What are the symptoms and signs of ovarian cancer? How long is the general survival period for patients with mid- to late-stage ovarian cancer?

Ovarian cancer is one of the most common tumors of female reproductive organs, and its incidence rate ranks third after cervical cancer and uterine cancer, accounting for about 4% of all malignant tumors in women. However, deaths from ovarian cancer account for the first place among all types of gynecological tumors, posing a serious threat to women's lives. The cause of ovarian cancer is still unclear, and its onset may be related to age, fertility, blood type, mental factors and environment.

1. Symptoms

1. It mostly occurs in perimenopausal women. Those over 35 years old are more likely to develop ovarian epithelial cancer, while those under 35 years old are more likely to develop germ cell malignant tumors.

2. Pain: Malignant ovarian tumors may cause a considerable degree of persistent pain and distension due to changes within the tumor, such as bleeding, necrosis, and rapid growth. Local tenderness may be found during examination.

3. Irregular menstruation includes irregular uterine bleeding and postmenopausal bleeding.

4. In the late stage of emaciation, the patient will suffer from progressive emaciation.

(II) Physical signs

1. Bilateral lower abdominal masses: Malignant ovarian tumors grow bilaterally in 75% of cases, while benign ovarian tumors grow bilaterally in only 15%.

2. Fixed mass is one of the characteristics of ovarian malignant tumors.

3. Ascites Although benign ovarian tumors such as fibroids or papillary cystadenomas may also be complicated by ascites, malignant ovarian tumors are more likely to be accompanied by ascites. In addition, because the malignant tumor cells have penetrated the tumor wall or have metastasized to the peritoneum (visual observation or microscopic examination), the ascites is often bloody.

4. For patients with prolonged cachexia, due to long-term consumption and loss of appetite, they will show cachexia symptoms such as progressive weight loss, fatigue, and listlessness.

1. Genetic reasons: The onset of ovarian cancer is closely related to genetic factors, and the incidence rate is high in patients with a family history of genetics.

2. Mental reasons: Because female patients are in a state of mental tension for a long time, it affects the autonomic nervous system and induces ovarian cancer.

3. Physical and chemical reasons: Ovarian lesions may occur due to direct exposure to X-rays or drug abuse.

4. Caused by the patient’s bad living habits.

5. Cancer cells: During the formation process of cancer cells, the proliferating cancer cells need to consume a large amount of nutrients from the human body, thereby destroying the body's immunity and resistance.

6. The location of the internal organs where the lesions occur: Since the location of the internal organs where the lesions occur is different, the function of the internal organs or organs where the lesions occur will be destroyed. Therefore, symptoms such as pain, difficulty in swallowing, vomiting, loss of appetite, fullness, coughing, bleeding, water accumulation, ascites, fever, abnormal urination and defecation, sweating, a feeling of falling, and bone necrosis appear, and the internal organs degenerate and become disordered. Cancer not only destroys the internal organs of the human body, but also destroys the immune function of the human body, leading to the failure of the internal organs and death.

1. Provide women with prevention awareness and conduct regular gynecological examinations: Female friends should have a good awareness of preventing ovarian cancer and have regular physical examinations to achieve early detection and early treatment, thereby increasing the success rate of ovarian cancer treatment.

2. Develop good living habits, pay attention to a balanced diet, and avoid excessive fat intake, which can induce ovarian cancer.

3. Pay attention to the use of hormones: Long-term use of hormones to regulate menstruation can also induce ovarian cancer. Female friends should be careful not to use hormones excessively.

The focus is on early detection of tumors. Regardless of whether they are benign or malignant, early patients often have no obvious symptoms. Benign tumors may become malignant, so regular screening should be carried out. In order to detect ovarian malignant tumors early, the following points should be noted:

(i) All solid ovarian masses or cysts larger than 6 cm should be surgically removed immediately.

(ii) For women before menarche or after menopause, ovarian tumors should be considered as tumors. For women of childbearing age, small adnexal cystic masses that do not shrink after 2 months of observation should be considered as tumors. If they increase in size during the observation period, surgery can be performed at any time.

