The first symptoms and signs of ovarian cancer in women - how to identify them in the early stages

What is ovarian cancer?

Ovarian cancer ( ovarian carcinoma ) is a malignant tumor in one or both ovaries in women. It can start in any of the three types of cells found in the ovary (see below).

Epithelial ovarian, fallopian tube, and peritoneal cancers develop in the same cell type and are very similar.

Recent research shows that many epithelial ovarian cancers begin in the fallopian tubes. Ovarian cancer often spreads from the ovaries to the diaphragm, the lining of the abdomen (peritoneum), and the fatty tissue that hangs inside the abdominal cavity (omentum).

Complications of oncological pathology

A malignant tumor during its development and spread can cause various complications that significantly reduce a patient’s chances of survival. Any neoplasm can twist, thereby causing a cessation of blood and nutrients to the organ. Against the background of this phenomenon, necrosis develops. It is accompanied by severe acute pain and hyperthermia. In this condition, the patient is immediately taken to the operating table.

Ascites is another serious complication of malignancy. It occurs when too much fluid accumulates in the abdominal cavity. The presence of ascites can be understood by an increase in abdominal volume. Biological fluid can also accumulate in the chest cavity. In this case, ascites is accompanied by severe shortness of breath and pleural effusion.

There are also the following complications of ovarian cancer:

Swelling of the lower extremities.
Pleurisy.
Rupture of the walls of internal organs.
Lymphostasis.

The development of carcinomatosis cannot be excluded. This pathology is observed when cells begin to move into the abdominal cavity through the lymphogenous route. There they penetrate the serosa. The cells then group together and form a tumor.

Ovaries

The ovaries are part of the female reproductive system, which also includes the fallopian tubes, uterus, cervix, vagina (birth canal), and vulva (external genitalia).

The ovaries are two small grape-shaped organs. They are located in the lower abdomen (pelvic cavity). There is one ovary on each side of the uterus, close to the end of the fallopian tubes. Each ovary consists of:

epithelial cells - found on the outside of the ovary in a layer known as the epithelium
germ cells - found inside the ovaries, these cells eventually mature into eggs (ova)
stromal cells - form connective (supporting) tissue in the ovaries and produce the female hormones estrogen and progesterone.

Every month, the ovaries release an egg in a process called ovulation. The egg moves through the fallopian tube into the uterus. If the egg is fertilized by sperm, it will implant itself into the lining of the uterus and grow into an embryo. If the egg is not fertilized by sperm, the mucous membrane is shed and flows out of the body through the vagina. This process is known as a woman's period (menstruation).

Estrogen and progesterone cause ovulation and menstruation. As a woman gets older, the ovaries gradually produce less of these hormones. When estrogen and progesterone levels drop low enough, a woman's periods become irregular and eventually stop. This is called menopause. After menopause, it is no longer possible to conceive a child. The ovaries also become smaller.

Main symptoms

It is useful for every woman to know what the early symptoms of ovarian carcinoma look like. The disease can begin at any age, but most often it manifests itself at the end of reproductive age, and the largest number of patients are women 60–65 years old.

At the very beginning, signs of tumor development are almost impossible to distinguish from irritable bowel syndrome (the seriousness of the IBS problem is described here). This syndrome is extremely widespread and affects more than 20% of the entire population from time to time. It is especially difficult for women who are addicted to strict diets to understand the symptoms. In this case, weakness, nausea, pain and discomfort in the abdomen are a common condition.

The whole complex of early symptoms looks like this:

slight weight loss;
fatigue, weakness;
disruptions in the menstrual cycle;
weak nagging pain in the lower abdomen;
occasional nausea, bloating, upset stomach;
loss of appetite;
saturation too fast.

Almost 100% of absolutely healthy women experience similar sensations during normal fatigue. It doesn’t even occur to the patient to see a doctor about this. But meanwhile, even a very small tumor can be detected during a gynecological examination. That is why doctors so persistently convince women not to avoid scheduled visits.

Often, carcinoma at an early stage is discovered completely unexpectedly, when a woman who considers herself healthy undergoes a medical examination.

As the tumor grows, the symptoms become more vivid and specific:

systematic bloody discharge appears from the genital tract;
the stomach increases in size against the background of general emaciation;
urination becomes more frequent;
suffer from persistent constipation;
pain increases noticeably before and during menstruation;
dull pain in the lower back, radiating to the hips.

But this external picture completely coincides with a protracted, but completely harmless functional cyst. To find out everything completely, you need to conduct a real diagnosis.

How common is ovarian carcinoma?

According to the International Agency for Research on Cancer, more than 165 thousand new cases of ovarian cancer are registered annually in the world, and more than 100 thousand women die from malignant ovarian tumors.

The average age at diagnosis is 55 - 65 years. It is the fifth most common cancer in women in the world. Ovarian cancer is more often diagnosed in women over 50 years of age.

Most common types of ovarian cancer

Epithelial

begins in the fallopian tubes, on the surface of the ovary (epithelium) or in the peritoneum;
the most common type of ovarian cancer (about 9 out of 10 cases);
subtypes include serous, mucinous, endometrioid, and clear cell carcinoma;
usually develops in women over 60 years of age.

