Ovarian cancer is the second most frequent cancer in Gynecology but it is the most aggressive. It is estimated that most cases are diagnosed in advanced stages, when the disease has already spread throughout the abdominal cavity or even outside the abdomen. The average age of onset of this type of cancer is 60 years and, although a great deal of research is currently underway, there is currently no effective method of early diagnosis of the disease, such as, for example, cervical cytology for cervical cancer. Since the development period of the disease is only a few months, gynecological screening with vaginal ultrasound has not been shown to prevent the incidence or improve the prognosis of the disease.
Symptoms of ovarian cancer
Symptoms associated with advanced ovarian cancer are very nonspecific and include:
- Abdominal pain
- Intolerance to certain foods
- Changes in bowel rhythm
- Abdominal distention
- Lower back pain
- Heartburn
Diagnosis of ovarian cancer
Given the lack of specificity of the symptoms, the clinical picture is often confused and the diagnosis can be delayed between 3 and 4 months. The way to diagnose it is by means of a gynecological or abdominal ultrasound with which the enlarged ovaries and the free fluid in the abdominal cavity that usually accompanies the vast majority of patients can be observed.
Therefore, the most important thing to do with women affected by ovarian cancer is to treat them appropriately.
Ovarian cancer: treatment
There are certain proven prognostic factors for survival which include:
- Age of the patient
- Histologic type
- Extent of disease,
- Degree of aggressiveness of the tumor
- General condition of the patient
- Type of initial surgery
The latter, however, is the only modifiable prognostic factor. That is to say, it is the only one on which action can be taken today to improve the prognosis of patients with advanced-stage ovarian cancer.
Adequate surgery for ovarian cancer means removing all of the disease before the start of chemotherapy. This usually includes removal of the uterus and ovaries, resection of the bowel, spleen, peritoneum (a thin membrane that internally lines the abdominal and pelvic cavity), resection of the diaphragm, and liver surgery. All this, in the same patient and in the same surgical act.
Frequent errors in cancer treatment
However, only a small minority of patients with advanced ovarian cancer are operated on by properly trained gynecologic oncologists. The main causes include:
- The patient’s trust in her lifelong gynecologist, who may have been the one who delivered her children but may not be the one best trained to perform this type of procedure.
- Patient’s preoccupation with resolving the condition immediately regardless of where, how or with whom.
- Economic difficulties or lack of desire to travel to other cities to be treated by specialized professionals.
- Lack of knowledge of the population and professionals of the existence of professionals prepared for this type of surgical treatment and of the importance of an adequate surgery to modify the prognosis of the disease.