(iii) Pelvic inflammatory masses, especially those suspected of pelvic tuberculosis or endometriosis, should be explored surgically if treatment is ineffective and tumors cannot be ruled out.

(iv) If endometrial adenomatous hyperplasia or endometrial adenocarcinoma is found after menopause, attention should be paid to the presence of ovarian tumors and surgical treatment should be performed promptly.

(V) During pelvic surgery, both ovaries should be carefully checked for lesions. In addition to the indications of ovarian disease itself, for women over 45 years old who need hysterectomy due to uterine disease, it is recommended to remove both adnexa at the same time.

1. Surgery

During surgery, detailed exploration should be performed first, including peritoneal lavage, palpation of pelvic and abdominal organs and pelvic and retroperitoneal lymph nodes, and multiple biopsies of the diaphragm, peritoneum, and greater omentum, in order to accurately stage the tumor. The surgical methods are divided into radical surgery and conservative surgery that preserves fertility. The scope of radical surgery includes bilateral adnexa, uterus, greater omentum, appendectomy, and pelvic and retroperitoneal lymph node dissection. For patients with extensive pelvic implantation and metastasis, it is recommended to perform tumor cell reduction surgery as much as possible. Williams et al. reported that the complete remission rate of postoperative chemotherapy for patients who underwent clean surgical resection was 83%, and the complete remission rate of postoperative chemotherapy for patients who were basically completely resected (residual tumor diameter 2 cm) was 42%. Therefore, although malignant germ cell tumors are sensitive to combined chemotherapy, it is still the key to successful treatment to remove the tumor as cleanly as possible during surgery.

2. Chemotherapy

Because ovarian tumors spread very early, surgery cannot remove the lesions in most cases, and the effect and application of radiotherapy are also very limited. Therefore, systemic chemotherapy is an important auxiliary treatment method. For some advanced patients, the tumor can be reduced after chemotherapy, creating favorable conditions for reoperation. There is no unified chemotherapy regimen for the treatment of malignant ovarian tumors. The principle is:

① It is better to use large doses intermittently or small doses continuously. The former means taking the medicine for about 1 week per course of treatment, with an interval of about 3 to 4 weeks. This can not only achieve an effective anti-tumor effect, but also help the body eliminate toxicity and restore immune function.

② Combination chemotherapy is more effective than single chemotherapy: In modern times, there is a trend towards combination therapy, but it should be noted that combination chemotherapy has more severe toxic reactions.

③ Based on drug sensitivity tests, selecting sensitive chemotherapy drugs can prolong the patient's survival time.

④ Different chemotherapy regimens are formulated according to tissue type. The commonly used chemotherapy regimens for ovarian cancer in recent years are as follows.

(1) Epithelial cancer and sex cord tumors are often used

(1) PAC regimen: CTX 400 mg intravenously on the first day, ADM 40 mg intravenously on the second day, DDP 80 mg intraperitoneally on the third day

(2) CFP regimen: CTX 400 mg intravenously injected on the first day, 5FU 150 mg intraperitoneally injected on the second day, DDP 80 mg intraperitoneally injected on the third day

(3) CP regimen: CXR 200 mg intravenous injection for 5 consecutive days and DDP 40 mg intravenous drip for 5 consecutive days

(4) CHFP regimen: 5FU 1000 mg intravenous drip on the first day or the eighth day; DDP 40 mg intravenous drip on the first day and the eighth day; CTX 100 mg orally twice a day on the second to seventh day and the ninth to the sixth day.