Sex cell

begins in egg (germ) cells;
a rare type of ovarian cancer (about 4% of cases);
usually develops in adolescents and women under 40 years of age.

Stromal cells (or sex cordstromal tumors)

a rare cancer that starts in the cells that produce the female hormones estrogen and progesterone;
usually occurs in women between 40 and 60;
may produce additional hormones such as estrogen.

What is the purpose of the organ?

The ovaries are organs that are part of a woman’s reproductive system. In essence, they are endocrine glands that produce sex hormones and eggs. Timely maturation of the egg in the follicle allows a woman to become pregnant, and the normal functioning of the ovaries ensures pregnancy.

In addition, the overall functioning of many systems of a woman’s body depends on the balanced production of hormones. In these organs, not only a malignant, but also a benign tumor can develop, which also disrupts the functioning of the ovary, but does not go beyond its limits, and therefore does not damage other organs.

First sign and symptoms

In the early stages, ovarian cancer usually has no symptoms. This means it is usually diagnosed when the cancer is more advanced.

When they appear, first signs may include:

pressure, pain or discomfort in the abdomen or pelvis;
bloated stomach and flatulence;
loss of appetite or feeling full after eating a little;
constipation, diarrhea;
frequent urination;
upset stomach and nausea;
fatigue;
unexplained weight loss or weight gain;
changes in menstrual cycle or bleeding after menopause;
pain during sex.

If these symptoms are new to you, severe or have persisted for more than a few weeks, write down how often they occur and make an appointment to discuss them with your GP (GP).

These symptoms can also occur with many other conditions and do not necessarily mean you have cancer, but it is best to get tested.

Pain syndrome

Pain in the early stages of cancer is very mild, and can easily be confused with ordinary colic and discomfort that accompany menstruation. True, these pains can appear at any time, regardless of the cycle.

Nagging pain and a persistent feeling of discomfort occur in the lower abdomen, lower back, and back. All this, of course, is very easy to mistake for a lot of other diseases and ailments, and, fortunately, in the vast majority of cases this is the case. For example, pain, discomfort, bloating and bleeding may not be caused by oncology at all, but by a harmless functional ovarian cyst (you can read more about these cysts here and here). Almost every young woman has to deal with such cysts at least once in her life. And again, almost all of them require only medical supervision, proper diet and intensive rest, after which they disappear without a trace.

Back pain can easily be mistaken for osteochondrosis, which haunts every adult. But with cancer, the pain is more constant and does not respond in any way to the prescribed set of exercises for osteochondrosis.

In later stages of cancer, the pain is also accompanied by breathing problems, characteristic of severe osteochondrosis. This is when large-scale examinations of the entire body begin, during which advanced cancer is discovered.

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Causes and risk factors

The causes of most cases of ovarian cancer are unknown, but risk factors include:

Age: Ovarian cancer is most common in women over 50 and in women who have stopped menstruating (menopause);
genetic factors : up to 20% of serous ovarian cancers (the most common subtype) are associated with an inherited defective gene, a smaller proportion of other types of ovarian cancer are also associated with genetic disorders;
family history : having one or more close relatives diagnosed with ovarian, breast, colon or uterine cancer;
reproductive history : women who have not had children or who have children over the age of 35 may be at greater risk;
lifestyle : such as smoking and excess weight (obesity);
hormonal factors : including early puberty or late menopause, or use of hormone replacement therapy (HRT) only for five years or more.

Several factors reduce the risk of developing ovarian cancer. These include having children, breastfeeding, using combined oral contraceptive pills for several years, and having a fallopian tube ligation (voluntary surgical sterilization of women).

How important are genetic factors?

Most women diagnosed with ovarian cancer do not have a family history of the disease.

Some women have an inherited defective gene that increases their risk of developing ovarian cancer. However, not all women who inherit the defective gene develop ovarian cancer, and not all women who inherit the defective gene have a family history of cancer.

The main genetic disorder known to increase the risk of ovarian cancer is hereditary breast/ovarian cancer, usually caused by a defect in the BRCA1 and BRCA2 .

Less commonly, Lynch syndrome (hereditary colon cancer without polyposis) can also be associated with ovarian cancer. It is found that about 15–20% of women with ovarian cancer have a defect in one of the BRCA genes or other similar genes.

Other genetic conditions continue to be identified and are often included in genetic testing for cancer risk. Genetic testing aims to identify defective genes that may increase the risk of developing cancer.

The cancer center specialist will evaluate your eligibility and, with your permission, order a blood test to check if you have BRCA1, BRCA2 , or another similar mutation. Knowing whether you have a specific faulty gene can help determine appropriate treatment options.

Ultrasound procedure of the ovary, interpretation for cancer

Pathology of ovarian development is detected during ultrasound of the pelvic and abdominal organs. Thanks to the response of tissues to sound waves, the device creates a pattern of organs. This is how the specialist determines any deviations in shape or size, as well as the location of the reproductive organs.

The most informative methods of diagnosis are vaginal and abdominal ultrasound. The abdominal view is characterized by examination through the skin of the abdomen, and the vaginal view is characterized by the insertion of a sensor into the woman’s vagina.

