Ovarian cancer

Description:

Ovarian cancer is very widespread pathology of the oncological plan in the field of urinogenital system. More often it is observed at the age of 40-50 years.
The microscopic picture is various - from cystous cavities with small friable plaques on an internal surface to the papillary and solid sites of a soft consistence, white color which are often breaking up. The tumor can sprout a surface of cysts and get into an abdominal cavity. Are microscopically noted sharp polymorphism of cells and kernels, it is a lot of mitoses.

Ovarian cancer reasons:

Cancer of an ovary develops most often in already available benign tumors, in tselioepitelialny  and, more rare, a psevdomutsiozny cystoma. Hormonal disturbances, at women of premenopausal age, and also at not giving birth, carry out to an ozlokachestvleniye of epithelial cells. A part is played by also hereditary factor.

Ovarian cancer symptoms:

The general condition of patients in early stages of ovarian cancer usually does not change. Nonspecific symptoms, such as bystry fatigue and the general weakness are sometimes noted. The first symptoms of a disease often are the periodic developing nausea, vomiting, subjective heavy feelings in lower parts of a stomach, dysfunction of intestines. The tumors located in a duglassovy pocket or in the field of a vesicouterine fold, even small can cause disorders of defecation and an urination. In process of progressing of malignant process in ovaries pain gains constant character,  are localized in the bottom of a stomach, in a waist and in ileal areas. The stomach increases due to accumulation of ascitic liquid in an abdominal cavity. Function of intestines and an urination is more often broken. There is an exudate in one or both pleural cavities. Displays of cancer intoxication consist in disturbances of functions of all systems. Cancer is characterized by usually bilateral damage of ovaries. Tumors have irregular shape, an uneven consistence (places dense, places elastic) and a hilly surface. The tumor arrangement behind a uterus and restriction of their mobility as a result of a spayaniye with a uterus or a peritoneum of a duglassov of space is often noted.
At ovarian cancer rapid growth of a tumor and emergence of metastasises in a belly epiploon, and also on a parietal and visceral peritoneum of a basin and an abdominal cavity is observed. Opukholevo the changed big epiploon is probed in an upper half of a stomach in the form of a dense lepeshkoobrazny motionless tumor. Metastasises in periaortal and supraclavicular lymph nodes, and also in a navel, a liver and on a pleura are most often noted.

Diagnosis:

Ovary cancer in an initial stage does not give the strong clinical signs distinguishing it from a benign tumor. Definition in a small basin  of a tumor of an uneven consistence, with hilly or slightly uneven surface, the limited surface located behind or sideways from a uterus forces to suspect a malignant new growth of an ovary. In an initial stage of cancer of ovary in blood the accelerated SOE and a leukocytosis is often observed.
Contrary to ovarian cancer with the erased clinical picture in the early period of development gormonalnoaktivny tumors already right at the beginning make impact on appearance of the woman and a condition of genitalias. Emergence of uterine bleedings, signs of "rejuvenation" and a hyperplasia of an endometria at detection allows to suspect a gormonalnoaktivny "ozhenstvlyayushchy" tumor of a small basin of unilateral tumoral formation of an ovary. If the listed symptoms arose at the woman in a menopause, and the found tumor has a dense consistence, the diagnosis of a teka-cellular tumor is more probable.
The dysgermoinoma most often occurs at girls and young women. Hormonal influence at this tumor is expressed more weakly, but dysfunction of ovaries is more often observed.
Valuable auxiliary diagnostic method of cancer of ovary is the cytologic research of ascitic liquid. At ovarian cancer in ascitic liquid elements of a malignant new growth, most often in the form of papillary or ferruterous structures and separate atypical epithelial cells are found. At tumors of an ovary radiological inspection of a stomach and intestines is necessary to exclude primary defeat by their cancer. For establishment of extent of spread of cancer and identification of a possible exudate in pleural cavities the chest fluoroscopy is surely carried out.
At suspicion of an ovary tumor like dysgermoinoma it is necessary to put reaction of urine to gonadotrophins which is positive thus tumors. Apply radiological inspection in the form of a contrast gisterografiya against the background of a pneumoperitoneum to the fact that to specify an arrangement of the malignant tumor which is not followed by ascites. In most cases the final diagnosis is established only at a laparotomy or after the histologic research of a remote tumor.

Cancer therapy of ovaries:

Cancer therapy of ovaries assumes the surgical, complex and combined methods. Complex treatment, in addition to operation, includes radiation therapy or a himioterpiya (hormonal therapy).
Surgical treatment at ovarian cancer quite often is the only method of treatment. At 1 and 2 stages of oncological process carrying out an extirpation or supravaginal amputation of a uterus with appendages is possible. The surgeon has to aim to keep integrity of cystous educations in a tumor of an ovary and not to allow hit of its liquid contents in an abdominal cavity. Even if in a big epiploon metastatic nodes do not vizializirutsya, it should be removed. At 3-4 stage of ovarian cancer carrying out surgical intervention and removal of the main arrays of a tumor and a resection of an epiploon is also possible.
After operational treatment radiation therapy which possibly by method of outside or intra belly radiation is usually appointed.
In a complex of chemotherapeutic treatment use antineoplastic drugs: Cyclophosphanum, тофосфамид, sarcolysine and others.
In the absence of contraindications the antineoplastic drug is administered in an abdominal cavity at the time of the end of operation, and then in the postoperative period intraperitoneally, intravenously, intramusculary. At widespread malignant tumors of ovaries it is reasonable to use himioterpevtichesky drugs before operation (if it is possible) or as the only method of treatment.
If malignant tumors are followed by an exudate in an abdominal cavity, it is necessary to administer the drug intraperitoneally after evacuation of ascitic liquid.
Hormonal therapy at malignant new growths is usually carried out in a complex with other medical actions. Preferential use androgenic drugs: testosterone-propionate is entered intramusculary on 50 mg every other day within 1,5-2 months. Then recommend methyltestosterone on 20 mg daily with a gradual dose decline.