Among gynecological cancers, people with uterine, cervical and ovarian cancers have the highest mortality.
Ovarian cancer primarily affects women who have gone through menopause, usually over the age of 50, but sometimes it can affect younger women.
General information about ovarian cancer
What is an ovary?
Ovaries are reproductive glands found only in females. Ovaries produce eggs for reproduction. The egg travels from the ovary through the fallopian tube into the uterus where the fertilized egg settles and develops into a fetus. Ovaries are also a major source of female hormones estrogen and progesterone. An ovary is located on each side of the uterus.
The ovaries are mainly made up of 3 types of cells. Each type of cell can develop into a different type of tumor:
- Epithelial tumors start from the cells that cover the outer surface of the ovaries. Most ovarian tumors are epithelial cell tumors.
- Germ cell tumors start from egg production cells.
- The tumors start from structural tissue cells that hold the ovaries together and produce female hormones estrogen and progesterone.
Some of these tumors are benign and never spread beyond the ovaries. Malignant tumors can spread to other parts of the body and can be fatal.
What is ovarian cancer?
- Ovarian cancer is when abnormal cells in the ovaries begin to grow and divide uncontrollably and eventually form a tumor growth.
- Ovarian cancer was previously thought to start only in the ovaries, but recent evidence suggests that many ovarian cancers can actually start from the cells of the fallopian tubes.
Is ovarian cancer dangerous?
- If not detected early, cancer cells will gradually grow into surrounding tissues and can spread to other areas of the body.
- Ovarian cancer usually goes undetected until it spreads in the pelvis and abdomen. Ovarian cancer discovered in the late stages of treatment is more difficult. Early ovarian cancer is still limited to ovaries that are more likely to be successfully treated.
Types of ovarian cancer
Ovarian cancer is currently known as a separate disease, named after the type of cancer cell: epithelial, germ cell and stroma. These are the three main types of cells that make up the ovaries. Each type of cell can develop into a different type of tumor and each differs in its spread, treatment and prognosis:
- Epithelial ovarian cancer : is the most common ovarian cancer, arising from the ovary surface. Fallopian tube cancer and primary peritoneal cancer are also included in the indications for this cancer.
- Germ cell ovarian cancer : arises from the reproductive cells of the ovary, and is very rare.
- Stromal cell ovarian cancer: arising from connective tissue cells, is very rare.
- Small cell carcinoma (SCCO) : the ovary is an extremely rare and uncertain ovarian cancer that cells in the SCCO are from ovarian epithelial cells, stromal stromal cells sex or germ cells.
The cause of ovarian cancer
Ovarian cancer occurs when cells divide and multiply in an uncontrolled way. However, exactly why this happens is unclear.
Cancer usually begins when a cell mutates in its DNA. Mutations indicate that cells grow and multiply rapidly, creating a tumor of abnormal cells. They can invade nearby tissues and break off from an initial tumor to spread elsewhere in the body.
The most recent and important finding of the cause of ovarian cancer is that it starts in the cells at the tip of the fallopian tube and not necessarily in the ovaries themselves.
Factors that increase your risk of ovarian cancer:
- Family history : Women with close relatives who have ovarian or breast cancer have a higher risk of ovarian cancer than other women. Genetic screening can determine whether someone carrying certain genes is associated with an increased risk.
- Age : Most cases of ovarian cancer occur after menopause, and especially in women over 63, rarely before age 40.
- Infertility or infertility treatment : Fertility drugs are associated with a higher risk of ovarian cancer, especially in women who use them for more than a year without becoming pregnant. People who are infertile may also be at higher risk than those who do not, possibly because they are not pregnant.
- Breast cancer: Women who receive a breast cancer diagnosis have a higher chance of being diagnosed with ovarian cancer.
- Hormone therapy: HRT slightly increases a woman’s risk of developing ovarian cancer. The risk seems to increase as HRT continues to persist and return to normal as soon as treatment is stopped.
- Obesity and being overweight : Obesity and being overweight appear to increase the risk of developing many cancers. Ovarian cancer is more common in women with a body mass index (BMI) above 30.
- L evil in endometrium : Women with endometriosis also have the risk of ovarian cancer by 30% higher compared to the other women.
Signs of ovarian cancer
In the early stages there may be little or no symptoms. Symptoms may be similar to other conditions, such as premenstrual syndrome (PMS), irritable bowel syndrome (IBS) or temporary bladder problems.
The main difference between ovarian cancer and other possible disorders is the survival and gradual reduction of symptoms.
Early symptoms of ovarian cancer may include:
- pain in the pelvis, lower abdomen or lower body
- indigestion or heartburn
- feeling full when eating
- urinating more frequently and urgently
- pain during intercourse
- change in bowel habits, such as constipation
As the cancer progresses, there may also be:
- weight loss
- shortness of breath
- loss of appetite
If you experience bloating, pressure, or pain in your abdomen or pelvis that lasts more than a few weeks, contact your doctor or go to the nearest health department immediately.
The stage ovarian cancer
If ovarian cancer is diagnosed, the next step is to determine its stage and level. Stage of cancer refers to the spread of cancer.
- Stage 1: Cancer cells only affect the ovaries or ovaries and have not spread to other areas.
- Stage 2: Cancer has affected one or both ovaries and other pelvic organs, such as the uterus, fallopian tubes, bladder or rectum.
- Stage 3: Cancer affects one or both ovaries and both the lining of the abdomen or the lymph nodes in the back of the abdomen.