The average duration of an ovarian ultrasound procedure is 20-30 minutes; from the photo on the screen, the specialist assesses the location of the ovaries, their size and shape, as well as the structure of the organ. In a normal state, they are located on both sides of the uterus, have a certain size (length from 2.5 cm to 4 cm) and structure (fibrous compounds, capsule with follicles).

What does ovarian cancer look like on ultrasound?

There are certain specific markers that indicate the development of an oncological process:

Asymmetry and changes in size, sometimes the outline of the organ is partially displayed.
Postmenopausal women have a neoplasm on the organ, similar in shape to a cystic cyst.
The presence of an enlarged vascular network at the site of the neoplasm.
In the absence of ovulation, an accumulation of fluid is detected behind the wall of the uterus.

Fixing at least one sign during ultrasound requires the appointment of an additional observation method. A specialist can monitor the development of the detected marker over 1-2 months.

If several marker signs are detected simultaneously during the examination, the woman is immediately sent to an oncologist, who will prescribe diagnostics for the thyroid gland, breast, lymph nodes, kidneys and reproductive organs. This is aimed at identifying metastasis of a malignant tumor.

Diagnostics

There is currently no effective screening test for ovarian cancer. If your doctor suspects you have an ovarian tumor, you may be asked to undergo some of the tests described in this section. These examinations can show whether there are any abnormalities that should be taken for biopsy.

The only way to confirm a diagnosis of ovarian cancer is to take a tissue sample (biopsy) and look at the cells under a microscope. This is usually done during surgery, which means the cancer is diagnosed and treated at the same time.

Gynecological examination

The doctor will check for any masses or lumps by feeling your stomach. To check the uterus and ovaries, the doctor will place two fingers inside the vagina while pressing the abdomen with the other hand. You may also have a vaginal examination using a speculum, an instrument that separates the vaginal walls.

The internal examination is not painful, but may be uncomfortable. The doctor may also perform a rectal exam by wearing gloves and placing a finger in the anus to feel the tissue behind the uterus where cancer cells may be growing.

The cervical screening test (which replaced the Papanicolaou smear, Pap test) does not diagnose ovarian cancer. It detects human papillomavirus infection (human papillomavirus (HPV)), which causes most cervical cancers, but not ovarian cancers.

CA-125 blood test

Your blood may be taken for tests to look for proteins produced by cancer cells. These proteins are called tumor markers. The most common tumor marker for ovarian cancer is CA-125.

CA-125 levels may be higher in some women with ovarian cancer. However, it may also increase for reasons other than cancer, including ovulation, menstruation, irritable bowel syndrome, liver or kidney disease, endometriosis, or uterine fibroids.

The CA-125 blood test is not used to diagnose ovarian cancer in women who do not have any symptoms. However, it may apply:

For diagnosis : The CA-125 test is more accurate in diagnosing ovarian cancer in women who have gone through menopause (postmenopause) than in those who have not (premenopause). Women with early stage ovarian cancer often have normal CA-125 levels. This is why doctors often combine CA-125 tests with ultrasound (see below).
During treatment : If you have ovarian cancer that causes CA-125 levels to rise, a blood test may be used to check the effectiveness of treatment. A falling CA-125 level may mean that therapy is helping, and a rising CA-125 may mean that treatment is not working, but the CA-125 level is only one element used by the treatment team to assess a woman's response to therapy.
After treatment : A CA-125 blood test is sometimes included in follow-up tests.

Visual diagnostics

Your doctor may recommend several imaging tests to determine the extent and stage of the disease. You may also have a chest x-ray to check the lungs for metastatic cancer or fluid.

Ultrasound of the pelvic organs: A pelvic ultrasound uses echoed sound waves to create a computer image of your uterus and ovaries. A medical professional called a sonographer or ultrasonographer performs the scan. This can be done in two ways:
Transvaginal ultrasound : The sonographer will insert a small probe wand into the vagina. It will be covered with a disposable plastic shell and gel to make it easier to insert. Some women find this procedure unpleasant, but it should not be painful. Talk to your doctor and sonographer if you feel worried, they will help you reassure yourself as this test is very necessary.

Transvaginal ultrasound is often the preferred type of ultrasound because it provides a clearer picture of the ovaries and uterus.

CT scan

A computed tomography (CT) scan uses X-rays to take pictures of the inside of the body. It is used to look for signs that cancer has spread, but a CT scan cannot detect all ovarian tumors. CT scans are usually done in a hospital or radiology clinic.

You will be asked not to eat or drink for several hours before the scan. A liquid dye, sometimes called contrast, may be injected into one of your veins to make the images clearer. The contrast causes organs to appear white on a scan, so anything unusual can be seen more clearly.

Contrast agents can make your entire body feel hot and leave a bitter taste in your mouth. You may also feel the need to urinate. These side effects usually go away quickly, but if they persist, tell the person doing the scan.

A CT scanner is a large donut-shaped machine. You will lie on a table that moves in and out of the scanner. The scan takes 10–20 minutes , but may require additional time to prepare and then wait for the scan. Although a CT scan may be noisy, it is painless. Most women can go home once the CT scan is completed.

