Lecture on ovarian cancer (cancer ovaries)

2021-03-18 12:00 AM

Ovarian cancer (cancer ovaries) is common in women with a high fertility rate, and in highly industrialized countries the incidence is high in white women. 

 

Ovarian cancer diagnosisbook

General perception

Ovarian cancer (cancer ovaries) is cancer that often causes the highest mortality rate among gynecological cancers, accounting for 52% in the US. Ovarian cancer ranks third after breast cancer and cervical cancer. A type of cancer that is increasing because of earlier diagnosis, but difficult treatment, bad prognosis.

Advantageous factor

Ovarian cancer (cancer ovaries) is common in women with a high fertility rate, and in highly industrialized countries the incidence is high in white women. The risk increases in the age group after 40, with an average age of 50-59 years.

Causes

Up to now, the cause of ovarian cancer (cancer ovaries) is unknown. But factors such as environmental pollution, especially asbestos and talc (hydrous magnesium silicate) are two industrial chemicals that often cause ovarian cancer. Diets high in animal fats, hormonal factors, genetic factors, and bacterial infections are factors related to ovarian cancer, and also in unborn infants. Pregnancy and those taking birth control pills are considered to be effective against ovarian cancer. As you can see, women with ovarian cancer have 3 to 4 times the risk of breast cancer and women with breast cancer have 2 times the risk of ovarian cancer (cancer ovaries).

Classifications

Classification according to the research

The ovaries produce many different types of tumors, so there are many categories of tumors by many authors. Currently, ovarian cancers are divided into three main groups:

Epidermal tumor (Adenocarcinoma). 

Germ cell tumors and sex cord-stromal tumors. 90% of ovarian cancers are epidermal cancers, of which serous tumors account for 40-45%. 

Mucous tumors 10%, endothelial tumors 25%, undifferentiated tumors 17%, bright cell cancer 6%, rare Brenner tumors.

Borderline tumors

Is an organizational tumor between benign and malignant tumors, in which the laity has not found that there has been no invasion of tumor cells in the buffer layer.

Ratio:

Borderline tumors are common in women 20-40 years old, the survival rate is 100% stage 1, but when the disease progresses, 50% die in the malignant stage.

Treatment:

When detecting a Borderline tumor in a young woman, it is advisable to remove the tumor and the ovary on both sides.

Spread

There are three ways that ovarian cancer (cancer ovaries) spreads:

  • It spreads directly from the tumor to the pelvis and peritoneum.
  • Tumor cells have spread to the pelvic and lower lymph nodes through the lymphatic tract.
  • Through the lymphatic pathway along with the ovary to the aortic lymph nodes, kidneys, the large connective membrane of the liver and lungs. Intestinal obstruction and ureteral infection are common complications. In the late stage, there may be ascites and resulting cachexia called ovarian facial expressions.

Symptoms and diagnosis

Symptoms

The most common symptom is that the patient has severe pain, feels bloated, feels distressed, sometimes there may be bleeding in the uterus. Because ovarian cancer is usually silent, with no warning symptoms, so 70% of patients come to the examination because they feel the tumor in the abdomen or find out by a regular gynecological examination.

If the tumor is small and not special, when the tumor is more than 5cm in diameter, it will be clear. If the tumor is larger than 5cm, in women aged 40-60, it is necessary to think about the malignant ovarian tumors count.

A tumor is prone to malignancy when it progresses rapidly, tumor density is firm, mobility is limited, and tumors develop on both sides of the ovary.

Test:

Cervical vaginal cytology is of little value in the diagnosis of ovarian cancer.

Ascites:

96% of late-stage cancer cells have opioid (+) cancer cells. According to Gzaham, there are early cancer cases where cells do not fall out in the subframe, so there are about 34% (-) wrong. This is a good way to predict and monitor the progression of the disease.

Supersonic:

Helps diagnose tumor size, abdominal fluid, tumor density.

CA 125:

The best tumor marker in ovarian cancer. Normally, 99% of healthy people have CA 125 levels less than 35 units in ml (35 units/ml) 90% with stage III and IV ovarian cancers with elevated CA 125 levels. Although, CA 125 is valuable in diagnosing ovarian cancer as CA 125 may increase in some other cancers such as cervical cancer, mucosal cancer, breast cancer, colon cancer, etc.

Significance of CA 125 concentration:

When the concentration of CA 125 in ovarian cancer increases, it is a progressive disease. When the concentration of CA 125 decreases, it is a progressive disease. However, it was also found that 15% of CA 125 levels decreased in patients with advanced ovarian cancer. After surgery, the CA 125 level usually returned to normal after 3 months.

Water in the ovarian tumor:

If an ovarian tumor is accompanied by ascites, it is of value in the progression and prognosis of the disease.

Ascites is lemon-yellow juice with a bad prognosis, according to WollT 32% of patients die in the first year if they have trouble. Ascites are usually caused by the peritoneum being spread by cancerous colonies in the abdomen, stimulating the secretion of fluids, and the water in the neck carries cancer cells to spread around the viscera.

If the dilated water is red blood, the prognosis is worse, 70% of patients die in the first year.

Treatment

The treatment of ovarian cancer (cancer ovaries) remains much controversial due to the difficult early detection of the disease, the complex anatomical nature of the disease, its progression and prognosis, and unpredictability.

Surgery

The first and important approach.

Purpose:

To evaluate the whole tumor, send pathological surgery or help chemotherapy with additional results. If the entire tumor cannot be removed, press biopsy, then chemotherapy when the tumor is smaller. It is possible to have second, third look surgery, if it is cancer, cut the tumor, cut the other ovary and the large connective tissue, remove the hysterectomy.

Chemotherapy

An important complementary treatment, especially effective for cases with many lesions, in many places, or are deeply located in a place where surgery is difficult or radiographs cannot reach.

Chemotherapy has the following advantages:

  • Most patients tolerate it.
  • Long-term treatment is possible.

It can be treated in many different situations such as an attack, defense, and symptoms, but chemotherapy has the following disadvantages:

  • Effects vary for each patient and for each type of cancer.
  • After a while, there was a familiar phenomenon.
  • Toxic to the hematopoietic system, causing immunosuppression, so before use, to check the function of liver, kidney, and blood count.
  • Prolonged treatment is required, and a sudden break is often dangerous for the patient. There are many chemicals for treating cancer, but these can be grouped into main groups.

The group of substances that damage DNA is effective throughout the reproductive cycle of the cell. For example, Thiotepa, Alkeran, cyclophosphamide, Chlorambucil.

Anti-metabolic substances, which fight the place of DNA production by replacing another substance in the synthetic chain. Examples: Fluouracil, Methotrexate.

Anti-mitotic agents, which are mainly active in the mitotic stage: Cisplatin, carboplatin, and decarbasin.

Anticancer antibiotics Actinonyxin D, Adrianycin, Bleomycin, etc.

Regimen:

Cisplastin 50mg / m2 (infusion for 4 hours).

Adriamyxin 50mg / m2 (intravenous slow injection).

Cyclophophamid 750mg / m2 (slow intravenous injection).

One infusion break for 3-4 weeks. With this regimen, the authors found that the patient's survival was extended by about 24 months.

Radiotherapy

Is a treatment method that has been mentioned for a long time. The basis of this approach is to use the radiation-killing effect to destroy dividing ditches 50 times more than normal organisms. The usual dose is 6000 Rad for 24 to 30 days.

Prognosis

In general, ovarian cancer is a bad prognosis, due to the late diagnosis, the tumor has already spilled into the abdomen.

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