Ovarian Cancer: Symptoms, Stages, Survival Rate & Treatment

Ovarian cancer is a malignant tumor affecting the ovaries. It may be of the primary character when the main center is located in the ovarian tissues. It may also be of secondary character with the center in any part of the body. Carcinoma (70 percent of all malignant tumors), germ cell and stromal tumors of the genital tract as well as other less frequent variations are the primary group. Metastatic tumors of the ovaries appear frequently enough: when the tumors of the endometrium are observed, tumors of the breast, colon, stomach, and cervical cancer.

Prevalence & Survival Rate

Ovarian cancer is the fifth according to the frequency of deaths caused by cancer in women, the leading cause of deaths caused by malignant gynecologic tumors, and the second according to the frequency of tumors in gynecology. Every year at least 225 thousand cases of ovarian cancer are registered and about 140 thousand end up lethally. In 75 percent of cases, ovarian cancer is diagnosed in the late stages. Even modern diagnostics appear to be not successful enough. Five-year survival during the third stage is about 24 percent and 4.6 percent during the fourth stage.

Causes

As in the cases with other cancer tumors, the causes are not completely studied. However, it is believed that ovarian cancer affects mainly nulliparous women (those, who had never given birth). Also, there is an opinion that ovarian cancer may be prevented by taking oral contraceptives. Without a doubt, ovarian cancer (as well as other types of cancer) may be inherited from one of the parents. Also, the risk for women with breast cancer is twice higher.

According to another opinion, the pathology may be caused by the consumption of food rich in animal fats.  The gonadotropic hyperstimulation, uterine fibroids, chronic encysted inflammatory processes, early and late menopause, uterus bleeding during post-menopause-are should also be attributed to risk factors.

Stages-Of-The-Disease

Stages of the Disease

  • IA – one of the ovaries is affected, no ascites;
  • IB –both ovaries are affected, no ascites;
  • IC – the appearance of a tumor on the surface of the ovary (s), ascites;
  • II – the disease is spread to the smaller pelvis;
  • IIA – the uterus or the fallopian tubes are damaged;
  • IIB –other pelvic tissues are damaged;
  • IIC – tumor on the surface of the ovary (s), ascites.
  • III – applies to the peritoneum, there are metastases in the liver and other organs within the abdominal cavity, the inguinal lymph nodes are damaged.
  • IIIA – spreading to the pelvis, dissermination of the peritoneum is observed.
  • IIIB – metastases above to 2 cm in diameter may be observed.
  • IIIC – Metastasis larger than 2 cm in diameter with the involvement of retroperitoneal and inguinal nodes appear.
  • IV – distant metastases take place.

Symptoms

Mainly ovarian cancer proceeds without any symptoms during the first stage. Besides, the first symptoms (increased stomach) are very often considered adnexitis ( inflammation of the ovaries) Tumor is gradually spread over the abdominal cavity affecting the omentum and causing fluid accumulation (ascites). Also to one of the first symptoms should be carried nagging pain in the lower abdomen. The pain is usually similar to the pain that occurs in cases of ovarian inflammation.

The Ways of Diagnosing the Ovarian Cancer

Ovarian cancer may be suspected during the examination of the stomach at gynecology. If the cancer is suspected the biopsy of the abdominal cavity is performed and the fluid is analyzed for the presence of the tumor cells. The biopsy in developed European countries is not recommended as it may lead to the sieving of the tumor. That is why the final diagnosis may be made only during surgery and according to the result of the analyses of the samples taken during the post-surgical period.

For cancer diagnosis and valuation of the metastatic damage, ultrasound diagnostics of the abdominal cavity and smaller pelvis are performed. In accompany to that the computer tomography of the chest, as well as CT scan or the MRI of the abdominal cavity, are performed. But the most informative way of diagnosing is a histological examination of the ovary. Such an examination allows us to figure out the nature and the structure of the tumor. According to the results, the oncologist forms the treatment tactics and makes a prognosis.

Treatment

The main methods of cancer treatment are surgery and chemotherapy. If the surgery is performed in the early stage of the disease only a damaged ovary may be removed. In more difficult cases depending on the level of the damage the uterus and omentum could be removed. Chemotherapy is usually based on combining of the medicines (Cisplatin or Carboplatin, Cyclophosphamide, Taxol, etc)

Transplantation of the Ovary

Due to the fact that some women are diagnosed with ovarian cancer at reproductive age after treatment, some of them might want to have children. Successful pregnancy after the removal of the ovaries and recovery from cancer is possible only if the not damaged tissue was cryopreserved and transplanted back. The research in that area was performed by Danish scientists led by Annette Jensen from Rigshospitalet Copenhagen.

The Danish project of cryopreservation and transplanting of the ovaries which started in 2000 was traced. Since that tissues samples were taken from almost 800 women, 41 out of which were chosen for participation. According to results, 30 percent of women got pregnant successfully both the natural way and with the help of IVF. The average age at the moment of transplantation was 33 years. Altogether 14 children were born during the research.

Prognosis

National cancer society (USA) with reference to the National Cancer Institute and SEER database published the statistics of survival based on the research from 2004 till 2010.

5-year survival rate according to the stage:

Table
  • I   90%
  • IA 94%
  • IB 92%
  • IC 85%
  • II 70%
  • IIA 78%
  • IIB 73%
  • III 39%
  • IIIA 59%
  • IIIB 52%
  • IIIC 39%
  • IV 17%

Death is usually caused by the development of ascites, bone metastases, lungs, liver, and brain, as well as violation of intestinal permeability or depletion.