Contrast agents used in CT scans usually contain iodine. If you have an allergic reaction to iodine, tell your doctor in advance. You should also tell them if you have diabetes, kidney disease, or are pregnant.

PET scan

A PET (positron emission tomography) scan highlights abnormal tissue in the body and can be more accurate than a CT scan. The results are often used to plan surgery and check the effectiveness of treatment.

Before the scan, you will be given a small amount of radioactive glucose solution . The solution makes cancer cells appear brighter in scans because they absorb more glucose solution than normal cells. You will be asked to sit quietly for 30 to 90 minutes while the glucose solution moves through your body, then you will be scanned for high levels of radioactive glucose.

Any radiation will leave your body within a few hours. Tell your doctor in advance if you are diabetic, pregnant, think you may be pregnant, or are breastfeeding.

Colonoscopy

Some women have a bowel test (colonoscopy) to make sure their symptoms are not caused by a bowel disorder. The doctor will insert a thin, flexible tube with a small camera and light (colonoscope) through the anus and into the intestines.

Before the test, you will have to change your diet and take prescribed laxatives to completely cleanse your bowels. The process varies depending on people and hospitals. Your doctor will give you specific instructions and tell you what to expect. You will likely be given pain medication that day so that you do not feel any discomfort.

A colonoscopy usually takes about 20–30 minutes . You will need someone to drive you home after this as you may feel drowsy or weak.

Staging and classification of ovarian cancer

The tests described above help determine whether you have ovarian cancer and whether it has spread to other parts of the body. This process is called staging and helps your healthcare team create a treatment plan.

Basic diagnostic methods

The main task of diagnosis is to differentiate malignant ovarian tumors from various types of cysts, uterine fibroids, adnexitis, and tuberculosis of the appendages. It should be noted that in the early stages of the disease it can be quite difficult to determine the malignant nature of the neoplasms and the final diagnosis is made only by analyzing the material removed during the operation.

To establish a diagnosis, the following methods are used:

Examination by a gynecologist. The tumor and the degree of its mobility are determined by palpating the appendages.
Lab tests. A clinical blood test allows you to detect deviations in basic blood parameters relative to reference values - increased leukocytosis, decreased platelet count, the presence of lymphoblasts and myeloblasts, decreased hemoglobin levels and accelerated ESR. In addition, an analysis of the level of sex hormones is carried out to detect hormonally active tumors. A blood test for the CA-125 tumor marker suggests the presence of a malignant process, although a slight increase in the level of this ovarian cancer antigen does not always indicate the presence of a tumor.
Ultrasound. Ultrasound location of the ovaries provides information about the presence of a tumor and its size. This type of examination also allows you to determine the fluid contents of cysts, the viscous or dense structure of the tumor.
PET-CT. This examination combines positron emission and computed tomography and allows you to obtain detailed information about the nature and location of the tumor, the presence of metastases, and the condition of surrounding tissues. The simultaneous use of PET and CT technologies makes it possible to reduce the time required for examination.
MRI (magnetic resonance imaging). Examination using radio waves, used instead of X-rays, is used not so much to diagnose ovarian tumors, but to detect distant metastases, especially in the bones and brain.
Laparoscopy. Examination of the abdominal cavity using fiber optics and taking material for biopsy is used in special cases when difficulties arise in establishing a diagnosis. For example, when papillary growths are detected in a cyst using this method, in some cases a histological examination is performed. In addition, laparoscopy can provide information about the extent of tumor growth into neighboring organs - bladder, intestines, etc. In this case, in addition to the gynecologist, the relevant specialists are involved in the operation to remove the tumor: urologist, proctologist and others.

Laparoscopic examination is an examination of the ovaries through small incisions in the abdominal wall using special equipment.

Ovarian cancer treatment

Treatment for ovarian cancer depends on the type of ovarian cancer, the stage of the cancer, your general health and fitness, your doctors' recommendations, and whether you want to have children in the future.

Treatment options by type of ovarian cancer

Epithelial

Surgery is the main treatment for all stages of ovarian epithelial cancer. The goal is to remove as much cancer as possible. Sometimes additional treatment is required.

Stage I ovarian cancer is usually treated only with surgery. Some women will be offered chemotherapy after surgery if there is a high risk of the cancer coming back.
Stages II, III and IV are usually treated with a combination of surgery and chemotherapy. New targeted therapies are available for targeted therapy for women with BRCA mutations. In some cases, radiation therapy is also offered.

Germ cell

Typically treated with surgery and/or chemotherapy.

Stromal cell

It is usually treated with surgery, sometimes followed by chemotherapy or targeted therapy.

Borderline tumor

Usually treated only with surgery.

Surgery

Your gynecological oncologist will tell you about the most appropriate type of surgery, as well as the risks and possible complications (such as infertility). If having children in the future is important to you, talk to your doctor before surgery and ask for a referral to a fertility specialist

Ovarian cancer is staged surgically . This means the surgery will help the doctor determine how far the tumor has spread in the pelvis.

