On May 8, the World Ovary Cancer Daya date established by organizations to fight cancer with the aim of making the disease visible and run the veil that causes late detection.
Pain or discomfort in the pelvic zoneabdominal swelling, weight loss and a feeling of satiety even after having eaten in small quantity. All these symptoms, often associated with digestive or stomach problems, can be an alert signal of the ovarian cancer.
It is a frequent tumor that has treatment, but that It is usually detected lateprecisely because their manifestations are little specific and are minimized or confused with other pathologies.
“Ovary cancer is a abnormal tumor cell formation that originate in the ovarian surface cells and/or fallopian tubes. Worldwide, as in our country where there are more than 2,000 new cases per yearoccupies the 8th place in incidence. In Argentina, sixth in mortality is located, with 1,400 deaths per year. It is the second cause of gynecological cancerafter cervical cancer”explained the doctor Ana Laura Mendaña (MN 135188), Clinical oncologist of the Oncological Gynecology Team of the Alexander Fleming Institute (IAF).
It is estimated that one in 70 to 80 women will suffer from this disease throughout life.
The expert warned that More than 70% of cases are diagnosed in stages III y IV as a consequence that symptoms are nonspecific, overlapping and similar to those of other more everyday pathologies.
“Despite having carried out multiple studies, it was not possible to identify an effective early diagnostic method that allows it to detect it in earlier stages. The importance of this lies in how much more initial is the tumor at the time of diagnosis, greater are healing rates”, He stressed. In general it is estimated that the 90% of cases are curable in stadium Iwhile in the most advanced stages the perspectives of cure fall to 15% or 20%.
The late finding, in practice, represents that when doctors must define a therapeutic strategy to face the tumor, it is already found “Locally advanced”. That is to say, con Commitment outside the ovaryusually in The peritoneumthe membrane that covers the abdominal-plasters organs.
“Unfortunately, population screening strategies and early ovarian cancer detection They do not have enough sensitivity and specificity as to generate a favorable impact on survival. The use of ultrasound and tumor markers is not enough in an unparalleled population to guarantee the detection of the initial stadium tumor, ”said the oncologist Mauro Orlando (Mn 72502), submEfe of Gynecological tumors area del Alexander Fleming Institute (IAF).
Prevention strategies today focus on a small group of women with genetic alterations, which are specifically BRCA gene mutations.
“In these cases, a salpingooforectomía prophylactic (Extirpation of ovaries and tubes) allows a significant reduction in the risk of developing ovary cancer and is indicated between 30 and 45 years, depending on the gene involved. The use of contraceptives can be another risk reducing maneuver in these women”the specialist detailed.
Given this scenario, the specialists find a potential to raise the detections in the annual checks that each woman carries out with her head doctor. “During the Gynecological controls routine a transvaginal ultrasound can be incorporated When the professional considers it appropriate and in patients with family history or predisposing genetic alterations that have not opted for preventive surgery, these surveillance studies are recommended to perform more frequently”Dr. Orlando explained.
Although the symptoms are nonspecific, it is important to present attention if they occur abdominal distensions, pelvic pain or recurrent evacuational disorders.
“Ideally, in the face of suspicion, the transvaginal ultrasoundand if an alteration is confirmed, proceed with the study of tumor markers and a magnetic tomography or resonance of abdomen and pelvis to define the best approach, which can be biopsy or surgery”added the specialist.
“Among the most important risk factors are hereditary history of ovarian cancer and/or breast in the family or have previously had breast cancer. In these situations it is important consult with a geneticist or his own oncologist To see if it is necessary Gonzalo daily (MN 95788), Chief of Oncological Gynecology Area of the IAF.
Based on different investigations, it is estimated that the chances of developing this tumor in the presence of the pathogenic mutation of the BCRA 1 and BCRA genes are from up to 30 and 60%respectively. Other associated risk factors are Obesity, smoking, not having children or having been a mother at an advanced age.
In addition, the hormonal treatments Both replacement in postmenopause and those used in fertility treatments can predispose to certain types of ovarian cancer.
In recent years there were advances in the knowledge of ovarian cancer and this knowledge promoted new therapies. “The development of drugs to prevent the tumor from returning after primary treatment has been a great advance. These oral maintenance therapies have not only achieved cure a greater number of patientsbut allow significantly delay relapses.
Drugs are also being developed that allow delivering the chemotherapy In a ‘more specific’ to the tumor, in patients with advanced disease with faster and more durable responses such as drug conjugated antibodies, ”said Dr. Giornelli.
To this are added that better sequences of use of surgeries and medication treatments have been established to achieve better results and better quality of life.
“The knowledge and development of molecular pathology also allows more precise diagnoses and individualized therapies. It is important to understand that these progress are achieved by conducting research studies. It must be supported since in addition to enabling access to potential new agents and improvements, it ensures maximum level treatment quality. The rapid dissemination of the knowledge generated by congresses and their impact on media and social networks facilitates the rapid adoption of new discoveries, ”said Dr. Orlando.
“While there is no test like breast cancer mammography or dad for cervical cancer, which allow it to detect it early; before any Digestive symptom (discomfort, changes in evacuation habit, etc.), which Does not improve in 3 to 4 weeks of treatment, you have to insist that the cause is studied. Ovary cancer has very nonspecific symptoms, but while before it is detected, the higher they are the possibilities of initially operating it; And for that it is essential to consult a specialized center with trained professionals, ”concluded Giornelli.
*The Alexander Fleming Institute specializes in the prevention, diagnosis, treatment and monitoring of oncological diseases and medical innovation.
