Ovarian cancer guide
What is ovarian cancer?
The ovaries are a paired organ of the female reproductive system. They are almond-shaped, located on both sides of the uterus, and responsible for producing eggs and hormones. Ovarian cancer is an overgrowth of malignant cells that make up the ovaries. Cells multiply and penetrate neighbouring organs.
The type of cell from which ovarian cancer begins determines the type of cancer and the treatment method. Types of ovarian cancer include:
- epithelial ovarian cancer - is the most common type and includes serous and mucinous carcinoma.
- stromal tumours - a rare type of tumour, are usually diagnosed earlier than other types of ovarian cancer.
- germ cell tumours - a rare type of ovarian cancer usually occur at a younger age.
Ovarian cancer is the most lethal gynaecological cancer. Less than half of patients survive more than five years after diagnosis. Ovarian cancer affects women of all ages but is often diagnosed after menopause. More than 75% of affected women are diagnosed late because the early-stage disease is usually asymptomatic, and the late-stage symptoms are nonspecific.
The symptoms of ovarian cancer, especially in the early stages, are very vague. Most often, signs appear when the disease has already spread. Symptoms include:
- abdominal pain or pelvic pain;
- difficulty eating (loss of appetite) or feeling full quickly;
- urinary symptoms, such as feeling like you need to urinate all the time or to urinate frequently;
The first action is to have a gynaecological examination, which usually involves a pelvic exam. Next, the doctor inserts two fingers into the vagina and presses on the abdomen with the other hand. Thus, consolidations can be detected. If ovarian cancer is suspected, the oncologist-gynaecologist will prescribe additional tests:
- A blood test - reveals the presence of proteins produced by cancer cells, also called tumour markers. It is used for screening or already for diagnosis.
- Ultrasound - is performed using a scanning device of a finger size, which is inserted into the vagina (transvaginal scanning) or external scanning (abdominal scanning). Sound waves are used to obtain images of organs and their changes.
- CT (computed tomography scan) - using x-rays, detailed photos of the internal organs are taken in different projections. The computer combines these images, and the doctor receives a three-dimensional image, which clearly shows any changes or formations. It is used to check the abdomen, chest, and pelvis for signs of the spread of ovarian cancer.
- MRI (magnetic resonance imaging scan) - uses an MRI machine's powerful magnet and radio waves to obtain detailed images of internal organs. The method determines the presence and size of an ovarian tumour.
- PET (positron emission tomography) - is a specialized imaging test that creates an image of organs and tissues inside the body. First, a certain amount of radioactive sugar is introduced into the bloodstream. Since cancer cells tend to absorb energy actively, they use more radioactive material. This substance is detected using a scanner, and the doctor gets an image of the inside of the body. In addition to visual diagnosis, the test allows seeing cancer activity.
- A biopsy - is one of the most accurate methods. It removes a tiny piece of suspected tissue with a needle for examination under a microscope. Then, a pathologist checks the tissue for the presence of cancer cells.
The tests will make an accurate diagnosis and help determine the type and size of the tumour and whether the tumour has spread to other organs.
There are several types of treatment for ovarian cancer. Since each case is unique, different treatments may exist, even for the same kind of cancer. In addition, cancer treatments may be used alone or in combination. Doctors will recommend the best treatment based on the type and stage, genetic makeup, age and general health.
- Systemic chemotherapy - anti-cancer (cytotoxic) drugs to kill cancer cells. Most drugs are administered intravenously or taken orally. As a rule, the schedule is based on cycles carried out over a certain period. The method helps remove a small number of cancer cells and decrease the tumour for further surgery or fighting metastases.
- Hormone therapy - drugs to block hormones needed for cancer cell growth. This method uses the dependence of the development of cancer cells on certain hormones. Due to the blockage of hormones, the increase in the number of cancer cells slows down or stops altogether.
- Targeted therapy - is directed at specific parts of cancer cells, namely, particular genes/proteins that promote the growth and survival of cancer. The method makes it possible to detect cancer cells and act on them selectively, attacking their internal work while not affecting healthy cells. It blocks the growth and spread of malignant cells without damaging normal cells.
- Immunotherapy - uses the body's natural defences to fight cancer with the help of medicines and the ability of the immune system to destroy affected cells.
