Since 2004, cancer has taken the place of cardiovascular disease the leading cause of premature mortality. It affects one in two men and three women. According to the National Institute for Public Health, the number of new cases of cancer in 2005 was estimated at 320 000, 180 000 in men and 140 000 women.
In men, the prostate cancer (62,000 new cases per year), lung cancer (24,000 new cases) and colon-rectum (20 000 cases) were the most frequent. In women, the three most common cancers are breast cancer (50,000 new cases per year), colon-rectum cancer (17,000 new cases) and lung cancer (7,000 new cases).
Definition of ovarian
Composed of different tissues, the ovaries are the female genital glands located on each side of the uterus to which they are connected by the fallopian tubes.
They have two functions: to produce eggs and secrete sex hormones (estrogen and progesterone).
The causes of ovarian cancer
There are several risk factors for ovarian cancer:
Age is the main risk factor, in fact, the risk of developing ovarian cancer increases with age.
Familial cancers represent only 5-10% of cases. Genes currently identified for their involvement in the predisposition to ovarian cancer are the same as those of the breast cancer gene BRCA 1 and BRCA 2 gene rarely.
Also, when there are multiple cases of ovarian or breast cancer in a family, a oncogenetic consultation should be considered.
Studies show that the risk may be higher in women with ovarian function disorders such as infertility. The use of treatments for menopause does not appear to have significant influence on the risk of ovarian cancer.
The symptoms of ovarian cancer
Tumor of the ovary often goes unnoticed for long. The diagnosis is then performed at a relatively advanced stage. The main symptoms are a feeling of weight in the abdomen, increased abdominal girth, pelvic pain or acute pain associated with certain movements.
Other symptoms, non-specific ovarian cancer, can occur. Examples are gynecological disorders (menstrual disorders, painful intercourse) or digestive disorders (loss of appetite, nausea, diarrhea or constipation, abdominal bloating ...).
Stages of development of ovarian cancer
There are 4 stages of ovarian cancer:
Stage I: the tumor is confined to one or both ovaries.
Stage II: the malignancy has spread to other organs in the pelvis (pelvis) such as the uterus or fallopian tubes.
Stage III: The tumor has spread outside the pelvis to the abdomen or lymph nodes
Stage IV cancer has metastasized beyond the peritoneum to the liver in particular.
The treatment of ovarian cancer
When cancer is identified at an early stage and when the disease is localized to one ovary, it is proposed a so-called conservative surgery for young women who have not yet had children. It withdraws when touched ovary, allowing the patient to have one or more children later.
However, samples will be performed at the peritoneum, omentum (a piece of fat that is located in the abdomen and is often the first site of spread of the disease) and lymph nodes for analysis anatomo-cyto-pathological. If the tumor is marked on both ovaries, the surgeon removed while leaving the uterus, if possible.
In other stages, surgery is to remove both ovaries, uterus, pelvic lymph nodes and para-aortic nodes and the omentum. Multiple biopsies of the peritoneum are consistently effected.
This surgery may be followed by postoperative chemotherapy.
In the case of advanced tumors must be removed surgically the ovaries, uterus, lymph nodes and omentum but also all visible peritoneal lesions, which may require additional surgical procedures: removal of the spleen, more or less extensive portions of the peritoneum, one or more segments of intestine ....
The quality of the initial surgery is therefore extremely important. Radiological preoperative (CT) and possibly a laparoscopy (intervention under general anesthesia where an optical fiber is inserted through the navel) to better assess the importance of the extension of the lesions.
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