“Ovary cancer does not warn with clear symptoms, and when it gives the face it is usually late,” alert Begoña Cid, gynecologist at the University Hospital Complex of A Coruña (Chuac) specialized in gynecological oncology.
On the occasion of World Ovary Cancer Daywhich is celebrated this Thursday, May 8, CID explains the challenges posed by a disease that affects almost 4,000 women a year in Spain and that, in most cases, it is detected in very advanced phases. Therefore, he insists: “It is essential to go to the gynecologist if persistent discomforts are presented for more than three weeks.”
What exactly is ovary cancer?
It is an anomalous growth of cells in the ovaries, which are part of the female reproductive system. There are three types of cells in ovaries (epithelial, germ and stroma), and from each one can derive a type of tumor. The most frequent are epithelial, and each subtype conditions its evolution and treatment.
Are the causes or risk factors known?
The concrete cause caused by ovary cancer is still unknown, but there are factors that increase the risk: advanced age, hereditary genetic alterations (such as BRCA1 and BRCA2 genes), endometriosis, early or late ondate on menstruation, and never have been pregnant. Up to 20 % of cases have hereditary origin.
“About 80% of cases are diagnosed in very advanced phases. In their initial stage cancer shows symptoms that can be confused with other benign disorders “
Bengogin, Gynecologist In the health area of A Coruña and CEE
Is there a more vulnerable patient profile?
There is no typical profile, except for women with family history. In these cases, genetic advice consultations can be referred and propose preventive surgery, removing tubes and ovaries when they are healthy before the disease appears.
What incidence does this disease have?
It is estimated that in 2025 about 3,748 new cases will be diagnosed in Spain. Ovary cancer represents 3 % of all female tumors and is one of the most caused mortality, since about 80 % of cases are diagnosed in very advanced phases. This late diagnosis is mainly due to the fact that in its initial stage the ovarian cancer It shows symptoms that can be confused with other benign disorders and the absence of an effective method of early detection.
What are those symptoms and how are they diagnosed?
The truth is that the symptoms are very nonspecific: abdominal swelling, heavy digestions, intestinal or urinary alterations, pelvic pain, tiredness, weight loss … Many women first consult in other services before going to the gynecologist. The important thing is to look at if these symptoms are maintained for more than three weeks.
In a consultation, a simple physical examination and an ultrasound can be enough to generate a diagnostic suspicion. It should also be clarified that a cytology or proof of the negative human papillomavirus does not rule out ovarian cancer, since they are different diseases.
Can it be prevented?
Prevention is only effective in cases with known genetic mutation, such as BRCA1 or BRCA2 genes, where preventive surgery is advised after having fulfilled the desire to be a mother. In the rest of the cases, you have to follow WHO recommendations to reduce the risk of any type of cancer: healthy life, balanced diet, physical exercise, avoid tobacco, alcohol and overweight.
“A simple physical examination and an ultrasound can be enough to generate a diagnostic suspicion”
Bengogin, Gynecologist In the health area of A Coruña and CEE
To what extent is an early diagnosis key?
It is fundamental. In initial phases, treatment is more effective and survival increases significantly. But only 20 % of cases are detected early, since the symptoms appear when the tumor is already advanced.
How is ovary cancer about?
The standard treatment is surgical: cytoreductive surgery is performed, that is, eliminate the entire visible tumor. This intervention must be done in specialized centers, since it is the main prognostic factor. Then chemotherapy is administered sooner or later, as the case may be. Despite the advances, about half of the patients will have a relapse in the first three years.
What advances are in research?
In addition to chemotherapy, we have directed treatments such as antiangiogenics or PLP inhibitors, which have meant a great change in patients with BRCA mutations. Conjugated antibodies are also being investigated to the folate-alpha receiver, present in many ovary tumors. There are already clinical trials in phase III.
What is the future of treatment?
The future goes through customization. Knowing the molecular alterations of each tumor allows you to design more effective and adequate treatments for each patient. This not only improves survival, but opens the door to the possibility of healing in some cases.
