Ovarian cancer (ovarian cancer) is a disease of the body’s cells that change and multiply uncontrollably.
A malignant tumor is a nodule or tissue proliferation consisting of tumoral cells that multiply continuously.
Malignant tumors affect neighboring tissues and organs and can cause serious damage.
In recent years, the incidence of tumors and cancers in the population has risen sharply, because lifestyle and environmental influences can favor the formation of neoplasms.
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What favors the formation of cancer?
- A sedentary lifestyle and office work increase stress;
- Junk food with lots of fried food, meat and ready-made desserts;
- medications, especially the frequent abuse of medications;
- Air and water pollution.
What are the ovaries?
The ovaries are part of the female reproductive system. They are located in the area of the basin. An ovary is about the size of an almond.
Ovaries produce the female hormones estrogen and progesterone. They also release the eggs. The egg travels from the ovary through the fallopian tube to the uterus.
When a woman enters menopause, the ovaries stop releasing eggs and hormone levels drop.
What is ovarian cancer?
Cancer begins in the cells, the building blocks of tissues. The tissues form the organs of the body.
Normally, the cells grow and divide because the body needs them.
As the cells get old, they die and new cells take their place.
Sometimes something goes wrong with this process. New cells are created without the organism needing them and the old cells do not die.
From these extra cells, new body tissue can be formed, which is called neoplasia or tumor.
Ovarian cancer
Ovarian cancer can affect other organs and spread: Infestation:
A malignant ovarian tumor can grow and affect adjacent organs, such as fallopian tubes and uterus.
Spread: The tumor cells can spread from the main tumor of the ovary. Spreading to the abdomen can lead to the development of new tumors that form on the tissue surface and nearby organs.
Mimigration: The tumor cells can spread through the lymphatic system to the lymph nodes of the pelvis, abdomen and chest. Or they spread through the bloodstream and reach organs such as the liver and lungs.
If the carcinoma spreads from its place of origin to another region of the body, the new tumor consists of the same type of abnormal cells and bears its name.
For example, if ovarian cancer spreads to the liver, the tumor cells in the liver are actually ovarian tumor cells. For this reason, it is considered ovarian cancer and not liver cancer.
Three main representatives of ovarian tumors
Epithelial ovarian cancer is the most common form of ovarian cancer. Germ cell and stromal tumors are much less common. Ovarian cancer can also develop from another malignant tumor that has spread from another region of the body:
- Epithelial ovarian tumors – arise from the superficial ovarian cells and occur mainly in adults.
- Germ cell tumors – arise from the cells that produce the eggs in the ovary. This rare form of cancer affects children and adolescents more frequently.
- Stromal and germ cord tumors – develop from the cells that hold the ovaries together.
Risk factors for ovarian cancer
It is not known exactly what causes epithelial ovarian cancer. However, there are some factors that can increase the risk.
Risk factors
Childlessness Women without children have a higher risk of developing ovarian cancer than women who have had children, even if the difference is very small.
Hormonal factors
With an early first menstrual period and a late last menstrual period, there is a slightly increased risk of ovarian cancer.
Hormone replacement therapy may increase the risk somewhat.
If hormone replacement therapy is interrupted, the risk gradually drops back to the normal danger level of the women who did not perform it.
Infertility Some research has shown that sterility can slightly increase the risk of ovarian cancer.
Health status
Endometriosis is a disease in which the lining of the uterus (endometrium) occurs outside the uterine cavity; in this case, there is a greater risk of ovarian cancer.Smoking An analysis combining the results of various individual studies has shown that female smokers have twice the risk of ovarian cancer for mucinous ovarian tumors.
Those who quit smoking reduce the risk back to normal over time.
The risk of serous or endometrioid tumors remains unchanged, but smokers have a reduced risk of clear cell ovarian tumors.
Body weight and diet
Being severely overweight can increase the risk of ovarian cancer.
A diet high in animal fats and low in fresh vegetables and fruits can increase the likelihood of ovarian cancer.
Fertility treatment
Some previous studies have found a link between taking fertility-promoting drugs and an increased risk of ovarian cancer.
However, recent research results do not confirm this theory.
Infertility is more likely to increase the risk of ovarian cancer, but it doesn’t happen as a result of fertility treatment.
Scientific research is trying to clarify this uncertainty.
The use of the contraceptive intrauterine device: the IUD
Research studies have shown that women who use the IUD have a higher risk of ovarian cancer; however, the risk is still low and further studies are needed.
Genetic factors
About 5-10% of ovarian tumors are caused by a defective, inherited gene.
