Clinic for Gynecology and Obstetrics
Chief Physician

Ovarian Cancer

PD MD Heiko B. G. Franz

Chief Physician

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Statistics 2017
  • 6205 patient admission
  • 20 physicians
  • 40 medical staff
  • 192 endosonography of the female sex organs
  • 91 excisions and destructions of ovarian tissue
  • 95 removals of the fallopian tube and ovary
  • 142 removals of the uterus
  • 867 caesarean section

Ovarian Cancer

Ovarian cancer is one of the most widespread cancer diseases in women. A tumor can be diagnosed even at young age, though the vast majority of cases take place during climacterical period. It's proved by statistics that shows this cancer is typical for women in their 50-70s. Besides, women who don't visit gynecologist for regular examination usually discover cancer at the latest stages. It's not only due to their ignorance, but peculiarities of the disease, too.

Causes of tumor

Doctors don't know the exact causes of this oncologic disease. However, there are many different factors that contribute to a higher risk of developing cancer. These include:

  • Biological inheritance. Most often, ovarian cancer occurs in women whose relatives (mother, grandmother, or sister) had this disease. Hereditary factor for cancer reaches 10%, so it's important to know medical history of your family and go through regular checks and examinations, if there were cases of cancer.
  • Age over 45. According to the statistics, in 90% of cases the disease develops during menopause, when female hormones (estrogen and progesterone) are produced in lower amount.
  • Hormonal disorders. Since ovaries are a part of the endocrine system, a cancer tumor can be triggered by hormonal disorders. For example, woman should become aware, if the level of androgens has increased.
  • Malfunction of ovaries. Any pathology in functioning of ovaries can trigger cancer development. Besides, diseases and problems with adrenal gland may provoke cancer, as well.
  • Obesity. Practice shows that ovarian cancer occurs more frequently in women suffering from extra weight. It is also connected with hormonal disorders in female body.
  • Infections of ovaries that promote inflammatory process.
  • Radioactive effects. Work that implies contact with radioactive elements or living in places contaminated with radiation.
  • Smoking and alcohol abuse.

Besides, other factors provoking development of cancer tumor are early puberty, uncontrolled sexual behavior accompanied by sexually transmitted diseases, abortions, or, vice versa, absence of sexual life. Too early or late menopause may also contribute to the disease.

Classification of disease

Specialists differentiate three types of the pathology:

  • Primary cancer. This cancerous tumor appears when abnormal cells start growing in ovaries. The disease usually affects both ovaries, and the tumor is solid. It progresses slowly and rarely reaches big sizes. Timely removal of this tumor allows solving this problem forever.
  • Secondary cancer. This is a more dangerous type of cancer, because it occurs because of cyst malignization. Every month, a receptive egg cell is released from the follicle in ovaries during ovulation. However, sometimes the follicle doesn't tear and an egg cell is not released. Such situation causes cyst formation. Pretty often, the cyst is resolved during menstruation, but in rare cases, it may stay. Some women don't hurry to remove cysts thinking that benign tumors won't do any harm for health. However, there's always a minor chance that a cyst can turn into a cancerous tumor.
  • Metastatic cancer. This cancerous tumor is formed from metastases appearing in other organs. As a rule, it's the stomach from where the metastases can get into female reproductive system with blood and lymph flow. In this case, a tumor quickly progresses and becomes malignant.

Symptoms of disease

At the initial stage, cancer develops almost without signs. The tumor is accidentally revealed during examination, because even bilateral damage of ovaries does not affect menstruation and doesn't cause pain.

While the tumor is progressing, some general symptoms similar to the symptoms of ovary inflammation can occur. A woman should be aware if she experiences the following:

  • pain in loins, or lower abdomen;
  • painful sensations during sexual act;
  • nausea and problems with stool;
  • fatigue, easy tiredness and irritation;
  • loss of appetite, quick saturation and unreasonable nausea.

When the cancer develops considerably, a woman starts experiencing specific symptoms including:

  • strange discharge between periods;
  • collection of fluid in abdomen, e.g. hydroperitoneum;
  • augmentation of belly because of hydroperitoneum and growth of the tumor;
  • sense of having a foreign body in the lower part of the abdomen;
  • augmentation of mammary glands;
  • vaginal bleeding not connected with menstruation;
  • strong pain in lower abdomen;
  • weight loss without cause;
  • frequent desire to urinate;
  • anemia (it often accompanies such kind of cancer);
  • high erythrocyte sedimentation rate in blood caused by inflammation.

If there are metastases, a woman experiences pain in joints and head, cough with blood or even seizures.