- Stage 4: Cancer has spread to other parts of the body, outside the peritoneal cavity. This cavity consists of the abdomen and pelvis. Areas that can be affected include the liver, spleen and fluid around the lungs.
Determining the stage and level will help the doctor decide the best treatment.
Treatment for ovarian cancer may include surgery, chemotherapy, radiation therapy, hormone therapy or targeted therapy.
The type of treatment depends on many factors, including the type of ovarian cancer, its stage and level, as well as the general health of the patient.
- Surgery is the main treatment for most ovarian cancers. The extent of surgery depends on the stage of the cancer, including removal of the ovaries, fallopian tubes, uterus as well as lymph nodes. adjacent blood and partial adipose tissue.
- The ablation may be less if the disease is diagnosed at a very early stage. The disease can be treated without removing both the ovaries and the uterus. This can protect a woman’s ability to have children.
- Chemotherapy is the use of certain drugs to kill cancer cells. Cytotoxic drugs provide drugs that are cytotoxic. These drugs prevent cancer cells from dividing and growing.
- Chemotherapy is used to target cancer cells that surgery can’t or doesn’t remove.
- Treatment usually involves 3 to 6 sessions of chemotherapy or cycles. They will be taken 3 to 4 weeks apart, to allow the body time to recover. If the cancer returns or begins to grow back, chemotherapy may be given again to shrink it.
- Newer drugs may target specific pathways or functions in cancer cells. These medications include Bevacizumab (Avastin) and Olaparib (Lynparza).
- Unlike traditional chemotherapy, these drugs limit damage to normal cells. This reduces common side effects.
- Hormone therapy may be added to treatment plans to cut off estrogen supply to slow the growth of cancer cells.
- This type of systemic therapy is rarely used to treat epithelial ovarian cancer, but is often used to treat ovarian stromal tumor.
- Hormone therapy may include: Goserelin (Zoladex), Leuprolide (Lupron), Tamoxifen or Aromtase inhibitors.
- Radiation therapy is rarely used as the main treatment for ovarian cancer. Invasive chemotherapy is usually more effective.
- Radiation therapy may be used if there are small traces of cancer in the reproductive system or to treat advanced cancer symptoms.
Prevention of ovarian cancer
There is no sure way to prevent ovarian cancer. But can reduce the risk of cancer:
- Pregnancy and lactation: Women who are pregnant before age 26 are at a lower risk of ovarian cancer than women who are not pregnant. The risk goes down with every full term pregnancy. Breastfeeding may reduce the risk even further.
- Reproduction history : Women who have had one or more full term pregnancies, especially before age 26, are at a lower risk. The more pregnant you are, the lower the risk.
- Birth control : Using birth control pills for at least 3 to 6 months seems to reduce the risk. The longer the medication is used, the lower the risk of appearing
- Gynecological surgery : Having surgery on the reproductive organs seems to reduce the risk of ovarian cancer. In women who undergo tubal ligation, this can be reduced to two-thirds. Hysterectomy can reduce the risk of 1/3.
Prospects for ovarian cancer
- The sooner ovarian cancer is diagnosed and treated, the higher the chance of cure. But often it is not detected early until it has spread and treatment is impossible.
- Even after successful treatment, there is a high chance that the cancer will return within a few years. If it comes back, it usually cannot be cured. But chemotherapy can help reduce symptoms and control cancer over months or years.
- Overall, about half of women with ovarian cancer will live at least five years after diagnosis and about one-third will live at least 10 years.
Source Reference Ovarian Cancer:
- Source mayoclinic.org Ovarian Cancer article : https://www.mayoclinic.org/diseases-conditions/ovarian-cancer/symptoms-causes/syc-20375941 , updated July 25, 2019.
- Source en.wikipedia.org Ovarian Cancer article : https://en.wikipedia.org/wiki/Ovarian_cancer , updated October 11, 2019.
- A reputable source index-china.com summarizes the article What is ovarian cancer? : https://index-china.com/ovarian-cancer/ , updated 13/3/2020.
Assoc.Prof.Dr. Tran Ngoc Anh is currently Hanoi Medical University Hospital, Associate Professor, Department of Internal Medicine, Gastroenterology and Head of Department of General-Uematology of Hanoi Medical University. Consulting doctor at ThuocLP Vietnamese health.
Professional qualifications, Academic degrees – Education:
Graduated from General Practitioner System, Hanoi Medical University
Graduated with a Master degree in Internal Medicine, Hanoi Medical University
Graduated from the training program specialized in Gastrointestinal, Henri Mondor Institute Center, University of Paris 6, French Republic 1996-1997; 1999
Graduated from the training program specialized in Gastrointestinal, North Royal Sydney Hospital, Australia; 2002
Graduated from a training program specialized in chronic liver diseases, Pizza, Italy 2009
Graduated with a PhD in Gastrointestinal, Hanoi Medical University
Associate Professor, Gastroenterology, Hanoi Medical University
Training and Scientific Research:
Published more than 200 articles in domestic and international specialized journals
Editor of many monographs and participates in compiling 2 textbooks.
Guide many students and graduate students of Hanoi Medical University
Manager of many grassroots research projects
Certificate of Good Clinical Practice (GCP: 2012, 2015), Ministry of Health
Specialized certificates: General gastrointestinal endoscopy, Interventional gastrointestinal endoscopy, General gastrointestinal ultrasound, Interventional gastrointestinal ultrasound (Bach Mai BV), Chronic liver disease.