Ovarian cancer
- Synonyms in a broader sense
- definition
- Occurrence in the population (epidemiology)
- Risk factors
- Risk factors
- Stromal tumors
- Granulosa cell tumors
- Theca cell tumors
- Androblastoma
- Germ cell tumors
All information given here is only of a general nature, tumor therapy always belongs in the hands of an experienced oncologist!
Synonyms in a broader sense
- Ovarian tumor
- cervical cancer
Medical: Ovarian - Carcinoma, Ovarian - Approx
English: ovarian cancer
definition
Ovarian cancer (ovarian carcinoma) is a malignant (malignant) tumor of the ovaries that can occur on one or both sides.
One differentiates the type of ovarian cancer on the basis of its fine tissue (histological) picture. The tumors are thus divided into epihelial tumors, germ cell tumors as well as germ cord and stromal tumors.
The swelling of the ovaries must be distinguished from benign or malignant tumors. Read more about this at: Swollen ovaries
Epithelial tumors are tumors that arise from cells on the surface of the ovaries. They make up about 60% of all malignant ovarian tumors. The germ cell tumors emanating from the germ cells of embryonic development (fruit development) account for about 20% of all malignant ovarian tumors. Stromal tumors are tumors that develop from the ovarian tissue and make up about 5% of all malignant ovarian tumors. Furthermore, around 20% of malignant ovarian tumors are colonizations of cells from a tumor that originally developed elsewhere (metastases). The metastases usually occur on both sides and about 30% originate from uterine cancer (uterine cancer) and approx. 20% from breast cancer (Breast cancer) or cancer from the gastrointestinal tract (gastrointestinal carcinoma) from.
- Ovary -
Ovary - Basic tissue of the ovary -
Stroma ovarii - Mature vesicle follicles -
Folliculus ovaricus tertiarius - Corpus luteum -
Corpus luteum - Uterine cavity -
Cavitas uteri - Cervix -
Ostium uteri - Ovarian ligament -
Ligamentum ovarii proprium - Fringed funnel of the fallopian tube -
Infundibulum tubae uterinae - Fallopian tubes -
Tuba uterina - Ovarian artery -
Ovarian artery
You can find an overview of all Dr-Gumpert images at: medical illustrations
Illustration ovaries
Occurrence in the population (epidemiology)
In the industrialized countries get sick about 2% of all women in her life on one Ovarian cancer (ovarian cancer).
About 70% of these are only recognized at a very late stage in the tumor. This is due to the fact that the ovarian cancer is usually almost invisible from the outside. There are hardly any signs of illness (symptoms) that are indicative of the tumor disease.
The consequence of this is that ovarian cancer has a 5 - year survival rate of approx. 20 - 30% bad prognosis Has.
Symptoms
No typical symptoms can be assigned to ovarian cancer. Most ovarian cancer goes unnoticed and is randomly examined by a specialist for gynecology discovered.
Signs that can indicate the presence of ovarian cancer can include changes in the Menstrual period (Menstruation) be. If there is increased bleeding between the cycle-related bleeding (intermenstrual bleeding) or does one occur Postmenopausal bleeding (climacteric) this can indicate ovarian cancer.
Especially in the advanced stage, pain can also appear as a symptom. These can also be on a page, for example only the left ovary, restrict.
However, something completely different harmless can also be concealed behind this symptom. In any case, the specialist in gynecology (gynecology) must be consulted, as early detection of ovarian cancer is associated with a much better prognosis.
An increase in the size of the abdomen with no noticeable increase in body weight and additional digestive disorders, a feeling of fullness and fatigue should also always be viewed critically, but can also be of a harmless nature.
Please also read our page Ovarian Cancer Symptoms.
Risk factors
It is noticeable that ovarian cancer (ovarian cancer) increases in the white breed is to be found. The white race seems to be a risk factor, so to speak.
Also are heaped Women over 40 years of age of this Cancer affected. Women with already recognizing (manifesting) Breast cancer Due to their genetic susceptibility (predisposition) to breast cancer, they also have an increased risk of developing ovarian cancer.
Another risk factor is the drug treatment to induce ovulation (Ovulation Induction), which is used, for example, in case of infertility (infertility).
Diets high in fat and meat also have a negative effect.
Summary:
- white skin color
- Age over 40
- Breast cancer
- Infertility treatment
- High fat / meat rich food
Protective factors
Protective factors are influences on the body that counteract or prevent the development of ovarian cancer.
Such are, for example, previous pregnancies (pregnancies) and long periods of breastfeeding. The "Birth control pills“(Oral Contraceptives) also have a beneficial effect. Regular use over a longer period of time can reduce the risk of ovarian cancer by up to 60%.
