Monday, June 22, 2020

Good at hidden and deceptive cancer-ovarian cancer

1. What is the incidence of ovarian cancer?

There are more than 230,000 new cases of ovarian cancer every year, and the number of deaths is 150,000. Every year, about 52,000 women in my country are diagnosed with ovarian cancer, and about 22,000 people die of ovarian cancer, which is equivalent to one person being diagnosed every 10 minutes and one person dying every 20 minutes.

The new cancer registration report of Chongqing in 2018 shows that the incidence of ovarian cancer is 7.99 per 100,000, which is relatively low. But it also made many female friends not pay enough attention. The National Cancer Prevention Research Office and the National Cancer Registration Center summarized the 2013 tumor registration work. In the past 10 years, the incidence of ovarian cancer in my country has increased by 30%, and the mortality rate has increased by 18%. Ovarian cancer has the lowest 5-year survival rate of gynecological malignancies, only 39%, and the highest 5-year recurrence rate, reaching 70%.

2. Will ovarian cancer be inherited?

It is currently found that 10% to 20% of ovarian cancer is related to genetic factors. Hereditary breast cancer-ovarian cancer syndrome and Lynch syndrome are the two most common hereditary ovarian cancer syndromes. Other syndromes related to hereditary ovarian cancer are rare.

Hereditary breast cancer-ovarian cancer syndrome

In some households, there are multiple women with breast and/or ovarian cancer, sometimes with other cancers. To this end, the concept of hereditary breast cancer-ovarian cancer syndrome, or HBOC syndrome, was proposed.

Further research shows that the syndrome accounts for about 80% of hereditary ovarian cancer. These ovarian cancers have an early age and a good prognosis. Patients often have mutations in the BRCA1 and/or BRCA2 genes.

Lynch syndrome

Also known as hereditary nonpolyposis colorectal cancer, it is a group of genetic diseases in which DNA mismatch repair genes are mutated. It usually occurs before the age of 45, and the patients are mainly colorectal cancer, followed by endometrial cancer, in addition to gastric cancer and ovarian cancer. Lynch syndrome is also the second leading cause of hereditary ovarian cancer. The main types of ovarian cancer in these patients are endometrioid carcinoma and clear cell carcinoma.

3. What is the chance of an average woman's life suffering from ovarian cancer?

In the general female population, the risk of developing ovarian cancer is about 1.3% in a lifetime.

But women with BRCA1 or BRCA2 mutations have a significantly increased risk of cancer. The incidence rate can reach 20%, and even relevant studies have shown that it can reach 40%.

American Hollywood actress Angelina Jolie carries a BRCA mutation gene, and her risk of ovarian cancer is 50%, and her breast cancer risk is as high as 87%. In order to avoid the occurrence of cancer, she chose to prevent ovaries and bilateral breasts.

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4. Can malignant ovarian tumors be prevented?

At present, in addition to living habits and environmental factors, inheritance is a clear carcinogenic factor, and some ovarian cancers are closely related to family genetics.

This part of people can use genetic counseling and early medical intervention to avoid ovarian cancer.

In terms of genetics, if immediate family members have ovarian cancer, breast cancer, endometrial cancer or colorectal cancer, and multiple occurrences in a family, you can go to a cancer specialist hospital for genetic counseling or related genetic testing to find out whether there is a correlation Gene mutations, such as breast cancer-related oncogenes (BRCA genes), Lynch genes (Lynch genes).

Secondly, it is also necessary to conduct regular gynecological examinations every year, such as gynecological ultrasound, tumor marker detection (CA125 combined with HE4), etc., can find some hidden lesions in advance, so that early detection and early treatment can be achieved.

In addition, it is usually necessary to develop good living habits, strengthen exercise, enhance physical fitness and improve immunity, which is also useful in the prevention of ovarian cancer.

5. What are the high-risk factors for ovarian cancer?

Genetics and family

Family history of ovarian cancer is an important high-risk factor for ovarian cancer. Women with BRCA1/BRCA2 gene mutations have a significantly higher risk of developing ovarian cancer before the age of 60 than the general population.

endocrine

Patients with breast cancer or endometrial cancer have a two-fold higher chance of developing ovarian cancer than the general population. The number of pregnancies is negatively correlated with ovarian cancer, indicating that pregnancy and breastfeeding cause ovulation to stop, reducing ovarian epithelial damage and reducing the risk of ovarian cancer.