Women with breast cancer have an increased risk of ovarian cancer.
This is because breast and ovarian cancer can be caused by the same defective genes.
Protective factors against ovarian cancer
The likelihood of developing ovarian cancer is reduced by:
- Contraceptive pill;
- birth of several children;
- Breastfeeding;
- removal of the uterus (hysterectomy) or tying off the fallopian tubes (tubal ligation);
- Phytoestrogens found in some foods: soybeans, legumes (beans, lentils and peas), various plants, tea, coffee and cereals. Some studies have shown that phytoestrogens can reduce the risk of ovarian cancer.
What are the symptoms of ovarian cancer?
In many cases, there are no symptoms for a long time after the onset of cancer.
Symptoms are not noticed until later, when the malignant tumor increases in size.
As the tumor grows, the first symptoms are:
- constant pain in the ovaries and a feeling of pressure in the abdomen (in the pelvic area);
- persistent bloating; an effective increase in abdominal circumference is also possible;
- Difficulty eating and quickly onset satiety.
In addition, the following complaints may occur:
- Anorexia
- unexplained weight loss,
- abdominal pain during sexual intercourse,
- frequent urination (the bladder is irritated by the nearby tumor),
- indigestion, such as constipation or diarrhea,
- significant swelling of the abdomen due to fluid retention in the abdomen (ascites).
These symptoms can also be provoked by various other diseases.
In addition, the symptoms are often non-specific at the beginning, such as a slight malaise in the lower abdomen. They may be caused by other diseases. As long as they don’t worsen, they can’t really be considered a sign of ovarian cancer.
One disease that is often confused with ovarian cancer is irritable bowel syndrome. It is not uncommon for it to develop in women over 50. As a rule, it begins at a younger age and can last into old age.
If no symptoms of irritable bowel syndrome have been noticeable in the past, but this now occurs after the age of 50, ovarian carcinoma should first be ruled out on the basis of examinations before an intestinal disease is diagnosed.
In addition, as the cancer spreads to other parts of the body, various other symptoms may occur.
How does the doctor diagnose ovarian cancer?
If ovarian cancer is suspected due to certain complaints, the doctor must determine whether these are really caused by a tumor or have other causes.
The doctor clarifies in a conversation whether the patient may have a personal or family background.
For diagnosis, one or more of the following examinations may be performed.
Physical examination
The doctor checks the signs of the disease, palpates the abdomen and looks for tumors or accumulations of fluids (ascites).
A fluid sample can be taken and examined for ovarian tumor cells.
Gynecological examination
The doctor palpates the ovaries and neighboring organs to detect tumors and changes in shape and size.
A smear test (Pap test) is part of a gynecological exam but is not used to analyze ovarian cells.
The Pap test is used for early detection of cervical cancer, but is not used to diagnose ovarian cancer.
Blood test A blood test provides information about so-called tumor markers in the blood. The detection of the protein CA 125 plays an important role here. The concentration of this substance in the blood and urine is significantly increased in the presence of carcinoma.
CA-125 is found on the surface of cells with ovarian cancer and on some normal tissues.
An increased level of the marker CA-125 may indicate cancer or other diseases.
The detection of CA-125 is not only used to diagnose ovarian cancer. This research has also been recognized by the Food and Drug Administration to examine how a woman responds to treatment for ovarian cancer and to detect relapses.
Ultrasound
The ultrasound device uses sound waves that are inaudible to humans.
The sound waves are sent to the organs located in the pelvis and reflected there; the computer creates an image of the echo of the sound waves.
For a better representation of the uterus, the transducer can be inserted into the vagina (transvaginal ultrasound).
Biopsy
In a biopsy, tissue or fluid is taken and examined for the presence of tumor cells.
Based on the results of blood and ultrasound tests, the doctor may advise surgical intervention (abdominal incision, medical laparotomy) to remove tissues and fluids from the pelvic and abdominal region.
As a rule, surgery is necessary to diagnose ovarian cancer.
In most women, a laparotomy is performed for diagnosis, in others this procedure is performed laparoscopically.
In this case, the doctor inserts a thin, camera-equipped tube (laparoscope) through a small incision in the abdomen.
Laparoscopy can remove a small, benign cyst or ovarian cancer in the early stages.
It can also be used to determine if the cancer has spread.
The pathologist uses a microscope to examine the tissue or fluid for tumor cells. If cells of ovarian cancer are found, the pathologist describes the degree of the disease. Stages 1, 2 and 3 describe the abnormalities of the tumor cells.
The tumor cells do not have the probability of growing and spreading in the first stage of the disease like the cells in the third stage.