Ovarian cancer

Ovarian cancer is a malignant tumor that most commonly arises from the epithelial tissue of the ovary. The disease develops against the background of borderline (precancerous) or benign neoplasms. According to worldwide statistics, mortality from ovarian cancer exceeds the total number of deaths from cervical and uterine cancer. This is associated with a high risk of ascites (accumulation of fluid in the abdominal cavity) and metastases to distant organs.

In developed countries, ovarian cancer is one of the most common cancers in women. Those patients who underwent artificial ovarian stimulation, abortion, and ovulation drugs are most at risk of developing the disease. To exclude a diagnosis, it is necessary to undergo a complex of examinations in a specialized clinic. Leave a request on the MedTour platform and get a consultation with the coordinating doctor regarding the diagnosis of ovarian cancer.

Why does ovarian cancer occur

Scientifically (according to research from the US National Cancer Institute), ovarian cancer begins to develop in the cells of the fallopian tubes. These abnormal cells are precursors to malignant tumors. Over the years, this leads to ovarian cancer.

Scientists still do not know what exactly causes the transformation of mutated cells from the fallopian tubes into a malignant ovarian tumor.

What can cause ovarian cancer:

• Heredity (the diagnosis was made in an older blood relative);
• Primary cancer that originates in the peritoneum;
• Endometriosis – an abnormal proliferation of the endometrium of the uterus outside the organ;
• Infertility (or women who have not given birth);
• Hormone replacement therapy (replacement of the lost hormonal function of the ovaries).

Women who have a family history of ovarian cancer or certain gene changes (such as BRCA1 or BRCA2) are at higher risk than women who do not have such relationships.

For women at hereditary risk, genetic testing can be used to get information about the likelihood of developing ovarian cancer. Such tests are carried out by specialists in the treatment of ovarian cancer abroad.

Ovarian cancer symptoms

In the early stages, ovarian cancer is asymptomatic. Women experience severe discomfort when the disease reaches stage 3-4.

What are the symptoms of ovarian cancer:

• Bloating;
• Lack of appetite;
• Pelvic pain;
• Frequent urination;
• Violation of the menstrual cycle;
• Pain during intercourse.

In patients with ovarian cancer, symptoms are active when the process is widespread. Most often, this is accompanied by unreasonable weight loss, general malaise, weakness, and fever.

At stage 4 ovarian cancer, the patient has fluid accumulation in the abdominal cavity. At the same time, pain is expressed not only in the abdomen, but also in the back at the slightest load.

Ovarian cancer diagnosis

The diagnosis of ovarian cancer should begin with the consultation of a gynecologist. The doctor conducts a rectovaginal examination and palpation of the abdomen, which helps to suggest the presence of pathology.

In specialized clinics, doctors carry out comprehensive diagnostics, which includes:

• Transvaginal ultrasound examination. The doctor sees by ultrasound signs of ovarian cancer: a tumor, involvement of the uterus and other related organs in the oncological process, the presence of fluid in the abdominal cavity.
• Laboratory blood tests. Special blood tests can detect cells that are characteristic of cancer.
• Biopsy. A specialist examines a sample of the tumor to determine its degree of malignancy.
• CT scan. Doctors perform CT scan of the chest, abdomen, and pelvic organs. This allows detect metastases in neighboring and distant structures of the body.
• Endoscopy. Examination of the stomach and mammary glands reveals a primary neoplasm, which often causes ovarian cancer as a secondary tumor.
• Positron emission tomography. Based on the results of PET-CT, the doctor gets a complete picture of the prevalence of the malignant tumor, the condition of neighboring organs and lymph nodes.

How to determine the stage of ovarian cancer – only a professional oncologist knows. It is impossible to independently diagnose oncology only on the basis of patient complaints. Some of the symptoms of ovarian cancer are similar to those of less serious diseases. Therefore, it is necessary to undergo the entire range of diagnostic procedures.