You will be given general anesthesia and will have a laparoscopy (with 3-4 small incisions in the abdomen) or laparotomy (with a long vertical incision from the navel to the bikini line). The type of surgery will depend on how confident the gynecologic oncologist is that cancer is present and how much they think the cancer has spread. Laparoscopy may be used to see if a suspicious lump is cancerous; however, most women with advanced cancer will undergo laparotomy.

Your gynecologic oncologist will check for cancer in your pelvis and abdomen and take samples of tissue and fluid (biopsy). During surgery, samples are usually sent to a laboratory specialist, who will immediately examine them for signs of cancer. This is called frozen section analysis or biopsy.

If cancer is present, the gynecologic oncologist will proceed with surgery and remove as much of the cancer as possible. This is called surgical release.

Types of surgery

Depending on how far the cancer has spread, one or more of the procedures listed below may be prescribed.

Total hysterectomy and bilateral salpingo-oophorectomyhysterectomy + bilateral salpingo-oophorectomy : Most women with ovarian cancer will have surgery to remove the uterus and cervix, as well as the fallopian tubes and ovaries.
Unilateral salpingo-oophorectomy : If the cancer is found early and is found in only one ovary, some young women who still want to have children may have only one ovary and fallopian tube removed.
Omentectomy : The omentum is a sheet of fatty tissue attached to the stomach and intestines. It hangs down in front of the intestines. Ovarian cancer often spreads to the omentum and may need to be removed. The procedure to remove the omentum is called an omentectomy.
Lymph node removal : The pelvic area contains a large group of lymph nodes. Cancer cells can spread from the ovaries to nearby lymph nodes. Your doctor may suggest removing some of them using a lymphadenectomy (also called lymph node dissection).
Colectomy : If the cancer has spread to the intestines, part of the intestine may be removed in a procedure called a colectomy. A new opening called a stoma (colostomy or ileostomy) may be created. Usually temporary.

All tissue and fluid removed during surgery are examined for the presence of cancer cells. The results will help confirm the type of ovarian cancer, if it has spread (metastasized), and its stage. It may not be possible to remove all cancerous tissue. Surgery is often followed by chemotherapy, which will reduce or destroy any remaining cancer cells.

The doctor should receive all test results within two weeks after surgery . Further treatment will depend on the type of ovarian cancer, the stage of the disease, and the amount of cancer remaining. If the cancer progresses , it is likely to come back, so surgery is usually followed by chemotherapy and sometimes targeted therapy. Radiation therapy is not often recommended.

Chemotherapy

Chemotherapy is the treatment of cancer using anticancer (cytotoxic) drugs. The goal is to destroy cancer cells while causing the least amount of damage possible to normal, healthy cells. Chemotherapy may be used:

After surgery : Most women receive chemotherapy (adjuvant chemotherapy) after surgery because cancer cells may remain in the body. Chemotherapy usually begins 2 to 4 weeks after surgery. The medications you receive will depend on the stage of the cancer and your overall health. For ovarian cancer, a combination of several drugs is usually given in repeated cycles over 4–5 months. Your treatment team will provide details about your specific schedule.
Before surgery : Some women with stage III or IV ovarian cancer need chemotherapy before surgery (neoadjuvant chemotherapy). The goal is to shrink tumors so they are easier to remove. Typically, three cycles of chemotherapy are used, followed by surgery, and then three more cycles.
As primary treatment : Chemotherapy may be recommended as primary treatment if you are not healthy enough for major surgery or if the cancer cannot be removed by surgery.

Chemotherapy is usually given as a combination of two drugs, or sometimes as a single drug. Administered intravenously. To reduce the need for repeated injections, some women have a small medical device or tube under the skin through which the chemotherapy is passed. This may be a port catheter implanted in the skin or another type of catheter.

What is the disease and how can it manifest itself?

By ovarian cancer, gynecological oncologists mean a whole group of malignant tumors that differ significantly in character, origin, behavior, etc. All these malignant neoplasms are united by a common feature: they affect the ovaries - the paired organs of the female reproductive system, in which eggs mature and sex hormones are produced.

A cancerous tumor is formed from ovarian tissue

The insidiousness of ovarian cancer is that in most cases, in the early stages of development, it practically does not manifest itself at all. For this reason, approximately ¾ of patients turn to doctors with the disease in an already advanced stage, when it is much more difficult, and sometimes impossible, to help them.

According to medical statistics, after 40–45 years of age, women have a significantly increased risk of developing malignant ovarian tumors. Before the onset of menopause, in the so-called premenopause, there is a constant decrease in the activity of the ovaries, which gradually reduce the secretion of sex hormones, which leads to an imbalance in the hormonal balance in the body. This situation sometimes causes the development of ovarian cancer. After 70–75 years, hormonal “storms” in the body subside, and the incidence of the disease declines.

The first signs of pathology

The very first manifestations of ovarian cancer can be considered the following symptoms:

mild abdominal discomfort;
fast fatiguability;
sensation of a foreign formation inside the abdomen, especially when changing body position, during bowel movements and sexual intercourse;
an increase in the number of leukocytes and acceleration of ESR (erythrocyte sedimentation rate) during a blood test.

It should be noted that these signs may not mean the presence of this pathology at all, but indicate, for example, the development of an ovarian cyst or internal hemorrhoids, but in this case you must consult a doctor and undergo the necessary examination.

