1.The function and importance of ovaries in the female reproductive system
The ovaries are the reproductive organs of women, and their main functions are to produce eggs and ovulate, and to synthesize and secrete sex hormones. However, the ovaries do not function in isolation, but are carefully regulated by the hypothalamic-pituitary-ovarian axis, which causes cyclical changes in hormone levels in the female body, resulting in regular menstruation.
As a woman ages, her ovaries undergo a series of changes. During a woman’s lifetime, only 400 to 500 follicles generally develop and ovulate. In adult women, the ovaries weigh about 5 to 6 grams, and after menopause they shrink and become smaller.
However, the ovaries are located deep in the pelvic cavity and cannot even be felt during a physical examination. When doing ultrasound examinations, not only does the ultrasound machine require extremely high resolution, but it also requires the ultrasound technician to have a lot of experience. Therefore, when doing gynecological ultrasound, the patient has to drink enough water to fill up the bladder and open up the intestinal canal before the doctor can see the ovaries.
Ovarian tumor incidence
Ovarian tumor is one of the common diseases in gynecology, and its variety ranks first among the tumors of all organs in the body. Its prevalence rate in gynecological diseases is 13-23.9%, among which malignant tumors account for about 10-20%. The incidence of ovarian cancer ranks second only to cervical cancer among gynecological malignancies. In recent years, its incidence has been on the rise.
2.What are the types of ovarian cysts?
As the name implies, ovarian cysts refer to the formation of cystic masses in the ovaries. Generally speaking, there are physiological ovarian cysts and pathological ovarian cysts. Benign ovarian cysts account for about 75% of cases, most of which are cystic in nature with smooth, well-defined and movable surfaces. Ovarian cysts must be clearly diagnosed in order to be treated in a targeted manner.
1. Functional cysts: These are the most common cysts. It occurs in women of reproductive age during the ovulatory cycle, where an abnormal amount of fluid collects in the follicles or within the corpus luteum, forming follicular cysts or corpus luteum cysts. These functional cysts can sometimes be very large, but usually disappear on their own within three months, with or without medication.
2. Hemorrhagic cysts: Sometimes follicular cysts and corpus luteum cysts grow too fast, causing the tissues of the ovary to tear and bleed. This blood accumulates in the ovary because there is no outlet for it, and is called a hemorrhagic cyst. These cysts usually go away on their own but take longer. If the discomfort is more pronounced, medication may be taken to alleviate the symptoms. Only in a few cases, when the patient presents with more severe symptoms, will it need to be removed surgically.
3. Plasmacytoepithelial cysts and mucinous epithelial cysts: cysts that remain after three months of observation are likely to be epithelial ovarian cysts rather than functional cysts. This is because plasma cells and mucus cells with secretory function are encapsulated in the ovary after ovulation and continuously secrete fluid to form cysts. These cysts will not disappear and need to be removed by surgery.
4. Chocolate cysts (endometrioma): endometriosis grows in the ovaries and forms a large amount of sticky, coffee-colored, chocolate-like fluid in the ovaries. Because endometriomas can grow larger over time, they gradually erode normal tissue and cause irreversible damage to ovarian tissue. After assessing its severity, it may need to be treated with surgery.
5. Teratoma: This is a very specific type of cyst that may have a problem with cell differentiation during the embryonic period and takes a long time to manifest itself. It can produce hair, teeth and some greasy aggregates in the ovaries. Since teratomas do not disappear on their own and may grow, there is a 15% chance of ovarian torsion, so it is best to remove them early. Generally speaking, the malignancy rate is less than 1 in 1000.
Ovarian cancer: The chance of developing ovarian cancer is quite low, but because it is located in the pelvic cavity, it is not easy to detect early.
3. What is the probability of benign ovarian tumors? What are the symptoms of benign tumors and how to treat them?
Clinical manifestations of benign ovarian tumors: tumors develop slowly and are often asymptomatic in the early stage, often found by chance during gynecological examination. If the tumor grows and fills up the pelvic cavity, it can produce pressure symptoms, such as frequent urination and constipation. If the tumor grows and fills the pelvic cavity, it may cause pressure symptoms such as urinary frequency and constipation. During gynecological examination, cystic or solid masses can be palpated on one or both sides of the uterus, with smooth and movable surface and not connected with the uterus. Generally benign tumors are painless and only cause abdominal pain when complications such as torsion, rupture or secondary infection occur.
Ovarian benign tumor is a more common benign gynecological tumor in clinical practice. Its management principle should be decided according to the patient’s age, fertility requirements and whether the tumor is unilateral or bilateral.