How to detect early ovarian cancer?

Diagnostics should include all necessary studies that are recommended by the World Health Organization. In clinics abroad, patients undergo all instrumental and laboratory examinations, including PET-CT.

Examples of the cost of PET-CT for ovarian cancer in clinics around the world:

• Ukraine – от $400;
• Turkey – от $800;
• South Korea – от $1 000;
• Israel – от $1 300;
• Germany – от $2 400.

Ovarian cancer survival

Ovarian cancer responds well to treatment if the patient is diagnosed on time. A timely visit to an oncologist and the correct treatment tactics give a favorable prognosis for a life expectancy of 5 years and even a complete cure.

The prognosis for survival largely depends on the type of ovarian cancer, the general condition of the patient and concomitant diseases. The highest 5-year survival rate is characteristic for mucinous tumors – 68%. With clear cell type – 60%, with endometrioid and serous cancer – 41%.

The 5-year survival rate for ovarian cancer is higher in younger women. Patients under 35 years old pass the five-year milestone in 80% of cases, over 65 years old this figure is about 40%.

Average statistics of five-year survival rate during treatment:

• Stage I – up to 95%;
• Stage II – up to 78%;
• Stage III – about 50%;
• Stage IV – up to 20%.

How long they live with ovarian cancer depends on the reliability of the diagnosis and the right treatment. There are protocols for each type and stage of cancer. In foreign clinics, doctors can supplement treatment with modern therapies that minimize the likelihood of relapse.

Ovarian cancer stages

Doctors determine the stage of ovarian cancer based on the size of the tumor and the extent to which it has spread to nearby organs and distant structures.

Each stage of the disease is characterized by:

• Stage 1 – the tumor does not go beyond the ovary;
• Stage 2 – the tumor grows into adjacent tissues and organs;
• Stage 3 – cancer cells spread to the lymph nodes and are found in the blood;
• Stage 4 – metastases grow outside the abdominal cavity.

Doctors determine primary, secondary, or metastatic ovarian involvement. Primary cancer develops directly in the glandular tissue. Secondary cancer develops in teratoid, serous and pseudomucinous ovarian cysts. Metastatic cancer is characterized by spread to neighboring and distant organs through the blood and lymph.

Types and kinds of ovarian malignant tumors

Ovarian cancer is classified into two types: epithelial and non-epithelial tumors.

Malignant epithelial tumors develop from epithelial cells that cover the outside of the ovaries. They are divided into kinds:

• Mucinous, endometrioid and serous (borderline, precancerous tumors);
• Clear cell (a rare form of cancer);
• Brenner’s tumors (a benign tumor that can degenerate into a cancerous one);
• Carcinoma (arises from the epithelium of the organ);
• Complex epithelial cancer (tumor development in several types of tissues).

Non-epithelial ovarian cancers:

• Tumors of the genital stroma (a rare type of malignant tumor);
• Rare cancerous lesions of soft tissue in the ovaries;
• Germ cell carcinoma (neoplasms that occur in childhood).

Ovarian cancer can have a variety of histological structures. About 80% of ovarian cancers originate in the epithelium, and about 10% are invasive mucus-forming carcinomas.

Epithelial tumors are carcinomas, the most common and dangerous of all types of ovarian cancer. This disease has the lowest survival rate of all malignant tumors of the reproductive system. Therefore, the earlier the disease is detected, the more chances for its successful cure.

The type and kind of tumor affects how quickly ovarian cancer develops and what the patient’s prognosis is. Rare cancers are more difficult to treat. In this case, it is necessary to seek medical help from an experienced oncologist who has clinical experience in the treatment of such malignant neoplasms.

Ovarian cancer treatment

Surgery combined with postoperative chemotherapy is the leading treatment for ovarian cancer. In some cases, chemotherapy is used in the preoperative period to reduce the manifestation of the disease.

