Ovarian cancer. What are the methods of diagnosis and treatment?

Insidious malignant female cancer, which is the fifth most commonly diagnosed cancer, develops asymptomatically in its initial stage. Colloquially, doctors refer to it - the silent killer, because only in a small percentage of women is it detected at an early stage. Low awareness of the existence of the disease does not help either. Ovarian cancer is still diagnosed too late, so we are actively joining the campaign to promote Ovarian Cancer Awareness. In the article you will find useful knowledge about the latest methods of diagnosis and treatment of ovarian cancer.

Ovarian cancer - diagnosis

Ovarian cancer is most often diagnosed̨ at higher stages (III and IV), when it has already spread to other organs and produces symptoms. Most patients havę nonspecific dyspeptic symptoms more than a year before the diagnosis of ovarian cancer. In more than 70% of patients, it is diagnosed only when ascites, an accumulation of fluid in the peritoneal cavity, appears. Most cases of ovarian cancer are recorded between the ages of 50 and 70. Hereditary breast cancer and hereditary ovarian cancer due to BRCA1 and BRCA2 gene mutations occur in all ethnic and racial groups. The risk of cancer increases in people who:

• have already suffered from cancer in the past,
• Have at least two relatives who have been diagnosed with cancer,
• are under the age of 60 and have had the same cancers in their parents,
• have loved ones suffering from cancer, especially breast and ovarian cancer,
• have relatives who have been diagnosed with several different cancers.

Ovarian cancer diagnosis - genetic and other tests

Because of its important role in prevention and treatment, all women with ovarian cancer should havé a genetic consultation and testing to assess the presence of mutations in the BRCA1/2 gene. It is believed that more than 40% of women who have inherited a defective copy of the BRCA1/2 gene will develop ovarian cancer about 70% will develop breast cancer, and those with BRCA1/2 mutations are also more likely to develop pancreatic or prostate cancer. Performing molecular testing for mutations in the BRCA1/2 (BRCA1 BRCA2) genes allows early identification of mutation carrier status in these genes. Detection of a mutation in a healthy person is an indication for inclusion in oncological surveillance aimed at early detection of cancer.

Ovarian tumors

There is a special group̨ of ovarian cancers with low malignant potential, called tumors of borderline malignancy. These tumors usually localizę in one ovary, occur̨ usually in women of reproductive age, and have an average age of 38-45 years. Nearly 75% of borderline tumors are diagnosed in the asymptomatic period, thanks to vaginal ultrasonography. 

Prevention of gynecological diseases is a key issue in taking care of women's health. Thanks to modern molecular diagnostics, experienced specialists and state-of-the-art diagnostic equipment, we can offer our patients world-class prevention. You can't delay any longer, especially when we're talking about one of the most promising malignancies in women.

Therefore, for preventive examinations come before you get sick! Regular preventive examinations are essential, among other things, because they help prevent disease and cancer.

Remember , cancers or other diseases detected at an early stage offer a good chance of cure.

What tests should be kept in mind? It is very important to have regular examinations:

• Breast self-examination, once a month, one week after your period, in your twenties,
• Breast palpation performed by a gynecologist or your primary care midwife every 6-12 months, after the age of twenty-five,
• Breast ultrasound, once a year, after the age of twenty-five,
• Mammography, every two years, in women over the age of forty,
• Gynecological examination and cytological examination, once a year, over the age of 25,
• Vaginal gynecological ultrasound, once a year, over 25 years of age.

If you have a family history of breast, ovarian, pancreatic or prostate cancer, perform a prophylactic evaluation for mutations in the BRCA1 and BRCA2 genes.

These tests, free of charge, under reimbursement by the National Health Fund, can be performed by women who have been classified as high-risk. On the other hand, those wishing to check whether they are mutation carriers can have them done for a fee.

When to perform an ultrasound?

Gynecological (vaginal) ultrasound is best performed once a year or once every two years. This examination allows to assesś the structure and position of the uterus, as well as the endometrium. The best way to monitor the ovaries so far seems to be ultrasound, during which the ovaries are also evaluated - determining their structure, location and the numbeŕ and sizé of follicles, in which the maturation of egg cells takes place. The use of ultrasonography makes it possible to spot changes early and detect abnormalities in the form of tumors and cysts. However, ultrasound alone may not be sufficient, and not every cyst in a menstruating woman will prove to require surgery.

Another diagnostic test used in ovarian cancer diagnosis is the evaluation of Ca-125 and HE-4 marker levels. ROMA test (Ca 125+ HE4+ risk assessment). In the early stages of ovarian cancer, marker levels may remain normal; at the same time, high marker levels do not always meanć cancer. We suggest that before each preventive gynecological ultrasound examination, marker levels should be determined Ca125, and store the results so that the attending physician can assess changes in the concentrations of this marker over the course of recent years.

Present the results to one of our gynecologists, who will prepare diagnostic and therapeutic suggestions after a thorough history taking and examination.

Ovarian cancer is still diagnosed too late, which is why ze encourage all women to visit their gynecologist regularly and get health checks to catch any changes at an early stage.