How can the disease manifest itself in later stages?

As the malignant tumor grows, it begins to put pressure on neighboring organs, which can no longer go unnoticed. In addition, most neoplasms have the ability to actively grow into surrounding tissues, disrupting their structure, and also give distant metastases. As a result, the patient may develop the following symptomatic picture:

nagging, and over time, sharp pain in the lower abdominal segment and lower back, intensifying with exercise;
pain after intercourse;
uterine bleeding not associated with menstruation;
ascites - accumulation of fluid in the abdominal cavity, a sign of which is an enlarged abdomen;
loss of appetite, weight loss;
weakness, irritability;
feeling of nausea;
change in stool character - constipation or diarrhea;
low-grade fever for no apparent reason or from time to time an unexpected temperature “candle”, reaching 380 and above;
an increase in the number of leukocytes and a high ESR in the blood test;
in the presence of distant metastases, symptoms in the organs where metastasis occurred - cough, bone pain, headaches, etc.

With ovarian cancer, fluid often accumulates in the abdominal cavity, causing an enlarged abdomen

When the leg of a cancerous tumor is torsed or when a neoplasm ruptures, a picture of an “acute abdomen” is observed, characterized by sharp, severe pain, accompanied by tension in the abdominal wall. But this is not a specific sign of ovarian cancer - similar signs are present in similar situations with benign neoplasms.

Peculiarities of symptoms of certain types of tumors

As already noted, ovarian cancer refers to a number of malignant neoplasms that have a different structure, character, can develop from various ovarian tissues, etc. More than three-quarters of all tumors are epithelial, that is, formed by the cells of the epithelial lining of this organ. The rest of ovarian cancer is divided into the following types:

endometrioid cancer, combining glandular contents and foci of epithelial tissue;
papillary adenocarcinoma, developing from ovarian cysts, often growing into the omentum and neighboring organs, but at the same time having a fairly favorable prognosis;
cystic neoplasms with mucinous (mucous), serous and teratoid (viscous) structure;
mesonephroid or clear cell cancer, which is highly aggressive due to the low differentiation of cancer cells;
Brenner's cancer, which grows from cells of the stromal (framework) of the ovary;
hormonally active tumors - granulosa cell carcinoma and adenoblastoma;
secondary ovarian tumors of a metastatic nature, i.e. brought from other organs where the primary tumor is located.

As a rule, all cancerous changes in the ovary to one degree or another have similar symptoms, except for neoplasms that have hormonal activity. Their difference is that they usually manifest themselves in the early stages of the disease, creating an excess of sex hormones in the body, both female and male, resulting in:

uterine bleeding;
menstrual irregularities;
amenorrhea (absence of menstruation) during reproductive age;
restoration of the menstrual cycle during the postmenopausal period;
development of some male sexual characteristics - deepening of the voice, hirsutism (active growth of hair on the face and body), changes in the figure according to the male type.

The appearance of hirsutism may indicate the development of a hormonally active ovarian tumor

Forecast

Prognosis means the expected outcome of a disease. You can discuss your prognosis and treatment options with your doctor, but no doctor can predict the exact course of the disease in an individual.

Epithelial cancer

The stage and extent of the cancer will influence the outcome. If epithelial ovarian cancer is diagnosed and treated before the cancer has spread beyond the ovary (stage I), it has a good prognosis. Many women with more advanced cancer may respond well to treatment, but the cancer often comes back (recurs) and further treatment is required.

Germ cell and stromal cell tumors

They usually respond well to treatment.

Borderline tumor

She also has a good prognosis.

Your doctor will consider many factors when assessing your prognosis. These include: survey results; type of ovarian cancer; stage; genetic factors; response to treatment; and other factors such as age, fitness and general health.

The treatment will cause some physical and emotional changes. Some women experience many side effects, while others have few. Most side effects are temporary, but some may be permanent. Some women may take up to 1-2 years to feel well again.

Prevention of the disease

Unfortunately, even regular examinations by a doctor do not provide a 100% guarantee of detecting ovarian cancer at the first stage of the disease. The above symptoms should be a signal for a woman to immediately visit a doctor and have her body examined.

In order to identify the disease as early as possible, it is necessary to visit a gynecologist at least once a year and regularly undergo tests for tumor markers. In addition, you should lead a full sex life, but avoid questionable sexual relations and abortions. And during intimacy, it is advisable to use condoms. If you take such care of your health, illness will bypass you. Take care of yourself!

Symptoms of the disease

At the initial stages, the manifestations of carcinoma are quite vague. But being attentive to their health, patients are highly likely to notice changes in the body. These symptoms include:

change in the nature of discharge during menstruation;
pain and discomfort during sex;
constant weakness, nausea;
spotting not associated with the menstrual cycle;
difficulty defecating and emptying the bladder.

As the pathology progresses, there is an increase in the volume of the abdomen due to the tumor itself, as well as developing ascites. Constant nagging pain in the lower abdomen, shortness of breath and low-grade fever are added.