Chemistry

The ovary is very sensitive to tobacco. In patients with long-term excessive smoking, the accumulation of carcinogens in tobacco increases in the body, which not only causes early amenorrhea, but also promotes ovarian cancer. In addition, women who are frequently exposed to paint, talc, and asbestos are also more likely to develop ovarian cancer.

Environment and life

Due to increased environmental pollution in industrialized countries, the incidence of ovarian cancer is also increasing. The incidence of ovarian cancer also has a certain relationship with diet. Marinated meat products, kimchi, and spoiled vegetables all contain a large amount of nitrite, which can degrade with amino acids to produce nitrosamines with strong carcinogenicity. In addition, a high-calorie, high-fat diet leads to increased levels of estrogen in the body, stimulates ovarian epithelial hyperplasia and malignant transformation, thereby increasing the risk of ovarian cancer.

Marriage and childbirth

Single women are more than half as likely to have ovarian cancer as married women, and women who have children have a lower risk of cancer than women who are not.

age

The incidence of ovarian cancer increases with age. The vast majority of epithelial ovarian cancers occur after the age of 50 and reach the peak of incidence at around 80. Therefore, with the increase in average life expectancy, the incidence of ovarian cancer is also increasing.

other

Impatience, excessive stress, nervousness, depression, inferiority, self-blame, and interpersonal tensions can cause damage to the body's immune system, which in turn can induce tumor growth. And cheerful, optimistic people are the least dangerous, and bad emotions can suppress the immune system function and weaken the body's own anti-cancer ability.

6. Is there a signal for ovarian cancer?

There are no specific symptoms in the early stage of ovarian cancer, and it is usually found early through normal physical examination. The following abnormalities should cause vigilance.

Menstrual disorders

Most ovarian cancer patients have no menstrual changes. If normal ovarian tissues are destroyed by cancer cells, hormone levels change, and the patient's overall condition is poor, there may be menorrhagia or amenorrhea. The pathological types of ovarian cancer are complex and changeable. Granulosa cell tumors of the ovary can secrete estrogen, which can cause precocious puberty, menstrual disorders or vaginal bleeding after menopause due to excessive estrogen production.

Bloating

Bloating is a "red card" warning for ovarian cancer. It is often the first symptom of ovarian cancer patients and can occur before they touch a lower abdominal mass. The reason is that the tumor itself is compressed and stretches the surrounding ligaments in the abdominal cavity. In addition, ovarian cancer is often accompanied by the occurrence of ascites, which makes patients often feel bloated. Therefore, if there is unexplained abdominal distension (especially during menopause), gynecological examination should be done in time.

Abdominal pain, low back pain

Ovarian cancer infiltrates the surrounding tissues, or adheres to adjacent tissues. Compression of nerves can cause abdominal pain and low back pain, usually from faint pain to dull pain, or even more severe pain.

Edema of lower extremities and vulva

Ovarian cancer mass gradually grows in the pelvic cavity, which can compress the pelvic veins and affect lymphatic reflux. Therefore, if the patient has edema of the lower extremities and vulva, it should be thought that the ovarian cancer may be "sick".

Unexplained weight loss

Ovarian lumps gradually grow, combined with the formation of ascites, which can mechanically compress the gastrointestinal tract, causing patients to reduce food intake and dyspepsia. In addition, the growth and reproduction of cancer cells consume a lot of nutrients, making patients increasingly thin, anemia, fatigue, and lacklustre.

Ovarian cancer should create a "full process" management

The tumor cells of early ovarian cancer are only limited to the ovary and belong to stage I, but it is often difficult to find early. Once the tumor cells have metastasized to the pelvic organs, it belongs to stage II. Stage I tumors are clinically called early tumors. Tumors of stage II to IV are called advanced stage tumors.

Ovarian cancer should create a "full-range" management model. It is necessary to develop a good lifestyle and do early screening; if more than one family member has breast cancer or ovarian cancer, it is recommended to go to a cancer specialist hospital for genetic counseling and necessary genetic testing.

Once the malignant ovarian tumor is diagnosed, no matter it is early or late, surgical treatment should be performed as soon as possible, and the tumor should be removed as much as possible, and combined with chemotherapy-based comprehensive treatment after surgery. For advanced cases, large lesions, extensive metastases, severe adhesions, or combined pleural and ascites, chemotherapy can be used to reduce the mass, prepare the conditions for subsequent surgical treatment, and increase the success rate and cure rate.

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