Ovarian cancer

Ovarian cancer (ovarian cancer) is a mostly malignant tumor on the ovaries. Ovarian cancer mostly affects older women beyond menopause.

What is ovarian cancer?

In the beginning, ovarian cancer does not cause any clear symptoms. However, unspecific symptoms that indicate a serious illness can occur.
© Henrie - stock.adobe.com

Ovarian cancer only causes symptoms at an advanced stage and therefore usually goes unnoticed for a long time. So far it has not been conclusively clarified which factors increase the risk of developing ovarian cancer.

Research assumes that certain changes in genetic material could be responsible. Ovarian cancer is usually noticed 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 initially limited to the ovary. The ovary has a relatively large amount of space in a woman's abdominal cavity, as it swells in the course of a cycle as the follicles mature and requires a lot of space. Unfortunately, this means that the growth of a tumor - ultimately the pathological enlargement of the ovary - is not noticed.

Ovarian cancer is divided into four different disease stages (FIGO classification): FIGO I: The tumor is limited 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: It metastases outside the abdomen were also formed (e.g. lungs).

causes

The causes of ovarian cancer are largely unknown. It is assumed that unhealthy lifestyle habits favor it. In addition, ovarian cancer is much more common in women after menopause than in younger women. Research assumes that certain gene mutations are ultimately responsible for the development of ovarian cancer.

There also appears to be a link between the number of times a woman has ovulated in her lifetime and ovarian cancer. For example, women who ovulate less because of many pregnancies or because of taking the pill are less likely to develop ovarian cancer.

A malignant tumor will almost certainly develop if a borderline tumor - i.e. a benign tumor - was present beforehand.

Symptoms, ailments & signs

In the beginning, ovarian cancer does not cause any clear symptoms. However, unspecific symptoms that indicate a serious illness can occur. Some women experience unusual menstrual cramps, for example menstrual disorders, intermenstrual bleeding or bleeding absences.

During the cycle, severe pain can also occur, which increases in intensity during ovulation. Bleeding after menopause is also typical. Advanced ovarian cancer can cause pain in the lower abdomen and a feeling of pressure in the lower abdomen. Occasionally, inexplicable weight loss occurs, which in turn can be associated with symptoms such as tiredness, decreased performance and an increasing feeling of illness.

Many women also complain of a fever and night sweats. As ovarian cancer progresses, ascites can develop. This manifests itself in an increase in the size of the abdomen and pressure pain. Larger tumors press on the surrounding organs and cause various complaints. These include diarrhea, constipation and flatulence, an increased need to urinate and urinary stasis with flank pain.

Certain types of tumors can produce sex hormones and thereby cause masculinization or feminization. Masculinization manifests itself through increased body hair growth, hair loss and a deeper voice. Feminization manifests itself in a lack of or increased menstrual bleeding, infertility and severe malaise.

Diagnosis & course

Since a tumor on the ovaries often does not cause any discomfort, abnormal cell growth is usually only detected during a routine examination by the gynecologist. If the doctor discovers a tumor while palpating the abdomen, he will search for possible further tumors in the next step by [[ultrasound].

Computer and magnetic resonance imaging can also provide further information on whether a tumor is present and, if so, whether and where the cancer has already spread. With absolute certainty, a diagnosis can only be made through an operation. Here the surgeon takes tissue or removes the tumor. A pathologist then examines the tissue and can thus make a reliable diagnosis.

Tumor markers, which are determined by examining the blood, can also provide information about whether a woman has ovarian cancer. A woman with ovarian cancer is unlikely to see any change. Only at a late stage can the belly become larger, although the woman is losing weight.

Complications

The earlier ovarian cancer is diagnosed and treated, the fewer complications there will be with this condition. In this case there is a good chance of complete healing without further damage. However, ovarian cancer can cause massive complications. It grows unnoticed for a long time and is often only diagnosed at a later stadium.

Therefore, this type of cancer takes a long time to affect other organs in the body. Ovarian cancer typically affects the lungs and organs in the abdomen. The affected cells are often transported into the abdominal cavity. As a result, a malignant ascites disease can develop.

These degenerate cells can subsequently spread rapidly throughout the organism and infiltrate other tissues. Another complication of ovarian cancer is pleural effusion, which can be triggered by cancer cells. A pleural effusion is a collection of fluid in a narrow gap between the lungs and the ribs. In addition, cancer of the ovaries can cause various complaints in the gastrointestinal tract.

With particularly large tumors, there is a risk that they will narrow the ureters in the pelvic area. This can lead to very severe colic and, in the worst case, to kidney failure. Further complications relate to the therapy of ovarian cancer. Side effects of chemotherapy and radiotherapy can cause multiple problems. Another possible complication is the triggering of menopause due to operations on the ovaries, especially in young patients.

When should you go to the doctor?