Treatment of carcinoma

When deciding on a treatment plan, many factors are taken into account: the type of tumor, stage of development, its location and size. Surgery is considered the most effective treatment method. For small tumors and the absence of metastases, resection of one or both ovaries is performed. In other situations, the uterus along with the omentums must be removed.

In addition to surgery, several courses of chemotherapy are required before and after removal of the affected organ. The goal is to stop further growth of carcinoma and reduce its size, destroy remaining lesions after surgery and prevent possible relapses. The choice of drugs and their dosage is carried out by the oncologist and chemotherapist.

Radiation therapy is not indicated in all cases, since not all tumors are sensitive to such effects. In advanced cases, it is used to reduce the suffering of patients. The effectiveness of this method is no more than 27%.

The prognosis for existing ovarian carcinoma is very serious. With timely treatment, you can get rid of this disease forever. Under other conditions, patient survival decreases, and the risk of relapse and metastasis increases. There is only one conclusion - women should regularly consult specialists for early detection and treatment of tumors.

General symptoms

In addition to specific symptoms, ovarian cancer is characterized by some common signs found in various types of cancer:

Loss of appetite. It occurs as a result of constant nausea, which occurs regardless of food intake. Along with loss of appetite, there may be a change in taste preferences. For example, giving up fatty and meat products.
Nausea. It is a consequence of a disruption in the production of pancreatic enzymes and the constant accumulation of toxins from decaying cells of the affected tissue. Depending on the stage of the disease, nausea can be periodic or constant, turning into frequent vomiting.
Weakness. It occurs due to anemia and is accompanied by drowsiness, loss of ability to work, and fever.

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Ovarian cancer, like every cancer disease, manifests itself asymptomatically and suddenly. It is the most common disease of the female reproductive system. A woman usually finds out that she has such an illness, usually when it is too late to do anything.

Causes

There are nonspecific reasons for the development of the oncological process, as well as specific ones, i.e. specific for each specific type of tumor. Nonspecific causes include all external environmental factors that reduce the body's resistance to pathogens and weaken the immune status.

In the case of ovarian carcinoma, there are a number of characteristic causes that have a direct impact on the development of a malignant neoplasm:

Absence of childbirth in the anamnesis is one of the actively researched reasons. Despite the lack of data on the pathogenetic mechanism, there is a certain correlation between the incidence of carcinoma and the absence of a history of pregnancy.
Another dependence has long been noticed: the use of combined oral contraceptives significantly increases the risk of developing malignant neoplasms in the ovaries, as well as vice versa - the lack of oral contraceptives is a factor in the formation of carcinoma.
Hereditary predisposition - despite the fact that in almost all cancers the hereditary factor plays a large role - in the case of ovarian carcinoma there is a clear connection between the detection of the disease and the burden of the family history.

Also, significant risk factors for the formation of carcinoma include systematic gonadotropic stimulation, the concomitant presence of myomatous nodes in the uterus, chronic inflammatory processes occurring in the internal genital organs and late onset of menopause.

Oncology at different ages

Women of different age groups experience specific disorders during the development of malignant neoplasms. The main features are as follows :

Signs in girls. If, during the appearance of a tumor in the body, there is a significant increase in the amount of estrogen, then puberty occurs quickly, which is not proportional to the age of development of the mammary glands. During the manifestation of these deviations (if this is not a hereditary feature), the girl should be examined as quickly as possible for oncology, the presence of gynecological and endocrine disorders.
Symptoms in mature women. During certain types of tumors, persistent menstrual irregularities occur. If a neoplasm appears with the release of androgens, then there is a sharp decrease in sexual desire. Angularity develops, facial contours change, the voice becomes rougher, and increased hair growth occurs.
Signs in elderly women. Symptoms are especially noticeable when a neoplasm develops with the release of estrogen. The patient, despite the emerging disease, begins to inexplicably look younger in appearance, and her sex drive increases. After a long absence of menstruation, they may reappear.

Treatment of ovarian tumor

If the ovarian tumor is more than 60 mm in size and retains its shape for more than 6 months or is malignant in nature, surgery is prescribed. The extent of surgical treatment is based on the type of tumor. To combat cancer cells, hysterectomy and incomplete resection of the greater omentum using laparotomy are prescribed.

Surgical excision of an ovarian tumor

Surgical intervention is prescribed for malignant type and increased size of the growth. The operation is performed based on the established diagnosis. The surgical process is influenced by many factors. Among them are:

type of tumor lesion;
the size of the build-up;
nature of the course;
affected area;
age category of patients, desire to preserve reproductive function and the possibility of childbearing.

If a tumor is detected in the early stages, it becomes possible to use the laparoscopy method. The method eliminates malignant cells while minimally damaging healthy ovarian material. This helps to recover faster in the postoperative period. Patients are able to return to their normal lifestyle.

Finding a benign tumor in the reproductive age category requires minimal surgical intervention. The doctor resorts to incomplete resection of the ovary or a procedure of unilateral excision of the ovary and fallopian tube. If the second ovary is not functioning well, patients are offered stimulation—egg cryopreservation. The method will help a woman in the future to give birth to a child using IVF.