(1) In young, unmarried or infertile patients with benign ovarian tumors on one side, tumor resection is feasible to preserve the normal ovarian tissue on the affected side.
(2) In bilateral benign ovarian tumors, if the patient is young, regardless of whether she is married or has children, the principle of preserving ovarian function should be followed and tumor resection should be performed. If the patient is over 50 years old, regardless of whether the tumor is unilateral or bilateral, hysterectomy + bilateral adnexal resection should be performed. For those aged 45-50 years who have not yet undergone natural menopause, one ovary can be preserved in order to preserve the ovarian function of the patient and prevent adverse images brought about by ovariectomy, but regular postoperative follow-up should be performed.
3) Remove the tumor as completely as possible to prevent the flow of cystic fluid and implantation of tumor cells in the abdominal cavity.
Frozen section microscopy is performed during surgery immediately after tumor removal to determine if the cyst is benign or malignant. If the cyst is benign, the ovary will be sutured after removal and the procedure will be completed. If it is malignant, further removal of the ovary or even the uterus is required.
4. Do all ovarian tumors require removal of the ovaries? Or in what cases can the ovaries be preserved?
Ovarian tumors can be divided into benign, malignant and junctional tumors according to their benign and malignant nature. It does not mean that all ovarian tumors should be removed, but they should be treated differently. Here, I will only talk about the cases where ovarian tissue needs to be preserved.
I. For benign tumors.
1. In young, unmarried or infertile patients with benign tumor of one ovary, tumor resection is feasible to preserve the normal ovarian tissues on the affected side, or since there is no normal ovarian tissue left in the affected ovary, unilateral adnexal resection is performed to preserve the normal ovary on the opposite side.
2. For bilateral benign ovarian tumors, if the patient is young, regardless of whether she is married or has children, the principle of preserving ovarian function should be followed and tumor resection should be performed.
For ovarian malignant tumors and junctional tumors, especially for epithelial ovarian cancer, surgery to preserve the reproductive function needs to be carefully and strictly selected, and the following conditions must be met: stage Ia, well differentiated cells or junctional tumors, normal appearance of the contralateral ovary or negative biopsy, negative abdominal cytology, negative high area, and follow-up conditions. For ovarian germ cell tumors, regardless of the early or late stage, surgery to preserve the reproductive function should be performed.
For ovarian cancer of stage II or above, no ovarian tissue should be preserved.
Generally speaking, if one ovary is removed and the other ovary is functioning well, fertility and sexual characteristics will not be affected in any way. If the other ovary is also removed, but it is not a “total” removal but a wedge removal, the ovary has great regenerative and compensatory capacity. These defective ovaries can still produce egg cells and the patient can still have children, but the chances of having children are lower.
As to whether both ovaries will lose their female sexual characteristics after removal, this concern is also superfluous. It has been found that the estrogen produced by the ovaries can promote the development of female sexual characteristics, but after the puberty period, female sexual characteristics are already in place, and the production and maintenance of sexual desire only depends on thinking, emotion and stimulation of sexually sensitive parts, and only a small amount of estrogen is needed to maintain the role. For example, in post-menopausal women, although the ovaries are atrophied and no longer produce estrogen, they can still maintain their sexual desire. Therefore, if an adult woman has to have both ovaries removed due to ovarian tumors or other disorders, she should not worry that the removal of her ovaries will affect her sex drive. There will be no major changes in the woman’s appearance, shape, or shape after surgery.
In some cases, after removal of both ovaries, women may become old and emaciated, have difficulty controlling their emotions, become easily agitated and regret after getting angry, and may experience headache, dizziness, tinnitus, sleepiness during the day, poor sleep and dreams at night, hot and cold, numbness in the hands and feet, etc. However, if they go to the hospital for examination, many laboratory tests are normal. This situation is due to the hormonal disorder in the body after ovarian removal and the body cannot adapt to it at once. With moderate hormone replacement therapy, this situation will soon improve. These “ovariectomy syndromes” occur more often in women with high fertility. This is because women in this age group have fully functioning ovaries, and the sudden decrease in estrogen after oophorectomy is too late for the body to adjust and adapt. If you are nearing menopause, your ovaries are shrinking and their function is already diminished, even if they are removed, the effects are not too serious. This is the reason why some people experience more discomfort after oophorectomy, while others do not have much effect after oophorectomy. In addition, bone loss tends to occur after ovariectomy, so fractures are likely to occur. At the same time, the vaginal wall becomes thinner, the secretion decreases, and the vagina is prone to dryness and pain during sexual intercourse. In this case using contraceptive cream can increase lubrication and reduce pain.
