the expert explains how to recognize and deal with it; also looking at family history
The world day dedicated to ovarian cancer returns on Sunday 8 May. In Italy every year there are over 5 thousand new diagnoses and symptoms that are often vague and superimposable to the most common gastrointestinal disorders mean that the diagnosis arrives too late. But some tricks can make a difference.
Benedetta de Mattei talked about it with one of the leading experts in this field, John Swap – Director of UOC Oncological Gynecology of the Agostino Gemelli Polyclinic and Full Professor of Gynecology and Obstetrics at theCatholic University of Rome.
How common is ovarian cancer in Italy and in the world?
Ovarian cancer accounts for about 30% of all malignant tumors of the female genital system and occupies the tenth place among all cancers in women, with 3% of all cases. Every year in Italy between 5,000 and 5,500 new ovarian cancers are diagnosed and about 30,000 women are currently being treated.
Are there any risk factors, what are they?
A serious risk factor, the one most associated with an increased risk of developing this neoplasm is a family history of gynecological malignancies, particularly of the ovary and breast, but also of the pancreas. This occurs in the presence of particular genetic mutations (BRCA1-BRCA2 genes), which predispose to this type of carcinoma. Today we know in fact that about 40% of these cases may be family-based, keep in mind that a woman who has a BRCA gene mutation has a 20 to 40 times higher chance of developing this cancer than the normal population.
What are the alarm bells to watch out for?
We rarely manage to diagnose early stage ovarian cancer because the symptoms are subtle, initially absent, and when there are they are confused with those of the gastrointestinal type, colic, so much so that patients usually go first to the gastroenterologist or the general practitioner and arrive to the gynecologist late for this very reason.
So the the real problem is that we almost always don’t have the opportunity to make an early diagnosis if not, the only possibility of prevention, identifying, through genetic testing, women who are familiar with this tumor and, when necessary, surgically carrying the ovaries once the reproductive desire is over.
However, the alarm bells to look out for are colitis disorders, such as abdominal bloating, bloating or difficulty digesting.
Are you coming for prevention?
There are currently no scientifically reliable screening programs for the early diagnosis of ovarian cancer. The annual visit to the gynecologist, with control transvaginal ultrasound, is advisable but the only form of prevention that women can do is precisely to study the familiarity and those, with hereditary mutations in the BRCA1 and / or BRCA2 genes, who are at risk must have very close checks, every 6 months, or possibly remove the ovaries.
How is the diagnosis reached?
The diagnosis is usually reached as we have said belatedly, the first examination is the transvaginal ultrasound followed by a CT scan and blood analysis to evaluate the markerseven if the the definitive diagnosis is surgical.
Come you cure?
Ovarian cancer is a complex and heterogeneous disease for the treatment of which we have two weapons: surgery and chemotherapy. Surely women today survive longer and better, the treatments are more effective and we have drugs available that years ago we did not use. PARP inhibitors, able to stabilize and significantly slow down the progression of the disease, are the ones that have slightly changed the evolution of this tumor. We have also learned to better manage relapses of the disease with both surgery and medical therapy. Having said that, today the panorama has certainly improved compared to years ago and through family history today it is possible to make an important prevention. There are also many new drugs being studied that could improve these results and we can therefore be optimistic.
What do you recommend to women today?
To women today I would like to say two things. The first is that the ovarian cancer is a diagnosis that understandably frightens but which today must face the disease with more confidence because so many things have changed and many are changing.
The second tip is to look at your family history: Anyone with a family member with ovarian cancer or breast cancer or even pancreatic cancer because it is the same gene should go to an inheritance cancer clinic and possibly test for the BRCA1 and BRCA2 genes because it can help to understand and direct women in the most correct way.
Benedetta de Mattei