“Ovarian cancer is in sixth place”

Begoña Sid is a gynecologist specializing in obstetrics and gynecology at the San Rafael Hospital in La Coruña. From SaludIdeal, we spoke with her about the prevalence of ovarian cancer in today’s society.

What is the prevalence of ovarian cancer today?

Among malignant tumors affecting women, ovarian cancer ranks 6th after breast, colon, lung, uterine and lymphomas, but is the first cause of death from gynecological cancer. 3,500 new cases are diagnosed annually, with the incidence in developed countries slowly but steadily increasing.

At what stage is this pathology now? Can this be cured?

The prognosis of this pathology is determined by the stage at the time of diagnosis, the possibility of resection of the entire tumor during surgery, and the use of chemotherapy. 90% of cases detected in the early stages are cured. In later stages, survival rate decreases. Management of these women by a multidisciplinary team consisting of oncologists, gynecologic oncologists, surgeons, pathologists, radiologists and radiotherapists can improve survival rates.

The cornerstone of treatment, which determines the prognosis regardless of stage, is surgery, which should be performed in centers and by specialized medical teams with experience in treating this type of tumor. Only with optimal surgical intervention in late stages can a 70% survival rate at 5 years be achieved. Platinum-based chemotherapy in combination with the use of antiangiogenic drugs and the use of PARP inhibitors made it possible to convert the disease into a chronic form and improve the quality of life of women with this pathology. There are many studies currently being conducted, including new immunotherapy drugs, which we hope will show us positive results and prolong survival.

How can we work to prevent ovarian cancer?

Currently, the cause of ovarian cancer is unknown. For this reason, no preventative measures are known, except in hereditary cases associated with a genetic mutation (BRCA 1 and 2), in which prophylactic adnexectomy (removal of the ovaries and fallopian tubes) is performed and a significant reduction is achieved. risk. The use of anovulatory contraceptives and tubal ligation are associated with a reduced risk of ovarian cancer.

What is the most common profile of patients with this type of cancer?

Any woman can develop this type of tumor, although the likelihood increases with age: the average age of onset is between 50 and 75 years, and it usually affects women past menopause. The most relevant and proven characteristics that may predispose to this tumor are:

• No pregnancies.
• Endometriosis.
• Age of first early menopause and late menopause.
• Breast cancer survivor.
• 10-15% hereditary, associated with BRCA 1 and 2 mutations or Lynch syndrome.

Is this common in young people?

It doesn’t occur often in young people, but that doesn’t mean it can’t happen at any age. When it occurs at a young age, it is usually associated with some inherited genetic changes, such as BRCA 1 and 2 mutations.

Ovarian cancer is considered a hidden pathology. Does he have any symptoms?

In the early stages, it is usually asymptomatic or very asymptomatic, with banal symptoms that are confused with benign pathologies. In primary health care and among women themselves, it is important to know that mild symptoms, but persisting for more than 2-3 weeks, may indicate the need for a gynecological examination:

• Pain in the abdomen or pelvic area with a feeling of heaviness.
• Bloating
• Satiety despite little food
• Changes in urination without other explanation
• Changes in bowel habits with diarrhea or constipation.
• Changes in the menstrual cycle. Irregular bleeding
• Low back pain with no other explanation
• Loss of appetite
• Weight loss
• Fatigue

The wide variety of symptoms with which this pathology can debut often means that before making a diagnosis, different specialists are often visited in the gynecological office. Up to 70% of cases are diagnosed in late stages.

How important are gynecological examinations at the time of diagnosis?

In 20% of cases, it is diagnosed in the early stages, when symptoms are absent or very mild, and a gynecological examination with physical examination and ultrasound is performed. Despite this, there is no reliable test for the early diagnosis of ovarian cancer. Neither ultrasound nor the determination of tumor markers have proven their effectiveness as preventive measures and early diagnosis.

What treatments are currently being developed?

Advances are being made in targeted therapy based on tumor characteristics, genetic and molecular changes, and an attempt is being made to find the most effective drug or combination of drugs aimed at curing the disease.

Traditional platinum and taxane chemotherapy continues to play a fundamental role in treatment, but with a better understanding of the molecular biology of epithelial ovarian cancer, we know that in some cases the DNA repair machinery is damaged and should be used with caution. PARP inhibitors are effective. Antiangiogenic drugs are also available that prevent neovascularization, thereby inhibiting tumor growth. There are numerous clinical trials currently underway, as well as various lines of research, which will hopefully lead to a cure for ovarian cancer, or at least make it chronic, in the near future. with very good quality of life results for women suffering from it.