5.What are the diseases related to ovaries? Relationship between other gynecological diseases and ovarian cancer (such as vaginitis, fibroids, cervical erosion, etc.)
There are many kinds of ovary-related diseases, especially tumors, and some of them are very typical clinically, such as ovarian malignant tumors, in addition to primary tumors, metastatic ovarian cancer is about 5% to 10%. As for some benign gynecological diseases, such as vaginitis, adnexal inflammation, or uterine fibroids, which many women often encounter, they are basically unrelated. However, in another case, such as endometriosis, if endometriosis persists for a long time, it may turn into ovarian cancer.
In addition, cervical cancer has a metastasis rate of 5% to 10%. In the treatment of this group of patients, we still emphasize that for young patients, the ovaries can be preserved according to the situation, so that although the reproductive function cannot be preserved, other female functions can be preserved. The more common endometrial cancer, especially type I endometrial cancer, which accounts for about 80% of endometrial cancer, is an estrogen-dependent malignancy, which is directly related to the ovaries. The latest research at home and abroad shows that the correlation between diabetes and ovarian cancer is getting more and more attention, which means that the risk of ovarian cancer is significantly higher in diabetic women than in normal people.
6. What are the symptoms of premature ovarian failure? How is it caused? Will it develop into ovarian cancer?
The decline of ovarian function is a natural phenomenon, and normal women’s ovarian function starts to decline gradually at the age of 45 to 50. In recent years, there has been a significant increase in the number of patients with premature ovarian failure, and it is common to see young white-collar workers in their 30s showing signs of premature ovarian failure in outpatient clinics. The exact cause of premature ovarian failure is not yet clear, but the more certain are immune, drug, surgical, infection and other factors of destruction.
The actual cause of this is not very well known, but it is more certain that there are immune factors, drugs, surgery and infection.
The first of these is the removal of both or one of the ovaries before the age of 40, which can cause the ovaries and other tissues to become hypofunctional and lead to premature ovarian failure. Therefore, invasive surgical operations, such as repeated abortions, should be avoided as much as possible.
Third, idiopathic premature ovarian failure. It is a kind of secondary amenorrhea without clear causative factors and is the most important type of premature ovarian failure. It mostly develops in the reproductive age, with clinical appearance of progressive or progressive menstrual scarcity, followed by amenorrhea with hot flashes, irritability and other menopausal symptoms, and atrophy of internal and external reproductive organs. Some young girls with irregular menstruation or even amenorrhea for a long time do not go to the hospital for treatment until they become infertile. The appearance of premature ovarian failure if not treated in a timely manner and allowed to amenorrhea, will make patients appear osteoporosis, cardiovascular disease and lipid metabolism disorders and other symptoms.
Fourth, infection: viruses such as herpes simplex virus and mumps virus can cause ovarian inflammation or immune ovarian damage leading to premature ovarian failure.
Five, the modern infertility rate is elevated, some women are forced to use ovulation promotion methods to improve the chances of pregnancy, but this practice, if excessive, is very damaging to the ovaries.
Six, excessive weight loss, resulting in a sharp decrease in body fat, when the fat ratio is too low will affect the level of estrogen in the body, because the main raw material for the synthesis of estrogen is fat, insufficient body fat, resulting in estrogen into insufficient, estrogen reduction and will cause menstrual disorders, and even amenorrhea, and non-normal amenorrhea will inhibit ovulation function of the ovaries, easy to cause premature failure of ovarian function, if not treated in a timely manner, and If treatment is not timely, it may even cause infertility. The premature failure of the ovaries will aggravate the menstrual disorder, thus forming a vicious circle.
Seven, modern women are in fierce competition, due to excessive mental stress, which in the long run will cause plant nerve dysfunction, affecting the endocrine regulation of the human body, resulting in premature decline of ovarian function, the secretion of estrogen is reduced, so that menopause comes early.
The reason is that the nicotine in cigarettes and the alcohol in wine interfere with normal menstruation and lead to menstrual disorders.
If amenorrhea occurs at least twice (at least one month apart) for more than six months before the age of 40, you should be highly alert to the occurrence of premature ovarian failure in combination with laboratory tests. The causes of premature ovarian failure are complex, and treatment is also mainly symptomatic; early diagnosis and treatment can significantly improve the prognosis. You should never look to beauty salons for ovarian maintenance.
Some patients who have already had children think that menopause is not a bad thing, at least there is less trouble every month and they don’t have to worry about pregnancy when they have sex. This is ignorant thinking. The ovaries are not only an organ that provides reproductive functions for women, but they also secrete estrogen and progesterone that directly or indirectly support the physiological functions of multiple systems throughout the body.