Whether ovarian cancer can be completely cured will depend on the patient’s individual diagnostic results and the cancer’s sensitivity to therapy.

The main indicators that doctors rely on when choosing a treatment regimen:

• The type and stage of ovarian cancer;
• The presence of fluid (ascites) in the abdominal cavity;
• Operability (is it possible to remove the entire tumor by surgery);
• Whether there are changes in the BRCA1 or BRCA2 genes;
• The patient’s age and general health;
• Cancer was diagnosed for the first time or recurred.

Key treatments for ovarian cancer:

• Surgery. Mostly, the only treatment for cancer is the complete removal of the uterus, fallopian tubes and ovaries from both sides. In this case, it may be necessary to remove regional lymph nodes. Surgery is performed to remove as much of the tumor and metastases as possible.
• Chemotherapy. Doctors give chemotherapy before surgery (to shrink the tumor) and after surgery (to destroy metastases). Variants of drug use: orally, intramuscularly, intravenously, intraarterially or through the introduction into the abdominal cavity.
• Radiation therapy. It is carried out according to certain indications (for some types of cancer). Modern installations for radiation therapy actively influence only the tumor, without affecting the healthy tissues of the body.

At the initial stage of the disease (in the absence of metastases in the organs), and if the woman wishes to preserve fertility, an operation can be performed only to remove the tumor and appendages on one side. This requires a highly qualified surgeon and a multidisciplinary assessment of the patient's condition.

Ovarian cancer treatment abroad

In modern clinics where ovarian cancer is treated according to international protocols, doctors use the latest equipment. Such equipment makes it possible to efficiently and with the least traumatism carry out operations and therapeutic procedures for patients with ovarian cancer.

Operations to remove ovarian cancer on a Da Vinci robot

Robotic operations allow surgical treatment of malignant tumors without large incisions compared to abdominal operations. This is important from an aesthetic point of view, as large scars are not left on the patient’s body.

Benefits of Da Vinci surgery:

• The surgeon makes cuts in the skin no more than 1.5 cm in diameter (with a cavity operation, incisions are 15-20 cm);
• The patient recovers faster than after classical surgery;
• Thanks to a special control panel, the risks of inaccurate movements of the surgeon’s hands are minimized;
• 3D visualization allows the doctor to fully control the process and see even the smallest areas of the tumor.

Radiosurgery for the treatment of ovarian cancer with CyberKnife

The peculiarity of this treatment lies in the precise effect on cancerous tissues. At the same time, the patient does not experience discomfort and does not need long-term hospitalization. The CyberKnife robotic installation can be used by doctors as an alternative to surgical intervention for certain types and stages of ovarian cancer.

Advantages of CyberKnife irradiation:

• Effective therapy for inoperable tumors;
• The ability to accurately affect the affected areas of organs;
• The side effect on the patient’s body is minimal, since healthy tissues are not affected during the procedure;
• An irradiation session lasts 30-90 minutes without the need for a subsequent hospital stay.

Radiosurgical treatment of ovarian cancer with the Gamma Knife

Using the Gamma Knife device, oncologists irradiate metastases that have spread to the brain. The therapy is effective for hard-to-reach tumors in the ovaries, which cause complications in distant structures of the body.

Advantages of Gamma Knife irradiation:

• Precise impact on tumors that affect multiple organs in the late stages of the disease;
• A painless procedure that does not require the patient to be anesthetized;
• Effective for inoperable or hard-to-reach neoplasms;
• Increases the chances of survival.

How much does ovarian cancer treatment cost

The formation of the final cost of ovarian cancer treatment will be influenced by a number of factors related to both the patient’s condition and the pricing policy of a particular clinic. The main criteria for pricing:

• Complex of diagnostic measures;
• Choice of treatment methods;
• Doctor’s qualification level (certificates, awards, clinical experience, knowledge of modern techniques);
• Country where the hospital is located (cost of flight, accommodation, medical services);
• Rehabilitation after surgery, providing special care.

