Tokushukai Medical Group

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Obstetrics and Gynecology Disease:Cancer of the Ovary

When getting large, it may exceed over 10cm in size.

Ovary is located with one each at left/right side of the womb, and usually its size is 2 to 3 cm. Inside of the ovary, there are many structures called as follicle and each of them contains one egg cell. Egg cell is periodically discharged from the ovary, and this is called as ovulation. Tumor developed in the ovary is called as ovarian tumor. Tumor is differentiated into benign, boarder malignant and malignant, and malignant ovarian tumor is called as Ovarian Cancer. It may exceed more than 10cm when it is large. There are many kinds of Ovarian Cancer and it is classified roughly into superficial epithelial and interstitial tumor, sex cord interstitial tumor and germ cell tumor.

Time lapses with no symptoms when small.

Symptoms of Ovarian Cancer are a sense of abdominal fullness (stomach is bloated) or hypogastric pain, but when it is small, it is common time passes with no symptoms, then when it gets large or when ascites fluid stand, symptoms may appear. There is sometimes a case that strong pain suddenly comes up when ovarian cancer has disrupted or ovarian cancer twists in the stomach called as torsion of the pedicle.

Most of the baggy shaped tumor is a benign disease.

Diagnostic process is that manipulation/internal examination and echography are conducted following to the medical interview, then diagnose existence/non-existence of ovarian tumor. In case tumor is cystic (baggy shape), it is a benign tumor, but in case fulfillment part (clot part) and cystic part are mixed or entire part is fulfillment, malignant tumor or borderline malignancy is suspicious. Furthermore, in case it is determined that the thorough examination is necessary, CT examination, MRI examination, measurement of tumor marker, and when ascites fluid can be collected by tapping because much fluid in it, ascites cytology examination is conducted. As ovarian may get enlarged by metastasized stomach cancer or bowel cancer, gastroscope or large bowel endoscope examination may be conducted. Primary doctor will make a comprehensive judgement of whether it is benign one or malignant one from these results, but final diagnosis is decided by pathological examination of tumor extracted from surgery.

Consider postoperative chemotherapy depend on the proliferation of ovary cancer.

Basic treatment for cancer is surgical treatment, but in case of ovarian cancer, most of them requires postoperative chemotherapy using anti-cancer drugs. For ovarian cancer, resection of womb, ovaries and oviducts on both sides, omental (membrane between stomach and large bowel) is the basic surgery. In addition to these, there is a case where resection of lymph node or composite resection of intestinal tract or peritonea depend on spreading of tumor. However, even in case of borderline malignancy or malignant tumor, there is a case where it is possible to conserve the healthy side of ovaries and oviducts depend on its nature or spreading (advanced phase). Hence, person who wish to have later pregnancy or parturition shall consult with the primary doctor.

For the ovarian cancer, necessity of postoperative chemotherapy or kind of anti-cancer drug are decided by its nature or spreading (advanced phase). More than 90% of ovarian cancer is categorized in epithelial/stromal tumor (epithelial ovarian cancer), and germ cell tumor onset mainly among young subjects are seen with few percent. Taxane preparations (Paclitaxel etc.) and platinum preparations (Carboplatin etc.) are generally used for postoperative chemotherapy for epithelial ovarian cancer, and excluding very early stage, 3 to 6 courses of the treatment are conducted with 3 to 4 weeks interval, depend on disease progress (advanced phase) or aspect (histological type). 5 years survival rate for the patients who has received this chemotherapy following to surgical operation is approximately 90% for stage I (localized at ovaria), approximately 70% for stage II (localized in pelvic viscera) and approximately 30% for more advanced stage III/IV.