Prevention / prophylaxis
If the family already has two diseases of breast cancer (breast cancer) or malignant (malignant) tumors Ovaries (ovaries) are known or a male family member suffers from breast cancer can, if desired, have a genetic examination respectively.
The person seeking advice is given intensive care by gynecologists (specialist in gynecology), oncologists (specialist in tumor diseases) and psychologists Breast cancer genes 1 and 2 examined.
If there is a change (mutation) in one of these genes, the patient should definitely undergo a gynecological examination at least every six months in order to be able to detect any changes in the ovaries at an early stage.
Palpation of the genital organs, the abdomen (abdomen), of liver (Hepar) and inguinal lymph nodes are part of the standard examination.
Diagnostics are also used
- Sonography
- Computed tomography (CT)
- Magnetic resonance imaging (MRI)
used.
If there is a change (mutation) in the gene and after family planning has been completed, the Ovaries and Fallopian tubes (Adenectomy) should be considered.
This is a preventive measure and can be requested by the person affected, but does not have to be done. The idea of the operation is that if there are no more ovaries, no more ovarian cancer can develop.
Since that Peritoneum Developmentally, however, it arises from the same cells as the ovaries, but ovarian cancer can nonetheless occur after removal of the ovaries; namely in Peritoneum (extra-ovarian ovarian cancer). This fact should be kept in mind after removal of the ovaries and fallopian tubes.
Please also read our page Removal of the ovaries.
causes
Why some cells in the ovaries transform (transform) into malignant cancer cells in some women is not yet fully understood.
In about 5% to 10% of women, however, the development of ovarian cancer is genetic. These patients have a change (mutation) in a gene.
Affected are "Breast cancer gene 1 " on chromosomes 17 (BRAC 1 = Breast Cancer Gene) and that "Breast cancer gene 2“On chromosomes 13 (BRAC 2 = Breast Cancer Gen 2), which also play a role in the development of breast cancer.
Further information can be found under our topic: Breast cancer
Risk factors
It is noticeable that ovarian cancer (ovarian cancer) increases in the white breed is to be found. The white race seems to be a risk factor, so to speak.
Also are heaped Women over 40 years of age affected by this cancer. Women with already recognizing (manifesting) Breast cancer Due to their genetic susceptibility (predisposition) to breast cancer, they also have an increased risk of developing ovarian cancer.
Another risk factor is the drug treatment to induce ovulation (Ovulation Induction), which is used, for example, in case of infertility (infertility).
Diets high in fat and meat also have a negative effect.
Summary:
- white skin color
- Age over 40
- Breast cancer
- Infertility treatment
- High fat / meat rich food
Detecting ovarian cancer
Although ovarian cancer is a common cancer in women, it is discovered too late in the majority of those affected as it usually does not cause any symptoms in the early stages and is therefore difficult to detect. Therefore, regular examinations should be carried out by the gynecologist, which should include an ultrasound examination of the ovaries, especially for women over the age of 50, in order to detect the disease at an early stage. Women who have already had breast or colon cancer themselves should also pay particular attention to regular ovarian examinations. If breast cancer occurs in the family, the risk of developing ovarian cancer is increased.
There are a few unspecific symptomswhich could indicate a possible malignant disease of the ovaries. So it can be at first inexplicable exhaustion and unintentional weight loss come. Some women also occur irregular, unusually heavy bleeding that cannot be explained by the normal monthly cycle. This is especially true for women who, although actually already in the Menopause suddenly develop profuse bleeding.
Only when the ovarian cancer has progressed so far that it impairs the function of other organs are further possible symptoms, e.g. general abdominal discomfort, a Feeling of fullness in the stomach, Flatulence, Increase in waist size, stomach pain and Indigestion. The increase in waist size is on Fluid build-up (Ascites), which are caused by impaired liver function and are located in the free abdominal cavity. Fluid can also accumulate in the lungs, which can lead to breathing problems (Pulmonary edema).
If the cancer has already progressed further, the tumor can infiltrate neighboring tissues and organs and compress them if necessary. As a result, e.g. Bladder discomfort, such as frequent urination, are caused. Impairment of bowel function is also possible, causing it to diarrhea and or constipation can come.
However, these symptoms are very unspecific for the diagnosis of ovarian cancer and can also be triggered by much more harmless diseases or other cancers. The final diagnosis can only be confirmed by a medical examination.
diagnosis
The diagnosis of ovarian cancer (ovarian carcinoma) can only be made through a medical examination.
Special early diagnosis examinations, such as the Mammography breast cancer screening does not exist. Since the disease presents very few symptoms in the early stages, most ovarian carcinomas are only diagnosed at a later stage.
