Ovarian Cancer
Does ovarian cancer have a cure? All the information on the causes, symptoms, and treatments of this disease.
Symptoms and Causes
Ovarian cancer is an uncontrolled growth of cells in the ovaries, the female reproductive glands. It is the third most common gynecologic tumor and has the highest mortality rate because it is usually diagnosed at advanced stages.
Depending on the ovarian cells that cause the cancer, there are three types of ovarian cancer:
- Epithelial ovarian cancer: The most common type. It originates from the cells covering the outer surface of the ovary.
- Germ cell tumor: Develops from the cells that produce eggs. It is very rare.
- Stromal tumor: Arises in stromal cells, which form the structural tissue that supports the ovary and produce female hormones. It is the least common type.
Symptoms
In its early stages, ovarian cancer may not present symptoms. When symptoms do appear, they are often attributed to other conditions. The most common symptoms include:
- Progressive abdominal bloating or swelling.
- Abdominal or pelvic pain.
- Feeling full quickly when eating.
- Weight loss.
- Frequent need to urinate.
- Fatigue.
- Stomach problems.
- Back pain.
- Constipation.
- Pain during sexual intercourse.
- Fatigue.
- Menstrual irregularities, such as heavy or irregular bleeding.
Causes
Ovarian cancer is caused by genetic mutations in ovarian cells that lead to their abnormal growth, resulting in tumor formation. The exact cause of these mutations is unknown, but a high percentage of cases are hereditary, involving alterations in the BRCA1 or BRCA2 genes, as well as genes associated with Lynch syndrome, Peutz-Jeghers syndrome, PTEN hamartoma tumor syndrome, or hereditary colorectal cancer. Additionally, some studies link ovarian cancer to incessant ovulation and the resulting scarring on the ovarian surface.
Risk Factors
Several factors increase the likelihood of developing ovarian cancer:
- Age: More common after menopause.
- Family history of ovarian, breast, or colorectal cancer.
- Personal history of breast cancer.
- Postmenopausal hormone replacement therapy with estrogen.
- Overweight or obesity.
- Endometriosis.
- Never having been pregnant or having a late pregnancy (after age 35).
- Early onset of menstruation or late menopause.
Complications
The main challenge of ovarian cancer is its late detection. Due to the non-specific nature of its symptoms, it is often diagnosed at an advanced stage when metastasis has already occurred. Metastasis means the cancer has spread to other organs, significantly reducing survival rates, especially if it has reached distant organs such as the liver or lungs. Epithelial cell cancer has a worse prognosis than germ cell or stromal cell cancers.
Prevention
There are no definitive preventive measures for ovarian cancer, but certain conditions may reduce the risk of developing it:
- Pregnancy and breastfeeding.
- Oral contraceptives.
- Intrauterine devices.
- Tubal ligation.
- Hysterectomy (removal of the uterus).
What type of doctor treats ovarian cancer?
Ovarian cancer is evaluated and treated by specialists in gynecology, medical oncology, and radiation oncology.
Diagnosis
To confirm ovarian cancer, several tests are required:
- Pelvic exam: A physical examination of the abdomen, genitals, vagina, and cervix.
- Blood tests: To detect tumor markers, especially CA-125. Hormone levels are also checked.
- Gynecologic ultrasound: A vaginal ultrasound probe provides a detailed view of the ovaries, detecting tumors and fluid in the pelvic cavity.
- Genetic testing: A genetic study may be recommended to rule out mutations in genes associated with ovarian cancer.
- Computed tomography (CT) scan: This test determines the size and location of the tumor in the pelvis and detects metastasis in pelvic lymph nodes, the spleen, liver, kidneys, or bladder. However, it only detects tumors larger than one or two centimeters.
- Biopsy: A sample of tumor tissue is analyzed to confirm the presence of cancer cells. This is usually done after surgical tumor removal but can also be performed beforehand using laparoscopy or needle aspiration guided by tomography.
- Paracentesis: If fluid accumulates in the abdominal cavity, a needle aspiration sample may be taken to detect cancer cells.
Treatment
Ovarian cancer treatment involves several approaches, depending on its size and degree of spread:
- Surgery: The primary treatment. The goal is to completely remove the tumor or, at minimum, leave residual tumor tissue smaller than one centimeter. Depending on the cancer stage, it may be necessary to remove both ovaries, the fallopian tubes, or the uterus. In very advanced stages, parts of other affected organs, such as the colon, liver, intestines, spleen, stomach, or bladder, may also be removed.
- Intraoperative radiotherapy: A single high-dose radiation treatment is applied directly to the remaining tumor tissue.
- Chemotherapy: Cancer-killing drugs are administered orally, intravenously, or directly into the abdominal cavity via a catheter (intraperitoneal chemotherapy). Chemotherapy is typically used after surgery to eliminate any remaining cancer cells but can also be administered before surgery to shrink the tumor.
- Hormone therapy: Medications that lower estrogen levels are used since this hormone promotes cancer cell growth. This treatment is mainly used for slow-growing cancers or recurrent cases.
- Targeted therapy: This treatment uses drugs that specifically identify and attack certain parts of cancer cells. PARP inhibitors, which block cellular DNA repair, are particularly used in cases with BRCA gene mutations.
- Immunotherapy: One of the newest treatments for ovarian cancer. It uses drugs that boost the immune system's ability to fight cancer.
- Palliative care: To relieve cancer symptoms and manage the side effects of treatment, specific medical care is provided, including psychological and emotional support for the patient.