If the pathology is detected at the threshold of the onset of menopause, surgical intervention is performed as if the growth is malignant. If the tumor stalk is torsed or the integrity of the membrane is damaged, an urgent operation comparable to adnexectomy is performed. Before and after surgery, the patient undergoes chemotherapy. The procedure helps to facilitate the surgical procedure and remove unresolved diseased cells.

Radiation therapy has a similar effect. Along with these treatment methods, the use of immunomodulators and vitamins are required. In the case of a wide area of distribution of the pathology, it is necessary to excise the uterus and appendages. After the treatment, the patient undergoes hormonal therapy for the rest of her life.

Therapeutic treatment of ovarian tumor

All patients undergo surgery to remove cancer, regardless of its nature. The method of surgical intervention is influenced by the type of growth, the area of distribution and the severity of symptoms. There are 2 types of operations:

Excision of a tumor together with an organ with benign properties.
Removal of the uterus with appendages and greater omentum in the early stages of oncology development.

Laparoscopy in a woman
If a woman has not given birth, one ovary is excised, and after the children are born, the rest of the organs are removed. This method is appropriate if the ovarian membrane is not affected by the affected cells and there are no signs of the spread of metastases. After eliminating the ovarian tumor, patients undergo chemotherapy and radiation therapy. The procedures can reduce the likelihood of relapse in the future. For patients who have undergone surgery in the early stages, drugs containing platinum (Cisplatin, Carboplatin) are prescribed. In the later stages, women undergo 6 courses of Paclitaxel and Carboplatin intravenously.

According to statistics, the probability of a recurrence of cancer is more than 30%. Many patients resort to folk remedies to cure ovarian tumors. Thanks to the research, experts have compiled a list of herbs and products that have a detrimental effect on affected cells:

Red pepper is effective in the fight against cancer cells. The product contains the substance capsaicin, which, when it gets on the affected areas, destroys them. The product is prepared using 2 kg of red pepper and flax oil. The vegetable is washed and chopped. It is important to use an eye mask and gloves to avoid contact of irritants with mucous membranes. Pour oil into a 2 liter jar and add finely chopped pepper. The resulting solution should be placed in a cool place for 1 week. Then the mixture is passed through a gauze cloth, the resulting liquid is drunk 1 tsp. 4 times a day. The drug requires caution due to the increased risk of burns to internal organs.
The golden mustache has proven to be effective in the gynecological field. Thoroughly peel and finely chop 100 freshly picked leaves. The chopped greens are placed in a glass vessel and filled with water. The jar lid must be screwed on tightly. The mixture is left in a dark place for half a month. It is recommended to drink 10 drops of the solution daily. The tincture is washed down with plenty of water.

Treatment

The treatment of this disease involves surgery and chemotherapy. In localized forms, as a rule, removal of the uterus, appendages, and resection of the omentum is indicated. For disseminated malignancy, palliative surgery is used, the goal of which is to shrink the tumor before chemotherapy. In this case, chemotherapy plays the main role. In the preoperative period, the use of drug therapy is carried out in order to reduce the manifestations of symptoms and alleviate the patient’s condition.

The main reasons for the appearance

Genetics play a fairly important role in the development of cancer. The risk of occurrence increases if someone in your family has been diagnosed with cancer.

Another common reason why the appendages or ovaries may become swollen is a hormonal imbalance. The appearance of hyperestrogenism is also provoked by the following factors :

rapid puberty (the cause of the development of pathology in adolescents);
disruption of hormone synthesis by the kidneys and pituitary gland, improper functioning of the ovaries and appendages;
improper use of contraceptive drugs, which leads to hormonal imbalance;
prolonged use of estrogen-containing products during menopause, amenorrhea, and during relief from menopausal symptoms in the elderly;
the presence of cancer in other internal organs. Quite often, metastases occur in the uterus during cancer of the stomach, colon, thyroid, uterus, and breast;
abortions and other negative physical effects on the body;
acute infectious and inflammatory diseases of the reproductive system.

The appearance of cancer can be provoked by the penetration of carcinogens into the body, as well as radiation. Infertility can lead to an increased risk of pathology, especially when during the treatment of this condition, drugs that activate the synthesis of estrogen are used for more than one year. During pregnancy, cancerous tumors do not appear.

The more pregnancies there were, the lower the chance of developing this tumor. This is due to the fact that during pregnancy and lactation there are no periods, that is, the possibility of disruption of endometrial tissue in the body, as well as hormonal imbalance, is reduced.

Classification of cancer tumors

There are several types of cancerous tumors. There are four types in total :

Primary. The neoplasm is initially malignant. Appearing in the ovaries, it begins to form metastases in other organs. This type of tumor is the most dangerous. Usually observed in young girls.
Secondary. The tumor appears as a result of the malignant transformation of a previously developed neoplasm - a cystoma (a benign growth that consists of small cysts filled with fluid inside). This type of cancer is usually observed in patients over 45 years of age.
Borderline. A tumor with a low level of malignancy develops in the ovaries, which does not spread beyond the limits for a long time.
Metastatic. Appears during the penetration of cancer-infected cells from other internal organs into the reproductive system (usually observed during stomach cancer). The neoplasm grows quite rapidly and begins to move into the abdominal cavity, where a large number of nodules form.