Normally, however, during the normal preventive medical check-up at the gynecologist, it is felt whether a Enlargement of the ovaries or there is pain in that area. If there are any abnormalities, a Ultrasound examination the ovaries be performed. To do this, the transducer of the ultrasound device is inserted vaginally. This is usually not painful for the woman. With the ultrasound waves the ovaries can then be made visible on the screen and on Cysts or other changes are investigated. An ultrasound image can also be made through the abdominal wall. If noticeable changes are noticed, additional examinations, e.g. a CT or MRI requested. There are possible Metastases demarcate early.
However, all of these examinations only provide indications of the disease. Also an examination of the blood for certain Tumor markers can provide information. This is the tumor marker for most ovarian cancer patients CA-125 elevated. However, general screening for this tumor marker for early diagnosis of the disease has not proven its worth. On a Bladder or colonoscopy can usually be dispensed with, as there are rarely pathological findings from ovarian cancer. Any possible spread to the intestines or the bladder will then be clarified during the operation of the tumor. The final diagnosis requires one surgical intervention, with which then a Tissue sample from the ovaries (Biopsy) is taken. This is then processed and examined under the microscope. If the suspected diagnosis of ovarian cancer is confirmed, the operation is continued and the tumor or the entire ovaries are removed. A closer examination of the removed tissue can then Stage of cancer and the aggressiveness of the tumor can be determined. Often times the uterus and the Lymph nodes be removed in the pelvic area, as tumor cells are often located there.
Growth and expansion
Epithelial tumors
The tumors that originate from the surface cells (epithelia) of the ovaries (ovaries) are differentiated based on their cell type. A distinction is made between serous, mucinous, endometroid, small-cell, light-cell tumors and so-called burner tumors.
Serous tumors are the most common malignant (malignant) changes among the epithelial tumors. They pose as fluid-filled Cysts (Cavities) and often appear on both ovaries (ovaries). They are often not recognized at an early stage. The cancer cells settle (metastasize) quickly to other organs via the lymphatic and blood paths.
Mucinous tumors start from mucus-forming cells. You are too 10% malicious.
While endometroid, light cell and small cell tumors are among the most aggressive tumors with a poor prognosis Brenner tumors 95% benign and have a good prognosis.
Tumor cells from epithelial tumors can settle (metastasize) in other organs in three different ways. In the majority of cases, the tumor cells detach themselves from the surface of the ovary (ovary) and then implant (implant) on the peritoneum, so they often lead to Peritoneal cancer. Another way in which the cancer cells settle is via the lymph (lymphogenic metastasis). Lymph nodes that are affected lie along the Main artery (aorta) and in Pelvis.
Of the Blood way represents a further possibility for the cancer cells to get into other organs and to settle there (hematogenous metastasis).
Stromal tumors
The tumors that develop from the ovarian tissue are divided into
- Granulosa cell tumors
- Theca cell tumors and
- Androblastomas.
About 50% of these tumors make up steroids. Which steroids are formed exactly depends on the type of tumor.
Granulosa cell tumors
Granulosa cell tumors, approximately 30% of which are malignant, start from granulosa cells of the ovary. In these cells of the ovary, estrogens are normally produced in a cycle-dependent manner. If a tumor develops from these cells, it also forms estrogens in half of the cases. However, this is no longer cycle-dependent, but permanent, so that too many estrogens are present in the body (hyperestrogenism).
This excessive supply of estrogens in the body naturally also affects the organism. As a result of the estrogens, the lining of the uterus (endometrium) begins to grow (proliferate). There is a thickening of the uterine lining (glandular - cystic hyperplasia). This results in bleeding disorders, which can give an initial indication of ovarian cancer. The thickening of the uterine lining can ultimately result in a prolonged existence Uterine cancer (Endometrial cancer) develop.
Theca cell tumors
Theca cell tumors Almost all of them are benign and also produce estrogens.
Androblastoma
Androgens, that is, male sex hormones, and, less often, estrogens are produced by the Androblastoma educated. However, androblastoma is usually a benign tumor that occurs primarily in young women. The androgens formed lead to masculinization in women (Androgenization).
This means that there is a male hair type in the woman (Hirsutism), the voice deeper, the Larynx grow taller and the body assumes male proportions. In addition, the clitoris becomes enlarged (clitoral hypertrophy), which is the female equivalent of the penis.
Germ cell tumors
Germ cell tumors come from cells of the embryonic development (fruit development of the body). About 95% of them are benign. The 5% malignant (malignant) germ cell tumors occur almost only in childhood and adolescence.
One distinguishes
- Dysgerminomas
- malignant teratomas
- endometrial sinus tumors and
- Chorionic carcinomas.
All these germ cell tumors have in common that tumor cells settle (metastasize) in other organs very early on via the bloodstream (hematogenous) or via the lymph (lymphogenous). Preferred organs for cell settlements (metastases) are Lungs (pulmo) and liver (Hepar).
