Ovarian Cancer: Symptoms, Causes and Treatment | Emergency Live

Among the benign tumors, the most common are ovarian cysts, which very often are functional and disappear without treatment.

There are three types of malignant tumors: epithelial tumors, germ cell tumors and stromal tumors.

Epithelial tumors arise from the epithelial cells that line the surface of the ovaries.

They are the most common and account for more than 90% of malignant ovarian tumors.

Germ cell tumors arise from the germ cells of the ovaries; they make up about 5% of malignant tumors and occur almost exclusively in adolescents.

Stromal tumors arise from the ovarian stroma, are often characterized by low-grade malignancy, and account for about 4% of ovarian malignancies.

Ovarian Cancer Symptoms

Ovarian cancer does not cause any symptoms in the early stages, so it is difficult to catch early.

The first symptoms are fairly non-specific and are often underestimated by women.

They are:

• loss of appetite
• swollen stomach
• aerophagia
• need to urinate frequently
• Feeling of fullness even on an empty stomach

When those real alarm bells ring, it’s a good idea to ask your gynecologist for a simple pelvic ultrasound, which can provide an important first diagnostic clue.

Ovarian Cancer: What Causes It?

Ovarian cancer is closely linked to age: most cases are diagnosed after menopause, between the ages of 50 and 69.

In addition, the longer the woman’s fertile period, the greater the likelihood of this cancer occurring.

Each ovulation was thought to represent a small trauma to the surface of the ovary, from which the tumor arises; For this reason, all events that reduce the number of ovulations are possible causes.

Pregnancy, the use of hormonal contraceptives and breastfeeding are considered protective factors that can reduce the risk of developing ovarian cancer.

The genetic factor also plays an important role; According to an estimate by the National Cancer Institute, between 7% and 10% of all cases are the result of a genetic change passed through generations, consisting of mutations in the BRCA1 and BRCA2 genes, which can cause ovarian cancer and breast cancer to occur at the same time or at different times times.

The risk rate for ovarian cancer is 39-46 percent when there is a BRCA1 gene mutation and 10-27 percent when there is a BRCA2 gene mutation.

Carrying a mutation in these genes means you have a higher chance, but not a certainty, of getting the disease.

In this case, however, it is important to carry out regular and thorough check-ups and to inform adult family members who may themselves be carriers of the mutation.

Bilateral annexiectomy (the surgical removal of the ovaries) is now recommended for women with the BRCA1 and BRCA2 gene mutations who have previously been pregnant or are past childbearing age.

How common is ovarian cancer?

Ovarian cancer is the ninth most common type of cancer in Italy, affecting approximately 4,490 women each year according to 2012 estimates by the Cancer Registry and accounting for 2.9% of all cancer diagnoses.

It is uncommon in Asian, African and South American countries, while in Europe it accounts for 5% of all female cancers.

Ovarian Cancer Prevention

Several screening programs have been proposed that may or may not involve performing a transvaginal ultrasound scan annually or not associated with testing for a tumor marker: CA125; However, the results were disappointing as CA125 is currently unreliable as it is too non-specific.

Another recently introduced tumor marker appears to be more reliable: HE4, which has greater sensitivity and specificity.

Nevertheless, studies have shown that an annual visit to the gynecologist, who performs bimanual ovarian palpation and transvaginal ultrasound control, can facilitate early diagnosis.

Diagnosis of ovarian cancer

The diagnosis is often made too late.

A gynecological examination with transvaginal ultrasound is essential; these are combined with laboratory tests to detect tumor markers such as CA125, CA19/9, HE4, CEA, alpha-fetoprotein.

A pelvic CT scan with contrast media and a PET scan to identify areas of high metabolic activity may be helpful.

Ovarian cancer can be diagnosed at different stages:

i, confined to the ovaries;

II, attached to one or both ovaries and extends to the pelvic organs;

III, on one or both ovaries, with extension to the pelvic organs and/or with metastases in the lymph nodes in the same area;

IV, with metastases also distant from the ovarian area, usually in the liver and lungs.

A good or bad prognosis depends on the stage of the tumor at the time of diagnosis, which must be as early as possible.

Treatment is based on surgery, chemotherapy, and the use of monoclonal antibodies

Surgery: Surgery is fundamental in the treatment of ovarian cancer. In addition to removing the tumor, it allows accurate staging of the neoplasm. In patients with advanced disease, surgery aims to remove any visible tumors (cytoreductive surgery) in addition to assessing the extent of the disease.

Chemotherapy: Chemotherapy remains the cornerstone treatment for ovarian cancer after surgery. Paclitaxel and carboplatin are used.

Monoclonal Antibodies: The tumor is closely associated with the formation of new blood vessels that nourish and grow the neoplasm. Drugs such as bevacizumab, a monoclonal antibody that specifically binds to and blocks the protein VEGF (vascular endothelial growth factor), which plays a key role in angiogenesis, have recently been used.

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