Ovarian cancer does not initially produce any clear symptoms. Possible warning signs should therefore always be clarified as a precaution. Women who experience unusual gas or abdominal pain, or who suddenly have no appetite, are best advised to speak to their GP or gynecologist. Other early symptoms: permanently changed stool behavior, frequent urination and bleeding outside of menstruation or after the menopause.

In the further course, the general condition also deteriorates and there is permanent malaise. If these symptoms occur, a medical examination is recommended. At the latest when an increasing waist circumference is noticed, a doctor must be called in, who can diagnose or rule out the disease. Possible advanced symptoms that must be clarified immediately are rubbing and noticeable water retention in the abdomen.

Particularly at risk are women of advanced age, who should regularly visit the gynecologist. A preventive examination is also recommended for women with a corresponding medical history.Basically, the warning signs should be taken seriously and clarified quickly. In addition to ovarian cancer, there may be other conditions that also need to be diagnosed and treated.

Doctors & therapists in your area

Treatment & Therapy

Ovarian cancer is usually treated in two steps: First, the tumor is removed by surgery, followed by chemotherapy.

During the operation, both ovaries, the fallopian tubes, the uterus and the surrounding peritoneum are usually removed. The surgeon will also search the surrounding abdomen for metastases.

The cancer cells of ovarian cancer respond particularly well to cytostatics. Cytostatics are drugs that kill cancer cells. Therapy with these drugs is therefore appropriate to kill any cancer cells that may be present after the operation.

Outlook & forecast

The prognosis for ovarian cancer depends on what stage the cancer is diagnosed at and when treatment starts. Without treatment, the disease is always fatal. If the cancer is discovered at an early stage without metastases, there is a very good chance of a complete cure. However, this is only possible if the tumor is limited to the ovary and can be completely removed.

If tumor cells remain, they will relapse years later. Overall, however, ovarian cancer has a poor prognosis because it is usually discovered very late. There are no complaints in the early stages. When the first symptoms appear, metastases have usually already developed and spread throughout the abdomen.

When the cancer spreads to the abdomen, parts of the peritoneum, intestines and other organs often have to be removed. Even then, it is still possible in individual cases to completely defeat the cancer if the remaining tumor cells are killed by a subsequent chemotherapy.

However, the outlook is 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 around 14 months. Overall, the 5-year ovarian cancer survival rate is 40 percent.

Prevent

Since no specific causes for ovarian cancer have been found so far, there is no recommendation regarding prevention. However, women who have been pregnant more often in the course of their lives or who have taken birth control pills for a long time have a lower risk of developing ovarian cancer. Early detection is everything: if there are signs outside of the norm - for example, bleeding outside of the menstrual period - a doctor should be consulted.

Aftercare

In the follow-up care of ovarian cancer, after the therapy is completed, the focus is on the detection of a recurrence of the tumor, the monitoring and treatment of side effects of the therapy, the support of the patients with psychological and social problems as well as the improvement and maintenance of the quality of life.

After the therapy, check-ups with a gynecologist are recommended every three months. How long the controls are necessary depends on the assessment of the attending physician. Usually the gynecologist starts the check-up with a detailed discussion, whereby in addition to physical complaints, psychological, social and sexual problems are also relevant.

After that, the gynecologist usually performs a gynecological examination and an ultrasound scan. Patients who do not have any particular symptoms do not need any further special examinations. If symptoms arise over time, such as an increase in the size of the abdomen due to water retention or shortness of breath, further examinations, including CT, MRI or PET / CT, can be useful.

Complaints that occur in the course of the treatment should be taken seriously by the affected patients and discussed with the treating gynecologist. Ovarian cancer therapy often involves radical surgery. The check-ups should therefore be used to identify and treat possible consequences of the operation at an early stage. Possible side effects of necessary chemotherapy can also be monitored through regular check-ups.

You can do that yourself

Treatment for ovarian cancer should be carried out by an oncologist. Usually a combination of surgery and chemotherapy is performed. Pure self-treatment is not recommended and should only be carried out in conjunction with therapy. However, alternative healing methods and naturopathy can alleviate the side effects and support recovery.

Acupuncture and acupressure can alleviate accompanying pain and nausea as well as anxiety and inner unrest. In general, everything is recommended that is good for the body and soul. Above all, the psychological stress for affected women should not be underestimated. In addition to psychotherapy, yoga and other mindfulness exercises also help.

These can be easily incorporated into everyday life and can reduce stress and reduce the risk of depression. Regular massages and lymphatic drainage support the organism in detoxifying and have a relaxing effect on body and mind. Ointments with arnica or calendula help with skin irritation. 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 preparations that support therapy: arnica has an anti-inflammatory effect and sulfur removes toxins. Phytotherapy was successful with mistletoe preparations. Mistletoe is said to have a growth-inhibiting effect on tumor cells and to strengthen the immune system. A diet rich in vital substances is also important in order to support the weakened organism - especially during chemotherapy.