Ovarian cancer. What are the diagnostic and treatment methods?

This insidious malignant female cancer, the fifth most frequently diagnosed cancer, develops asymptomatically in its initial stages. Doctors colloquially call it a silent killer , as only a small percentage of women are diagnosed at an early stage. Low awareness of the disease's existence also doesn't help. Ovarian cancer is still diagnosed too late, which is why we are actively participating in a campaign to promote Ovarian Cancer Awareness. This article will provide you with useful information about the latest methods of diagnosing and treating ovarian cancer.

Ovarian cancer – diagnosis

Ovarian cancer is most often diagnosed at higher stages (III and IV), when it has already spread to other organs and is symptomatic. Most patients experience nonspecific dyspeptic symptoms for more than a year before being diagnosed with ovarian cancer. Over 70% of patients are diagnosed only after developing ascites, a fluid accumulation in the peritoneal cavity. Most cases of ovarian cancer are reported between the ages of 50 and 70. Hereditary breast cancer and hereditary ovarian cancer due to BRCA1 and BRCA2 gene mutations occur in all ethnic and racial groups. The risk of cancer increases in people who:

• have had cancer in the past,
• have at least two relatives who have been diagnosed with cancer,
• are under 60 years of age and their parents had the same cancers,
• have relatives suffering from cancer, especially breast and ovarian cancer,
• have relatives who have been diagnosed with several different cancers.

Ovarian cancer diagnosis – genetic and other tests

Due to their important role in prevention and treatment, all women with ovarian cancer should undergo genetic counseling and testing for BRCA1/2 gene mutations. It is believed that over 40% of women who inherit a damaged copy of the BRCA1/2 gene will develop ovarian cancer, approximately 70% will develop breast cancer, and individuals with a BRCA1/2 mutation are also more likely to develop pancreatic or prostate cancer. Molecular testing for BRCA1/2 gene mutations ( BRCA1 BRCA2 ) allows for early identification of mutation carrier status. Detection of a mutation in a healthy individual is an indication for oncological surveillance aimed at early cancer detection.

Ovarian tumors

There is a specific group of ovarian cancers with low malignant potential, called borderline tumors. These tumors typically occur in one ovary, are common in women of reproductive age, and have an average age of onset of 38-45 years. Nearly 75% of borderline tumors are diagnosed in the asymptomatic phase, using transvaginal ultrasound. 

Preventing gynecological diseases is key to women's health . Thanks to modern molecular diagnostics, experienced specialists, and state-of-the-art diagnostic equipment, we can offer our patients world-class preventative care. This can no longer be delayed, especially when we're talking about one of the most unfavorable cancers in women.

So, get your preventative checkups before you get sick! Regular preventative checkups are essential, among other things, because they help prevent disease and cancer.

Remember! Cancer or other diseases detected at an early stage have a good chance of recovery.

What tests should you remember ? It's very important to get tested regularly:

• breast self-examination, once a month, a week after your period, after the age of twenty,
• breast palpation examination performed by a gynecologist or your primary care midwife every 6-12 months, after the age of twenty-five,
• Breast ultrasound, once a year, after the age of twenty-five,
• mammography every two years for women over forty years of age,
• gynecological examination and cytological examination, once a year, over the age of 25,
• Transvaginal gynecological ultrasound, once a year, over 25 years of age.

If your family has a history of breast, ovarian, pancreatic or prostate cancer, perform a preventive assessment of the occurrence of mutations in the BRCA1 and BRCA2 genes.

These tests are available free of charge and reimbursed by the National Health Fund to women classified as high-risk. Individuals wishing to check for mutations can have them performed for a fee.

When should an ultrasound examination be performed?

A gynecological (transvaginal) ultrasound is best performed once a year or every two years. This examination allows for the assessment of the structure and position of the uterus, as well as the uterine lining (endometrium). The best way to monitor ovarian function appears to be an ultrasound, which also assesses the ovaries, determining their structure, position, and the number and size of follicles where egg cells mature. Ultrasound allows for early detection of changes and abnormalities such as tumors and cysts. However, an ultrasound alone may not be sufficient, and not every cyst in a menstruating woman will require surgery.

Other diagnostic tests used in ovarian cancer diagnosis include assessing Ca-125 and HE-4 levels. The ROMA test (Ca 125+ HE4+ risk assessment). In the early stages of ovarian cancer, marker levels may remain within the normal range; however, high marker concentrations do not always indicate cancer measuring Ca-125 before every preventive gynecological ultrasound and storing the results so that your doctor can assess changes in this marker levels over the years.

Present the test results to one of our gynecologists , who, after a thorough interview and examination, will prepare diagnostic and therapeutic proposals.

Ovarian cancer is still diagnosed too late, so we encourage all women to visit their gynecologist regularly and undergo health check-ups to detect any changes at an early stage.