diagnose in its early stages as it has no specific symptoms. This causes the diagnosis to be made when the tumor is already at an advanced stage and often disseminated to other organs, such as the lungs and liver. Thus, depending on the severity and degree of dissemination of the tumor, the disease can lead the patient to death.

Treatments

The treatment of ovarian cancer will be carried out according to the type of tumor (which cell type is reached), the degree of evolution and the presence or absence of metastasis. The doctor will analyze these parameters and may adopt surgery, radiotherapy and chemotherapy as a treatment procedure.

Surgery

Surgical treatment for ovarian cancer usually involves extensive surgery to remove both ovaries, fallopian tubes, uterus, adjacent lymph nodes, and the layer of fat that lines the abdominal cavity (omentum). These are usually where ovarian cancer spreads.
When diagnosed in earlier stages, it is possible that the surgery involves only the removal of the compromised ovary and fallopian tube, and does not compromise the woman’s fertility.

Radiotherapy

The radiotherapy procedure involves bombarding the tumor with high-energy rays to kill cancer cells or make them shrink in size. Radiation therapy is usually combined with surgery and chemotherapy to optimize results.

Chemotherapy

Chemotherapy consists of treating the patient with drugs. Usually, chemotherapy is combined with radiotherapy and/or surgery to obtain better results and reduce the incidence of the tumor coming back. Medications can be given into the bloodstream or injected directly into the abdominal cavity.

The drugs used can be administered alone or combined with others, depending on the tumor grade and the patient’s characteristics. Some commonly used drugs include: vinca alkaloids, cisplatin, carboplatin, and taxanes. In 2012, ANVISA approved the combination of trabectedin and doxorubicin for the treatment of recurrent ovarian cancer.

Recently, the Vaudois University Hospital Center in Switzerland in partnership with the University of Pennsylvania in the USA developed a vaccine for the treatment of ovarian cancer. The vaccine uses dendritic cells from the patient’s own immune system to attack tumor cells. The vaccine was well tolerated and had high efficacy in patients. Read more about this important breakthrough: Promising New Therapy for Ovarian Cancer .

Herbal medicine

There are currently no medicinal plants approved for use in the treatment of ovarian cancer . However, there are several studies with medicinal plant extracts and their effect on tumor cells. These include ginkgo biloba and green tea . A study published in the city of Stockholm by the Karoinska Institute proved that drinking tea during the day can reduce the risk of developing ovarian cancer.

In addition, medicinal plants can be used to alleviate the side effects of chemotherapy and radiotherapy. Among the plants used, the following stand out:

– Valerian : to improve the quality of sleep.

– Bilberry : for gastrointestinal and liver symptoms.

– Chamomile : used as a tranquilizer and to combat insomnia.

– Melissa : for gastrointestinal symptoms.

– Fennel : indicated for stomach problems.

There are several other herbs that can help reduce pain and side effects. Talk to your doctor about this.

Tips

Ovarian cancer is difficult to diagnose, so watching for early signs, even if they are nonspecific, is very important. If you already have cases of ovarian, breast or colorectal cancer in your family , or if you still have the BRCA1 and BRCA2 genes, be on the lookout for signs such as:

– Menstrual irregularities.

– Various abdominal pains.

– Changes in bowel and urinary habits.

– Increased volume of the abdomen.

– Bleeding when urinating.

If you have suspected ovarian cancer, seek a doctor and ask him to do the appropriate tests. Remember, the earlier the cancer is detected, the greater the chances of cure.

Prevention

There are a number of measures you can take to prevent ovarian cancer, including:

– Quit smoking . Smoking increases the risk of many diseases, including ovarian cancer.

– Consume alcohol moderately.

– Have a balanced low-fat diet.

– Talk to your doctor about using birth control pills. Women who use this type of medication have a reduced risk of developing ovarian cancer. But beware: the use of birth control pills increases the risk of other diseases (such as thrombosis , stroke , etc.).

– Get tested frequently if you have hereditary cancers in your family, especially breast and colorectal cancers.

– Go to the doctor frequently if you have the BRCA1 and BRCA2 genes.

– Take tests to check for the presence of cysts in the ovaries. The danger of developing ovarian cancer exists when the cysts are larger than 10 cm and have both solid and liquid areas.

 Read also: Promising new therapy against ovarian cancer

Jeanne Kenney
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I’m a stylist trainer, a content creator, and an entrepreneur passion. Virgo sign and Pisces ascendant, I move easily between my dreams, the crazy world I want, and my feet on the ground to carry out my projects.

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