Stages of ovarian cancer

  • Stage I. It's the beginning of the disease when the tumor affects one or two ovaries and does not spread over their edges. This is why such kind of tumor is pretty hard to reveal. However, when malignant cells start escaping the ovaries, there's fluid that starts collecting in the abdomen. This symptom can appear to be very helpful for revealing the tumor.
  • Stage II. At this stage, the tumor takes root in both ovaries and goes outside them affecting pelvic organs – intestine and sigmoid bowel, uterus and bladder. Women who have this cancer revealed often complain about dragging pain in the lower abdomen, frequent desire to urinate and stomach disorders. In rare cases, touching of the lower abdomen allows revealing some solid tumor.
  • Stage III. Practice shows that ovarian cancer is revealed at this stage in 70% of cases. Cancer cells go beyond pelvic organs and can be found in abdomen. During surgery, these cells can be seen with an unarmed eye. Only when this stage comes to the end, cancerous cells go into the lymph system and are spread throughout the body. Therefore, cancer at stage III is reversible, but it gets harder and harder to struggle against it.
  • Stage IV. At this stage, doctors diagnose distant metastases, most often – in lungs and liver. The most pronounced symptom is strong pain that can subside only when using efficient pain killers. The malignant process has developed too seriously, and prognosis for this stage is usually poor.

Oncologists regard ovarian cancer as one of the most dangerous tumors in women. It gives too many metastases that quickly spread over body evading new and new territories. This tumor has another disadvantage: it's resistible to radiation and is hard to cure with chemotherapy.

Diagnostics

It should be noted that diagnostics of ovarian cancer is pretty hard. First and foremost, it's conditioned by unclear symptoms of cancer, due to which it's often mistaken for some other female diseases.

This is why women usually visit doctors when they have cancer at stage III, and the tumor is already quickly progressing and spreading metastases. To diagnose the disease, a doctor does the following:

  • Biomanual examination (two-hand palpation of ovaries). It should be noted that during menopause, ovaries are hard to feel. If they are palpated well, it should put the doctor on the alert. If a tumor has become too big, a specialist can easily palpate it and define its form, size and mobility.
  • Ultrasound. During this diagnostic method, an external sensor defines tumors that have reached 7 cm in diameter, and transvaginal sensor shows tumors more than 2 cm in diameter. This is one of the most helpful methods.
  • Doppler sonography. If ultrasound cannot reveal cancer of ovaries, Doppler sonography is performed additionally to define abnormalities in blood supply (new vessels form around the tumor, which boosts blood flow).
  • CT and MRT. Computer tomography is made to define the size of the tumor, and magnetic resonance tomography allows finding distant metastases in several projections.
  • Positron emission tomography. This method allows revealing even small distant metastases, because cancer cells are marked with isotopes.
  • Revelation of cancer-specific markers. For instance, СА-125 cancer-specific marker exceeds the normal level, if there's a malignant tumor. However, this isn't the basic method, because this cancer-specific marker also reacts on the outrage of pancreatitis and inflammation of appendages.

If these methods are not enough, a doctor can perform laparoscopy: make a small incision in the area of ovaries and inject a drug for visual examination. If cancer is revealed, it should be removed instantly.

Treatment of ovarian cancer

The only efficient method of ovarian cancer treatment is removal of the tumor. As a rule, it's combined with chemotherapy to reach better results.

The extent of operation depends on the size and spread of the cancerous tumor. If it has affected ovaries only, it's enough to remove the organ and a fallopian tube only. However, if the disease has started to progress and emit metastases, both ovaries, uterus, omentum, lymph nodes and soft tissues should be removed.

Treatment complex includes chemotherapy. This method not always gives positive results and has many side effects, but there's no alternative to this approach. Today, the most efficient drugs are cyclophosphan, methotrexat, taxol and fluorouracil. These medications are given in courses depending on the stage of disease and its severity.

Survival rate

According to WНO statistics, 1-year survival rate is 60%, 3-year survival rate is 40%, 5-year survival rate is 35%. However, if the diseases was revealed at stage I or II, 5-year survival rate is more than 90%. It proves that the disease should be diagnosed as soon as possible.

Prophylactics

Unfortunately, even regular examinations don't give 100% guarantee that the cancer will re revealed at the first stage. Above mentioned symptoms should alert women and make them visit the doctor and go through analyses.

In order to reveal ovarian cancer as soon as possible, it's crucial to visit gynecologist twice a year and have tests of tumor markers. Active sexual life should be maintained, but without abortions and chaotic sexual intercourses. Condoms should be used for sexual intercourse. If you take proper care about your body, you won't be at the risk of developing the disease.

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