The cost of a course of chemotherapy in leading clinics in the world varies on average from $300 to $1 600. The price of drugs in Europe and Turkey is the same, but the cost of the therapy itself will depend on the form of the drug (pills, injections, etc.) and the composition of the formula (for each stage and certain medications are suitable for the type of cancer). If the patient needs intravenous administration of chemotherapy drugs, the clinic may include staff services and the length of stay in the ward in the cost of treatment.

If a patient is considering the option of surgical treatment of a tumor on a Da Vinci robot, then Ukraine comes to the fore in terms of price-quality ratio. The cost of a robotic operation will be about $10 000. Turkish clinics offer operations on the Da Vinci robot at a price of $18 000. This is due to the extensive clinical experience of specialists and work on the latest generation installations. It is also worth considering the additional costs of travel and accommodation in the country.

Frequently asked questions about ovarian cancer

To undergo the diagnosis and treatment of ovarian cancer in the oncology clinic, leave a message on the MedTour website. A medical coordinator will help you choose the best option among specialized medical institutions and arrange a trip to the hospital.

Frequently Asked Questions

1

What are the earliest symptoms of ovarian cancer?

A woman should immediately consult a doctor if she has:

• Feeling of stretching in the lower abdomen;
• Systematic abdominal pain without a specific localization;
• Bloating without changes in diet.

1

Where to go for ovarian cancer treatment?

The most popular destinations for the treatment of cancer among medical tourists are Turkey, Israel, South Korea and European countries.

In the context of the COVID-19 pandemic, in terms of accessibility to the country and value for money, the priority remains clinics for the treatment of ovarian cancer in Turkey and Ukraine, where women are successfully treated for ovarian cancer.

1

What test to take for ovarian cancer?

Laboratory diagnostics based on modern medical centers offers a wide range of studies for the diagnosis of ovarian cancer: tumor markers, genetic testing, complete blood count and biochemistry.

1

What are the operations for ovarian cancer?

According to individual medical indications, surgeons perform the following types of surgery to treat ovarian cancer:

• Hysterectomy – removal of the cervix and body of the uterus;
• Omentectomy – removal of the greater omentum (an extension of the gastro-colonic ligament, hanging in the abdominal cavity in the form of an “apron”);
• Lymphadenectomy – removal of lymph nodes.

1

How to prevent recurrence of ovarian cancer?

The cause of recurrence of ovarian cancer is metastases, which can persist inside the body. After treatment, relapse is triggered by certain factors that affect metastases. They are the reasons why the disease returns.

Recurrence of ovarian cancer can be prevented if the patient is attentive to any changes in well-being. In this case, it is necessary to immediately contact an oncologist and undergo repeated examinations.

General tips to help reduce the risk of ovarian cancer recurrence:

• Follow the doctor’s recommendations and periodically be examined by a gynecologist;
• Lead a healthy lifestyle that includes proper nutrition and moderate exercise.

In some cases, oncologists recommend that patients undergo mammological screening once a year. In a number of countries, the consultation of a mammologist is included in the diagnostic protocols for the prevention of ovarian cancer and its recurrence.

1

What diseases can contribute to the formation of a tumor in the ovaries?

Women who are diagnosed with obesity, diabetes mellitus, thyroid pathology are more prone to the formation of benign and malignant ovarian tumors.

1

What can be confused with ovarian cancer?

At different stages, ovarian cancer is characterized by nonspecific manifestations and is often disguised as a different disease. Sometimes doctors make a preliminary false diagnosis due to similar symptoms. Insufficiently qualified doctors confuse diseases of the gastrointestinal tract and urinary system with ovarian cancer.

Published: 03.09.2021

Updated: 01.10.2021

Medical author:

Ilona Baidiuk

Information on this webpage verified by the medical expert

Medical Doctor, oncologist, PHD student

Kateryna Maliarchuk