- Radiation therapy - the use of high-energy x-rays or other particles to kill cancer cells, which are sent to the affected area with special equipment. The goal is the destruction of affected cells, minimally affecting the surrounding tissues.
- Surgery - is the primary treatment option for ovarian cancer. Types of ovarian cancer surgery are:
- surgery to remove one ovary - applicable in the early stages of the development of an ovarian neoplasm, surgery may be limited to removing one ovary and fallopian tube. This type of surgical treatment preserves childbearing functions for a woman.
- surgery to remove two ovaries - is used when the tumour has developed on both ovaries and consists in removing both ovaries and fallopian tubes. In this case, the uterus remains intact. There is also the possibility of pregnancy using your own frozen or donor eggs.
- ovaries and uterus removal - if cancer has spread to neighbouring organs, the ovaries, fallopian tubes, uterus, nearby lymph nodes and abdominal fat are removed. Childbearing functions are not preserved.
- advanced cancer surgery - when advanced ovarian cancer is detected, the surgeon removes the most cancerous tumour, while chemotherapy is recommended before and after surgery.
The treatment can be difficult or even impossible when diagnosing advanced ovarian cancer. In this case, the team of doctors is faced with limiting cancer growth and its symptoms, prolonging and improving the quality of life.
New treatment options
Despite optimising treatment protocols and clinical trials, there have been only modest successes in improving survival. Therefore, ovarian cancer remains the most severe gynaecological malignancy. The latest advances in the origin, diagnosis and treatment of ovarian cancer are essential for patients. New therapies for ovarian cancer include:
- Transarterial chemoembolisation (TACE) for metastases - is a minimally invasive procedure for ovarian cancer metastases. It involves injecting a chemotherapy drug directly into the affected area locally (through the vessels). There is also a blockage (embolisation) of the blood arteries that feed the tumour to cut off the blood supply and keep chemotherapy inside the tumour.
- Transarterial chemoperfusion (TACP) for metastases - is the local injection of a chemotherapy drug into the vessels that feed the tumour. Tumour cells are destroyed with a high dose and point exposure, often used for distant metastases in hard-to-reach places.
- Proton therapy - is radiotherapy in which a beam with a given amount of radiation (protons) is sent precisely to the affected area. Proton particles pass through healthy tissues and only affect the ovarian tumour.
- Ablative therapy (RFA, MWA, Ethanol) - the effect of thermal energy on tumours through needle electrodes. It leads to the reduction and destruction of the ovarian tumour.
- Surgical treatment (da Vinci® robot-assisted ovarian cancer surgery) - a surgical operation to remove the affected ovary using a robotic system. The da Vinci® system allows gynaecological surgeries to be performed using smaller incisions, reducing complications and recovery time.
Thanks to the methods described above, significant advances have been made in treating ovarian cancer. Moreover, it brings hope and improved outcomes for many women, even in the terminal stages.
Statistics and prognosis
Ovarian cancer is the second most common gynaecological cancer in the world. The disease causes more deaths than any other female reproductive system cancer. Although the risk is only 1.5% of the total population, it is the fifth leading cause of cancer death in women, as 60% of women with ovarian cancer have metastatic disease.
Based on the American Cancer Society data, the five-year survival rate for initial-stage ovarian cancer is 93%. The five-year survival rate for stage II-III cancer is 75%, and the five-year survival rate for stage IV cancer is 31%.
So what's next for women diagnosed with ovarian cancer? The latest developments and combination therapy are the near future for the treatment. Our patients receive qualified assistance and a combination of different methods, which shows significant effectiveness.
If you or your relatives are diagnosed with ovarian cancer, the most important thing is to find a team of professionals as soon as possible. Like any other problem, Ovarian cancer is only a problem if you have not yet seen the correct answer or solution! For information on accessing the latest treatments, please get support from the AiroMedical team.
- NHS: Overview - Ovarian cancer
- CDC INFORMATION: What Are the Risk Factors for Ovarian Cancer?
- SAGE Publications Ltd: Ovarian Cancer: Diagnostic, Biological and Prognostic Aspects
- American Academy of Family Physicians: Diagnosis and Management of Ovarian Cancer
- American Cancer Society: Survival Rates for Ovarian Cancer
- Cancer Research UK: Ovarian cancer survival
- Cancer Council Victoria: Diagnosing ovarian cancer