What is Ovarian Cancer?
Ovarian cancer is a disease that occurs in the ovary of women. Women have two ovaries, one on the right and one on the left. The almond-sized ovaries take part in the secretion of important hormones such as progesterone and estrogen, while at the same time forming the egg, which is one of the masterpieces of reproduction.
The basis of the ovaries, which contain cells in many different structures, is epithelial cells. Ovarian cancer may occur with uncontrolled divisions and increase in numbers in these cells or cells in the embryonic period. In ovarian cancer that occurs after menopause in some of the cases, the starting point is usually in the epithelial tissues. If ovarian cancer occurs under the age of twenty, attention should be paid to embryonic tumors.
What are the Symptoms of Ovarian Cancer?
As with many types of cancer, ovarian cancer is also insidious, so it may not show many symptoms at early period. The symptoms of this cancer are usually individual-specific and a typical finding may not be mentioned. In general, it can be counted as abdominal pain, bloating and stomach problems, which are also symptoms of many diseases. As a result of the progression of ovarian cancer, symptoms such as palpable mass in the abdomen, downward pressure, fluid accumulation in the abdomen, and complaints during urination or in the intestines due to pressure on the structures or organs in the surrounding region are among the symptoms.
In some types of cancer, hormonal irregularities may occur. Accordingly, the effects such as menstrual irregularities, increase in male hormone, hair growth and male pattern hair loss can be observed. Most complaints in ovarian cancers are about swelling in the abdomen. In the light of all these, the symptoms of ovarian cancer in general include intestinal problems, constipation problem, change in urination, loss of appetite, sudden feeling of fullness, vaginal bleeding, weight loss, pressure and swelling in the abdomen, pain or fullness in the groin, gas or bloating. nausea may occur.
Why Does Ovarian Cancer Occur?
As in some types of cancer, the cause of ovarian cancer has not been clearly explained. It is believed to be caused by genetic, environmental and hormonal factors. In general, the risk is slightly higher in those with a family history of breast or ovarian cancer, those who use fertility-inducing drugs, and those who have never been pregnant. According to studies, this risk is less in those who use birth control pills and give birth.
Diagnosis in Ovarian Cancer
Early diagnosis is of great importance in ovarian cancer as well as in all types of cancer. It is recommended that women go to check-ups regularly for early diagnosis and this follow-up should be taken care of. Early diagnosis of ovarian cancer is possible with a palpable mass during a gynecological examination or with masses in the ovaries during ultrasound.
Not every mass seen in the ovaries is harmful. Most cysts in women of reproductive age are harmless. Cancer risk may not be sought in these cysts that disappear spontaneously over time, but the precautions should still be taken.
Some markers are used in the blood in masses with tumor features and in their advanced stages. In particular, the marker CA 125 is found at high levels in the blood in some tumor types. However, a definite determination cannot be made by looking at this alone. Apart from markers, benign or malignant tumor differentiation can be made using imaging techniques such as Doppler ultrasound. All these examinations and methods used are auxiliary methods and are not sufficient to make a definitive diagnosis. Analyzing the tumor taken from the suspicious region of the body in laboratories, that is, biopsy, is a very effective method for definitive diagnosis.
What is CA 125?
CA 125 is a protein located on the surface of cancer cells. This protein level may be high in individuals with ovarian cancer.
Treatment Methods in Ovarian Cancer
Chemotherapy
Chemotherapy is the treatment of effective drug delivery against cancer cells into the body’s circulatory system. It can be applied to destroy cancerous cells that have spread to the lymph nodes or remain as a residue after surgery. Chemotherapy given after regional treatment after the operation is considered as adjuvant treatment. One of the goals of this treatment is to keep cancer cells from recurring after removal at a minimal level. It is tried to increase the chance of treatment by applying aggressive treatments to high-risk ovarian cancer patients. Apart from this, it can also be applied to prolong the lifespan in advanced stage patients and to minimize some of the symptoms and complaints experienced by the patient.
Intra-abdominal Warm Chemotherapy (HIPEC)
It is a vein injection applied following surgery in advanced ovarian cancer. This treatment is the process of applying hot chemotherapy in the abdomen. It is called hyperthermic intraperitoneal chemotherapy (HIPEC).
Radiotherapy
In radiotherapy, also known as radiation therapy, high-energy rays are sent to the target region of the patient to prevent the proliferation and the damage of cancerous cells. In radiotherapy, which is used as a regional treatment, the rays sent to the target region destroy the DNA structures of cancerous cells and kill them. It can be applied alone or as combined with chemotherapy. It can also be used to shrink the tumor before or after the surgical operation or to clean the cancerous cells that can be described as residue. It appears as a supportive, palliative treatment option in patients who cannot take chemotherapy drugs, in relapse sites, and in some cases. The aim of palliative treatment is to minimize the complaints that reduce the patient’s quality of life. Side effects of radiotherapy can be listed as stomach cramps, nausea, diarrhea, vomiting and bowel movements. Apart from this, it also creates a feeling of fatigue in the patient.
Immunotherapy
Immunotherapy aims to trigger the immune system, which is the body’s defense system, so that they can recognize and destroy cancerous cells more easily. At this point, 6 methods are used in ovarian cancer: monoclonal antibodies, immune checkpoint regulators, adjuvant immunotherapies, oncolytic viruses, adoptive T cell transfer and therapeutic vaccines.
Monoclonal antibodies (mAbs) are cells created in vitro and that defend by targeting tumor-specific antigens. At this point, agents that prevent the feeding of the tumor by targeting the vascular endothelial growth factor, which supports the growth and development of cancerous cells, have also been developed.
Immune Checkpoint Inhibitors / Immune System Modifiers
These agents are involved in the control and regulation of the response of the defense system. These drugs remove the inhibitory state of cancer cells on the defense system.