(2) Germ cell tumors and sarcomas are often used

(1) VAC regimen: VCR 2 mg intravenous injection on day 1 ACD 300 ug intravenous drip on days 2 to 6 CTX 300 mg intravenous injection on days 2 to 6

(2) FAC regimen: 5 Fulooomg intravenous drip for 5 consecutive days, ACD 300ug intravenous drip for 5 consecutive days, CTX 300mg intravenous injection for 5 consecutive days

(3) PVB regimen: VLB 20mg (or VCR 2mg) intravenous injection on the first day BLM 30mg intramuscular or intraperitoneal injection on the second day DDP 20-30mg intravenous drip or intraperitoneal injection on the first to fifth days The above regimens are generally given at intervals of 3-4 weeks per course, depending on the patient's physical condition, degree of reaction, blood picture, liver and kidney function, etc. The medication should be used for at least 4-6 courses. For patients with advanced or insensitive tumors, the course of treatment should be more, generally 8-10 courses in the first year, and reduced to 3-4 courses in the second year.

4. Radioimmunotherapy

The radiosensitivity of ovarian malignant tumors varies greatly. Ovarian endodermal sinus tumor, immature teratoma, and embryonal carcinoma are the least sensitive, ovarian epithelial cancer and granulosa cell carcinoma are moderately sensitive, and dysgerminoma is the most sensitive. Radiotherapy after surgery can control it. Since ovarian cancer metastasizes to the abdominal cavity early, the irradiation range includes the abdominal cavity and pelvic cavity. The liver and kidney areas are protected to avoid radiation damage. The radiation dose of the whole abdominal cavity is 3000cGY~5000cGY/6~8 weeks. Internal irradiation refers to the injection of limb gold (198AU) or phosphorus (32P) into the abdominal cavity, which can make the abdominal surface reach a dose that is difficult to reach with external irradiation. Due to its limited penetration, it can be used to treat superficial metastasis in the abdominal cavity, residual tumors under the microscope, or ruptured stage I tumors during surgery to improve the five-year survival rate. The disadvantage is that the abdominal cavity must be free of adhesions to make the radioactive isotopes evenly distributed, otherwise it can cause intestinal damage and cause serious consequences. Generally, the amount of 198AU is 120-150 millicuries, and that of 32P is 10-20 millicuries.

1. Do not be partial to one kind of food, and eat more foods rich in fiber, trace elements and cellulose, such as mushrooms, soybeans, fresh vegetables, winter mushrooms and turtles, kelp, seaweed, oysters, etc.

2. Patients with advanced ovarian cancer cannot eat, but can be given fluid replacement or intravenous high-nutrient infusion.

3. In addition to milk and eggs, you should eat more fresh vegetables and fruits, supplement protein and multiple vitamins, and avoid eating sow meat.

4. After the operation, you should pay attention to taking more foods that nourish the body and regulate menstruation, and nourish the liver and kidneys, such as pomegranate, monk fruit, longan, mulberry, black sesame, black fungus, mung bean, placenta, crucian carp, and carp.

5. Broccoli, kale, cauliflower, cabbage, Chinese cabbage, etc.; or natural foods rich in vitamin E, such as soybeans and cabbage. Ovarian cancer patients who eat a lot of these vegetables for a long time live longer, but taking vitamin pills has no such effect. At the same time, this study pointed out that patients who eat the most dairy products after contracting the disease have a 30% higher chance of early death than those who eat the least dairy products.

6. It is advisable to eat more foods that have anti-ovarian tumor effects: horseshoe crab, seahorse, turtle, dragon ball tea, and hawthorn.

7. People with bleeding should eat sheep's blood, snails, clams, squid, shepherd's purse, lotus root, mushroom, watercress, stone ear, ginkgo nuts, and persimmons.

8. If infected, it is advisable to eat eels, clams, water snakes, needle fish, carp, kelp, celery, sesame, buckwheat, rapeseed, toon, red beans, and mung beans.

9. For abdominal pain and bloating, it is advisable to eat pork kidneys, bayberry, hawthorn, tangerine cake, walnuts and chestnuts.

1. Ovarian cancer patients should eat a light diet and avoid or eat less high doses of lactose and excessive animal fat.

2. Do not eat smoked, moldy, or nitrite-containing foods, eat less fried, spicy, and pickled foods, do not smoke, drink excessively, or overeat.

3. Avoid smoking and drinking.

4. Avoid irritating foods such as onions, garlic, peppers, and cinnamon.

5. Avoid greasy, fried, moldy, and pickled foods.