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Internationally 75-80% of ovarian cancer cases will be diagnosed at an advanced stage. How can this trend change? What kind of tests are required? Gynecologist Vassilios Sioulas answers these questions
“But 6 months ago I had an ultrasound at my Gynecologist and everything was fine, how is it possible that I have advanced ovarian cancer now”; “I have irritable bowel and attributed the symptoms there, I’m afraid I wasted my time”…
Common words of patients in the doctor’s office when imaging tests show ovarian cancer with spread to other parts of the abdomen. Anxiety, frustration, anger. Absolutely human emotions, but the scientific data cannot be disputed: 75-80% of cases of ovarian cancer will be diagnosed internationally at an advanced stage. Why is this happening; And most importantly, what can we do to change it?
What can lead to ovarian cancer? The main risk factors for the disease include:
- Age over 60 years.
- Early onset of periods or late menopause.
- Genetic predisposition (mainly BRCA 1&2 gene mutations, Lynch syndrome) and hereditary history of ovarian or breast cancer.
- Infertility and infertility.
- Endometriosis.
The most common type of ovarian cancer is called high-grade, serous carcinoma. And contrary to what we believed for many years, it almost never starts in the ovaries. The initial cellular lesion is called STIC (serous tubal intraepithelial carcinoma) and is found in the fallopian tubes. Unfortunately, STIC has no symptoms and is not diagnosed by gynecological ultrasound or cancer markers. In fact, with the exception of its incidental finding in a biopsy after removal of the fallopian tubes, there is currently no way to recognize it early. Until this one is found globally, let’s see what we can do.
How does ovarian cancer manifest itself?
Symptoms that ovarian cancer can cause include:
- Abdominal stretching.
- Loss of appetite or rapid satiety with food.
- Pain or pressure in the pelvis, abdomen or lower back (lower back).
- Unexplained changes in body weight or extreme fatigue.
- Changes in bowel habits (mainly, new-onset constipation).
- Symptoms from the urinary system, such as frequency or urgency to urinate.
- Bleeding or unusual vaginal discharge after menopause.
From the above, it can be seen that the symptoms of ovarian cancer are not characteristic and can accompany other, usually benign, diseases (e.g. irritable bowel syndrome, endometriosis, etc.). Therefore, when they persist for more than two weeks (eg “bloating” of the abdomen), they should not be ignored, even if after visiting a Gynecologist specialized in Oncology their benign nature is finally proven. This is also true for younger women, especially if their family history increases the likelihood of the disease.
How Gynecologists specializing in Oncology can help in the prevention or early diagnosis of the disease
It is widely known that Gynecologists who have specialized in Oncology are the most suitable Doctors to operate on patients with early and advanced ovarian cancer, since they lead to the best survival rates. Nowadays, however, their role is crucial even for healthy women. Thanks to their dedication to gynecological cancer issues, they give the time every woman needs to:
– They educate her thoroughly about the predisposing factors of ovarian cancer and its “insidious” symptoms, encouraging her to talk immediately about anything new that may appear.
– Analyze her family history in detail and identify women who would benefit from genetic testing (blood testing).
– Discuss the advantages of prophylactic tubal removal with or without the ovaries at the end of family planning, address her respective concerns and, above all, individualize their recommendation according to each woman’s unique risk for ovarian cancer.