Difficulties in the diagnostic process of ovarian cancer

Ovarian cancer is an extremely dangerous and aggressive oncological pathology all over the world. More than 5% of all cancer deaths are due to ovarian cancer. In Ukraine, ovarian tumor is the third most common among all oncogynecological diseases. The risk of developing ovarian cancer increases with age, but, nevertheless, women of absolutely any age are susceptible to this disease. Cases of ovarian cancer have been reported even in girls of primary school age. In addition, ovarian cancer often has a very blurred, mild picture, and is often diagnosed already in the last stages. That is why preventive gynecological examinations conducted by competent gynecologists are so important.

What factors influence the development of ovarian cancer?

Reliable causes of ovarian tumors to date remain unclear. There are three main theories suggesting the following causes of ovarian cancer:

• chronic hyperestrogenism - excessive production of estrogens in the female body does not directly affect the malignant transformation of ovarian tissues, but creates favorable conditions for the development of a malignant process in estrogen-sensitive tissues;
• "continuous ovulation" - early onset of menstruation, late menopause and a low number of pregnancies lead to damage to the ovarian cortex, through the frequent release of follicles. Thus, the likelihood of developing an oncological process is significantly increased;
• genetic theory - a woman's family history of breast cancer or cancer of other genital organs puts her at risk for developing ovarian cancer.

Forms of ovarian cancer: primary, secondary, metastatic

1. Primary ovarian cancer is a tumor of the ovary that initially develops directly in this organ. Often, such a tumor of a glandular or papillary structure, but in rare cases, primary ovarian cancer can develop from the integumentary epithelium.
2. Secondary ovarian cancer or cystadenocarcinoma is the most common type of ovarian cancer. Such a tumor arises from benign formations of the ovary, through their malignant transformation - malignancy.
3. Metastatic ovarian cancer or Krukenberg's tumor is an ovarian tumor that develops after metastatic lesion of ovarian tissue by malignant cells spreading from another primary focus. The primary focus is most often located in the uterus, thyroid and mammary glands, as well as in the organs of the gastrointestinal tract. Women of reproductive age are most susceptible to this type of cancer.

Clinical picture of ovarian cancer: possible manifestations

The main difficulty in diagnosing ovarian cancer is that localized forms of the disease often remain asymptomatic, and the first symptoms begin to appear when the tumor is already in the last stages. General weakness, fatigue, loss of appetite, fever, nausea and vomiting are symptoms that appear in the initial stages of almost any disease. They are easily stopped by medications, and patients often do not attach much importance to them. Pain syndrome in ovarian cancer appears when the pedicle of the tumor is twisted or its capsule is perforated. A change in the size and shape of the abdomen occurs only in the event of ascites, or an excessively large size of the tumor, which is extremely rare.

What is the difficulty in diagnosing ovarian cancer

If a patient is suspected of having ovarian cancer, instrumental diagnostic methods are the most informative and, therefore, preferable. A specific marker for ovarian cancer, CA-125, is found in almost all patients with ovarian cancer. But at the initial stages of the oncological process, its specificity is very low, which is why laboratory methods for diagnosing ovarian tumors are not considered sufficiently informative. The following instrumental diagnostic methods are used:

transvaginal echography - allows you to determine the size of the tumor, as well as its structure. Ovarian cancer is an irregularly shaped volumetric formation with a large number of partitions and growths.
color dopplerography - visualizes a large number of vessels in tumor tissues, all of which have low blood flow resistance.
Computed tomography and magnetic resonance imaging are diagnostic methods that help to visualize the size and nature of an ovarian tumor as accurately as possible.
chromocystoscopy is a diagnostic method that allows you to accurately clarify the stage of the malignant process.

Which therapies are used in the treatment of ovarian cancer

The treatment of ovarian cancer must be comprehensive. Due to the fact that radiation for ovarian tumors is an ineffective therapeutic method, it is customary to combine surgical treatment with polychemotherapy. The volume of surgical intervention is determined by the size and prevalence of the tumor process: it can be either supravaginal amputation of the uterus with appendages, or a radical operation - extirpation of the uterus with appendages and resection of the omentum. The complexity and diversity of the histological structures of an ovarian tumor force the use of polychemotherapy, both pre - and postoperative and independent. Cytostatics such as platinum and chloroethylamines are widely used. In most cases, at least 6 courses of cytostatic therapy are given with intervals of 3-4 weeks between courses.

Prognosis and methods of prevention of ovarian cancer

The prognosis for the patient directly depends on the stage of the disease, as well as the structure of the ovarian tumor. Five-year survival rate with timely diagnosis and effective therapy in the first stage of ovarian cancer is 90%, in the second - 50%, in the third - 10%, and in the fourth stage it decreases to 5%. To prevent the occurrence of an ovarian tumor, it is necessary to conduct timely preventive examinations of patients, especially those at risk, in order to timely diagnose and eliminate benign ovarian processes that are capable of malignancy. In addition, the main risk factors for ovarian cancer, such as smoking, unhealthy diet and uncontrolled use of hormonal drugs, must be eliminated.