OVARIAN CANCERS

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Ovarian cancer is the type of cancer with the highest mortality rate among female organ (gynecological) cancers. It accounts for approximately 3% of all cancers in women. Cancers in the ovaries may originate from these organs, but they may also occur through the spread of breast and gastrointestinal system cancers.

Ovarian cancers generally do not show early symptoms and therefore diagnosis at an early stage is not possible. However, during control examinations, diagnosis can be made at an early stage. They are divided into 3 groups according to the cell types they originate from;

1. Epithelial Ovarian Tumors: They originate from the superficial cells of the ovaries. ovarian cancers It constitutes 90%. There are many subtypes. About 5-10% of these cancers occur as a result of familial predisposition. People with ovarian, breast and colon cancer in first-degree relatives (mother, sister, grandmother, etc.) may have a familial (genetic) predisposition. These people should be followed very closely throughout their lives.

What are the factors that increase and decrease the risk of this type of cancer?

Advanced age (over 40 years of age), not having given birth, undergoing infertility treatment, previous breast and cancer of the uterine lining (endometrium) Having a history of cancer, having a family history of ovarian, breast or colon cancer, and eating a diet rich in animal fats increases the risk.

Having multiple births using birth control pills, breastfeeding, tubal ligation and hysterectomy, a diet rich in vegetables, and vitamins A and C reduce the risk.

What can be done for early diagnosis? Is there a screening test?

There is no test that can be performed for early diagnosis other than annual examinations in the patient group whose risk is within normal limits. However, for those with high risk, especially those with high familial risk, it is recommended that they have a blood test called CA-125 and a vaginal ultrasonography examination at least once a year.

How is the diagnosis made?

Our biggest aid in diagnosis is ultrasonography. With ultrasonography, we can detect with approximately 90% accuracy that masses originating from the ovary contain benign or malignant criteria. Tomography and MRI imaging methods can be used as an aid. With these methods, we can also obtain information about the prevalence of the disease.

Ovarian cysts that appear to have thick walls and thick chambers on ultrasonography are malignant. Monitoring blood flow in these compartments with color Doppler ultrasonography supports the diagnosis of cancer.

CA-125 etc. is used to support our diagnosis in suspicious cases and to help in the follow-up of the patient after surgery. blood tests are performed.

Are there any cases that fall between benign and malignant?

There are borderline cases that we call "Borderline". These tumors have low cancer potential. Diagnosis can only be made by pathological examination performed during surgery. However, surgery is used in their treatment, just like in cases of ovarian cancer. Follow-ups are done in the same way.

How is the treatment?

The main treatment for ovarian cancer is surgery. In cases where the diagnosis is uncertain, pathological examination is performed during the surgery and the size of the surgery is decided. Surgery also allows us to determine the stage of the disease. The main goal of surgery should be to remove all cancerous tissues as much as possible. This may not always be possible, especially in advanced cases. In such cases, possible cancer foci are removed, and then the patient is given drug treatment (chemotherapy). After this treatment, we have the chance to operate on the patient again and remove the remaining tumor tissues. Despite all these treatments, the patient's chance of living long in advanced stage ovarian cancer is not high.

2. Germ Cell Tumors: It is the second most common type of ovarian tumor. They constitute 20% of all ovarian tumors. About 60-70% of these tumors occur before the age of 20. Since they grow rapidly, they cause pain complaints and can be diagnosed at an early stage in 50-70% of cases. The most common germ cell tumor is the dermoid cyst. It is a benign ovarian tumor.

Since these tumors are seen at an early age and are mostly detected in the early stages, surgery may consider removing only the affected ovary and leaving the other ovary and uterus.

3. Sex cord stromal tumors: They constitute 5-8% of ovarian tumors. Their most important feature is that they mostly secrete hormones. Some types secrete female hormones (estrogen), and some secrete male hormones (androgens). There is a chance of early diagnosis due to the effects of the hormones they secrete. Although it is seen in women of all age groups, it is mostly seen in reproductive ages. For this reason, removing only the affected ovary and leaving the intact ovary and uterus in the surgery will ensure that the woman maintains her fertility.

Tumors that spread to the ovaries from other regions

Gastrointestinal tumors most commonly spread to the ovaries. In this case, both ovaries will usually be involved. The second most common breast cancer spreads to the ovaries.

For this reason, the gastrointestinal system and breast tissues of patients diagnosed with ovarian cancer should be examined very carefully.