Ovarian Cancer of the Ovary
The ovaries are 4x3x2 cm organs, one on each side of the uterus. They are responsible for secreting hormones and producing eggs. The egg produced is captured by the tube organs located next to it. The fusion of sperm and egg takes place in the type organs. Cancer can develop in the ovaries over time. The average age of ovarian cancer is 65 years.
Who is more common?
The mechanisms of ovarian cancer are becoming clearer day by day. It is more common in women who start menstruating at an early age and enter menopause late. Other risk factors include not having given birth to a child, not breastfeeding, sexually transmitted diseases, living in an industrialized society and family history.
Recent studies have shown that familial cancer genes are the cause of the disease in 20% of ovarian cancer.
Ovarian cancer and breast cancer have common gene defects. Every patient with cancer should be examined for these genes. In the presence of these genes, the age of cancer can be reduced to 45-50 years. PARP inhibitors, which have recently become available, greatly prolong life in these patients. Familial breast-ovarian cancer genes should be checked to protect other relatives of the patient and to use effective drugs.
How does ovarian cancer spread and how can it be detected?
There is no screening method for ovarian cancer as there is for breast and cervical cancer. Therefore, social screening is not possible by calling every woman. Patients with familial breast-ovarian cancer genes are followed up with ultrasound and blood tests. Patients with ovarian masses or cysts should be regularly checked for cancer. If the cyst is large, has solid (meat-like areas), has multiple compartments and chambers, has blood flow, and has finger-like protrusions, the possibility of cancer is high. If there is fluid in the abdomen, it may be a sign of advanced cancer.
Ovarian cancer spreads directly into the abdomen. It first spreads to the peritoneum and uterus, and in advanced stages to the intestines, the fatty tissue called omentum, and all intra-abdominal organs such as the stomach, liver and spleen.
75% of patients consult a doctor in advanced stages. There is no specific symptom for the disease. Complaints such as abdominal distension, indigestion, palpable mass, weight loss and weakness are frequently observed.
What is the treatment of ovarian cancer and preparation for treatment?
The treatment of ovarian cancer is to remove all tumor tissue and then give chemotherapy. Ovarian cancer surgery is a very challenging and specialized surgery. It should be performed by people who are trained and experienced in this field. The most important point in the patient’s life expectancy and the course of the disease is not to leave any tumor in the surgery. For this reason, organs such as the intestine and spleen may need to be removed in addition to the uterus and ovary when necessary.
If the disease is very advanced in MRI (MRI scan) or other films before surgery and has spread to non-removable areas such as the intestinal root, surgery is postponed. The patient is given chemotherapy and then surgery is performed. Chemotherapy is given again after surgery.
What is the prognosis of ovarian cancer?
Most patients relapse (recur) within the first two years. Because of these characteristics, ovarian cancer treatment is a long and patient path like running a marathon. In case of recurrent disease, surgery and chemotherapy options are used again.
Ovarian cancer is a disease where early diagnosis and surgery are very important.
What is hot chemotherapy for ovarian cancer? HIPEC
In simple terms, it is the administration of chemotherapy with hot serum into the abdomen during cancer surgery. The procedure is called HIPEC (hyperthermic intraperitoneal chemotherapy) in English. This is done with a special machine. It is administered in the operating room without waking the patient after the operation. Chemotherapy is administered into the abdomen with heated serum through several pipes, and is drawn back into the machine through other pipes. This process is repeated like continuous dialysis for 90-120 minutes. Very high concentrations of chemotherapy can be administered in the abdomen. The hot serum also kills cancer cells. This method is frequently used recently. The procedure has certain risks. It should be performed by experienced people due to risks such as burning of the intestines, kidney failure, opening of the stitches.