Ovarian cancer (ovarian carcinoma) is a usually malignant growth on the ovaries. Ovarian cancer usually affects older women beyond menopause.
What is ovarian cancer?
Ovarian cancer does not cause symptoms until an advanced stage and therefore usually remains unnoticed for a very long time. So far, it has not been possible to conclusively clarify which factors increase the risk of developing ovarian cancer. Research assumes that certain changes in the genetic material could be responsible. Ovarian cancer is usually detected during a routine ultrasound examination. If the initial suspicion is confirmed, the tumor is surgically removed, followed by chemotherapy. The chances of recovery are good. Ovarian cancer affects the female gonads and is confined to the ovary in the early stages. The ovary has a relatively large amount of space in a woman’s abdominal cavity because it swells during a cycle as the follicles mature, requiring a lot of space. Unfortunately, this leads to the growth of a tumor – ultimately the pathological enlargement of the ovary – not being noticed. Ovarian cancer is divided into four different stages of disease (FIGO classification): FIGO I: the tumor is confined to the ovary, FIGO II: the ovarian cancer has spread to the pelvis, FIGO III: the ovarian cancer has spread to the abdominal cavity, and FIGO IV: metastases have also formed outside the abdomen (e.g., lungs).
Causes
The causes of ovarian cancer are largely unknown. Unhealthy lifestyle habits are thought to promote development. In addition, women beyond menopause are much more likely to develop ovarian cancer than younger women. Research suggests that certain gene mutations are ultimately responsible for the development of ovarian cancer. In addition, there appears to be a link between the number of ovulations a woman has had during her lifetime and ovarian cancer. Thus, women who have had fewer ovulations because of many pregnancies or because they take the pill are less likely to develop ovarian cancer. Quite certainly, a malignant tumor develops if a borderline tumor – that is, a benign tumor – was previously present.
Symptoms, complaints, and signs
Initially, ovarian cancer does not cause definite symptoms. However, nonspecific symptoms may occur that indicate serious disease. Some women experience unusual menstrual symptoms, for example, disruption of the menstrual cycle, bleeding between periods, or precipitous bleeding. During the menstrual cycle, there may also be severe pain, which increases in intensity during the period of ovulation. Bleeding after menopause is also typical. Advanced ovarian cancer may cause lower abdominal pain and a feeling of pressure in the lower abdomen. Occasionally, an unexplained weight loss occurs, which in turn may be associated with complaints such as fatigue, loss of performance and an increasing feeling of illness. Many women also complain of fever and night sweats. As ovarian cancer progresses, abdominal dropsy may develop. This is manifested by a growth of the abdominal circumference and pressure pain. Larger tumors press on the surrounding organs, causing a variety of symptoms. These include diarrhea, constipation and flatulence, increased urination and urinary retention with flank pain. Certain types of tumors can produce sex hormones, causing masculinization or feminization. Masculinization is manifested by increased body hair growth, hair loss, and a deeper voice. Feminization is manifested by absent or increased menstrual periods, infertility, and a strong sense of malaise.
Diagnosis and course
Because a lump on the ovaries often causes no discomfort, abnormal cell growth is usually not detected until a routine examination by a gynecologist. If the doctor discovers a lump during abdominal palpation, he or she will next use [[ultrasound]] to look for possible additional tumors. Computer tomography and magnetic resonance imaging can also provide further information as to whether a tumor is present and, if so, whether and where the cancer has already spread. With final certainty, a diagnosis can only be made through surgery. Here, the surgeon removes tissue or removes the tumor.A pathologist then examines the tissue and can thus make a reliable diagnosis. Tumor markers, which are determined via an examination of the blood, can also provide information about whether a woman has ovarian cancer. A woman suffering from ovarian cancer will hardly notice any change. It is only at a late stage that the abdomen may become thicker, even though the woman is losing weight.
Complications
The earlier ovarian cancer is diagnosed and treated, the fewer complications occur with this disease. In this case, there is a good chance of complete recovery without further sequelae. However, ovarian cancer can cause massive complications. It grows unnoticed for a long time and is often diagnosed at a later stage. Therefore, this type of cancer has a long time to affect other organs in the body. Ovarian cancer typically affects the lungs and organs in the abdomen. In this process, the affected cells are often transported to the abdominal cavity. As a result, a malignant abdominal dropsy, called ascites, can develop. These degenerated cells can subsequently spread rapidly throughout the organism and infiltrate other tissues. Another complication of ovarian cancer is pleural effusion, which can be caused by cancer cells. Pleural effusion refers to an accumulation of fluid in a narrow gap between the lungs and the ribs. In addition, various gastrointestinal symptoms can occur with cancer of the ovaries. If the tumors are particularly large, there is a risk that they will constrict the ureters in the pelvic area. This can lead to very severe colic and, in the worst case, kidney failure. Other complications relate to ovarian cancer therapy. Side effects of chemotherapy and radiation therapy can cause multiple problems. Especially in young patients, triggering menopause due to ovarian surgery is another possible complication.
When should you see a doctor?
