Ovarian Cancer
Ovarian cancer often presents with nonspecific symptoms such as abdominal bloating, pain, a palpable mass during abdominal examination, weight loss, and loss of appetite. Frequently, ovarian cysts or masses are detected incidentally during imaging studies performed for other reasons. Ovarian cancer can progress silently. Although it is commonly known as a disease of older women, some younger women may develop intermediate forms of ovarian cancer or cancers originating from the supportive and germinal layers of the ovary. A family history of colorectal or breast cancer also increases the risk of ovarian cancer.
Because symptoms may not be obvious, patients are sometimes diagnosed at advanced stages. Diagnostic evaluation includes gynecological examination, sampling of abdominal fluid (ascites) if present for pathological analysis, imaging of the entire abdominal structures via CT or MRI, and thoracic CT for lung assessment. Since breast cancer and gastrointestinal tumors (such as colorectal and stomach cancers) can metastasize to the ovaries and mimic ovarian cancer, relevant patients may also undergo gastroscopy, colonoscopy, and breast examination to rule out these conditions.
Ovarian cancer can involve other intra-abdominal organs outside the uterus and ovaries through direct extension or the movement of intra-abdominal fluid. Upper abdominal organs such as the liver, spleen, and omentum (a fatty tissue in the abdomen) are commonly affected. Therefore, surgery may require procedures targeting other organs involved by the tumor. Complex surgical procedures may include removal of the spleen, excision of omental cake tissue, resection of the diaphragm (the membrane separating the liver and lungs), clearance of tumor tissues on the intestines, and, if necessary, partial or complete removal of the colon. In young women with intermediate-form cancers or early-stage low-grade tumors, fertility-sparing surgery may be performed.
Postoperative treatment may include chemotherapy depending on pathological results. In some selected cases, surgery is recommended after 3–4 cycles of chemotherapy, followed by an additional 3–4 cycles of chemotherapy post-surgery.
After initial treatment, patients are closely monitored. Disease stage, tumor characteristics, and response to treatment all influence the risk of recurrence.