Ovarian cancer does not initially cause clear symptoms. Possible warning signs should therefore be clarified in any case as a precaution. Women who experience unusual bloating or abdominal pain or suddenly have no appetite are best to talk to their family doctor or gynecologist. Other early symptoms include a permanent change in bowel behavior, frequent urination, and bleeding outside of menstruation or after menopause. As the disease progresses, the general condition also worsens and there is a permanent feeling of malaise. If these complaints occur, a medical examination is recommended. At the latest when an increasing abdominal girth is noticed, a doctor must be consulted who can diagnose or rule out the disease. Possible advanced symptoms that need to be clarified immediately are churning and noticeable water retention in the abdominal area. Women of advanced age are particularly at risk and should have regular check-ups with their gynecologist. Women with a corresponding medical history are also recommended to have a precautionary examination. In principle, the warning signs should be taken seriously and clarified quickly. In addition to ovarian cancer, other diseases may be present that also need to be diagnosed and treated.
Treatment and therapy
Treatment of ovarian cancer usually involves two steps: First, the lump is removed by surgery, followed by chemotherapy. During surgery, both ovaries, the fallopian tubes, the uterus, and the surrounding peritoneum are usually removed. The surgeon will also search the surrounding abdomen for metastases. Ovarian cancer cells respond particularly well to cytostatic drugs. Cytostatics are drugs that kill cancer cells. Therapy with these drugs is therefore appropriate to kill any cancer cells that may be present after surgery.
Outlook and prognosis
The prognosis for ovarian cancer depends on the stage at which the cancer is diagnosed and when treatment begins. Without treatment, the disease is always fatal. If the cancer is detected at an early stage without metastases, there is a very good chance of complete cure. However, this is only possible if the tumor is confined to the ovary and can be completely removed. If tumor cells remain, the cancer will recur after years.Overall, however, ovarian cancer has a poor prognosis because it is usually discovered very late. In the early stages, there are no symptoms. When the first symptoms appear, metastases have usually already developed and spread throughout the abdominal cavity. If the cancer has spread to the abdominal cavity, parts of the peritoneum, intestines and other organs often have to be removed. Even then, in individual cases it is still possible to completely defeat the cancer if the remaining tumor cells are killed by subsequent chemotherapy. However, the prospects are very poor if the cancer has already spread to the entire body. Then metastases also develop in the liver and lungs. At this stage, the average life expectancy is still about 14 months. Overall, the 5-year survival rate for ovarian cancer is 40 percent.
Prevention
Because no specific causes of ovarian cancer have yet been found, there is no recommendation regarding prevention. However, women who have been pregnant more often during their lives or who have taken birth control pills for a long period of time have a lower risk of developing ovarian cancer. Early detection is everything: If there are any signs outside the norm – for example, bleeding outside of menstruation – a doctor should be consulted.
Follow-up care
After therapy is completed, ovarian cancer follow-up focuses on detecting tumor recurrence, monitoring and treating side effects of therapy, helping patients with psychological and social problems, and improving and maintaining quality of life. Following therapy, check-ups with a gynecologist are recommended every three months. How long the check-ups are necessary depends on the assessment of the treating physician. Normally, the gynecologist begins the check-up with a detailed discussion, in which psychological, social and sexual problems are relevant in addition to physical complaints. After that, the gynecologist usually performs a gynecological examination and an ultrasound examination. Patients who do not experience any particular symptoms do not require any further special examinations. If symptoms occur during the course of the procedure, such as an increase in abdominal girth due to water retention or shortness of breath, further examinations, including CT, MRI or PET/CT, may be useful. Complaints that occur during the course of the disease should be taken seriously by affected patients and discussed with the treating gynecologist. The therapy of ovarian cancer often includes radical surgery. Therefore, the control examinations should be used to be able to recognize and treat possible consequences of the operation at an early stage. Any side effects of necessary chemotherapy can also be monitored by regular check-ups.
What you can do yourself
Treatment for ovarian cancer must be performed by an oncologist. Most often, a combination of surgery and chemotherapy is performed. Pure self-treatment is not recommended and should only accompany therapy. However, alternative healing methods and naturopathy can alleviate the accompanying symptoms and support recovery. Acupuncture and acupressure can alleviate accompanying pain and nausea as well as anxiety and inner restlessness. In general, everything that is good for the body and soul is recommended. Above all, the psychological burden for affected women should not be underestimated. In addition to psychotherapy, yoga and other mindfulness exercises can also help. These can be easily incorporated into everyday life and can reduce stress and the risk of depression. Regular massages and lymphatic drainage help the body to detoxify and have a relaxing effect on body and mind. Ointments with arnica or calendula help with skin irritations. The plants monk’s pepper and lady’s mantle have a regulating effect on the female hormone balance. They stabilize the cycle and relieve abdominal pain. Homeopathy also offers therapy-supporting preparations: Arnica has an anti-inflammatory effect and sulfur drains toxins. Phytotherapy has been successful with mistletoe preparations. Mistletoe is said to have a growth-inhibiting effect on tumor cells as well as immune-strengthening properties.It is also important to eat a diet rich in vital substances to support the weakened organism – especially during chemotherapy.