When the body is deficient in estrogen and progesterone, metabolism is disturbed, especially the imbalance of bone metabolism, resulting in accelerated calcium loss, which not only exposes women to the risk of osteoporosis. It also increases the chance of cardiovascular diseases.
When the lack of estrogen and progesterone affects the function of the autonomic nervous system, women may also experience generalized hot flashes, sweating, emotional instability and other symptoms of menopausal syndrome, which may develop into depression in severe cases. Other women may experience premature degeneration of female characteristics such as lack of elasticity of skin and mucous membrane, breast atrophy, reduced vaginal secretions, and vulvar atrophy.
Therefore, patients with premature ovarian failure should seek medical attention in a timely manner, and once diagnosed should actively cooperate with the doctor and adhere to the correct treatment. In severe cases, even if the normal function of the ovaries cannot be fully restored, all the above-mentioned adverse effects will be minimized.
There is no clear relationship between premature ovarian failure and ovarian cancer.
7.Many beauty institutions offer “ovarian maintenance” treatments, how useful are they? Is it necessary?
The so-called “ovarian maintenance” in beauty salons is nothing more than massage and application of essential oils on the skin surface of the abdomen. However, it is almost impossible for essential oils to penetrate into the bloodstream, as they penetrate into the skin at most. The “maintenance” of the ovaries alone cannot affect the functioning of other parts of the body, and it is difficult to say whether the effect of slowing down the aging process is there or not.
However, many people will feel that after a period of “ovarian maintenance”, their face looks better than before, and even menstrual cramps have been relieved. In fact, in the process of massage, the oil will seep into the skin, so it will feel very comfortable. The beautician’s warm and thoughtful psychological guidance played a key role.” So, many beauty methods nowadays are actually psychological beauty, which can help consumers relax their tense body and mind while also behaving more confidently.” Rather, after the abdominal massage, the intestines play a certain stimulating effect on the improvement of constipation will have a certain effect. Therefore, most of the efficacy of “ovarian maintenance” is still attributed to the psychological effect.
8.How should I maintain my ovaries in my life?
After women reach middle age, ovarian function begins to decline, when the number of ovulation decreases, the level of hormone secretion decreases, and even menstruation stops, breast flaccidity and atrophy, other sex characteristics degenerate, internal and external genitalia atrophy, and women gradually lose their former youthful glory. Therefore, women, especially middle-aged women, should pay attention to the maintenance of ovaries. The healthy lifestyle is beneficial to ovarian maintenance, enhance health awareness, change bad habits and establish a civilized and scientific lifestyle for ovarian maintenance.
The first is to properly strengthen the exercise, exercise is conducive to promote metabolism and blood circulation, delaying the aging of organs. Middle-aged women should pay attention to weight control, it has been confirmed that obesity is an independent risk factor for many chronic diseases and death. Modern office women, most of the time at work is in a sitting state, after work is also a car, long-term sedentary, resulting in impaired circulation of Qi and blood, leading to dysmenorrhea. Therefore, strengthening exercise is very important to keep the body and mind young.
Secondly, a healthy lifestyle is beneficial to ovarian maintenance. The best maintenance is to pay attention to a good diet, avoiding late nights, excessive weight loss, smoking and alcohol. The damage of smoking for women is also relatively large, tobacco burning can generate and release a large number of toxic substances, the greater the impact on female reproductive function, clinical manifestations of ovarian function and low levels of estrogen.
Third, to ensure adequate sleep, dinner should not be too full, not to do strenuous exercise at night.
Fourth, maintaining a harmonious sex life can enhance confidence in life, a happy spirit, eliminate loneliness, relieve psychological stress, and can improve the body’s immune function.
9. Does endocrine disorder also cause ovarian tumor? What are the causes of endocrine disorders?
Modern women are prone to endocrine disorders because of their special physiological processes such as menstruation, belt, fetus and childbirth, and the dual pressure of career and family in daily life. There are many reasons for endocrine disorders in women. Emotional factors, physiological factors, nutritional factors, environmental factors, etc. can all affect women’s endocrine secretion. Emotional factors are more common to cause endocrine disorders. As modern women are under pressure from various aspects, they are prone to hormone secretion disorder and endocrine disorders due to long-term tension.
Endocrine disorders are closely related to many female diseases, such as ovarian cysts, breast enlargement, uterine fibroids, vaginal inflammation, menstrual disorders, etc. caused by endocrine disorders.
Moreover, we often encounter the situation in clinical work that many ovarian cancer patients have suffered great mental trauma or mental stimulation for a period of time before developing ovarian cancer, which leads to endocrine disorder, hormone level imbalance and decrease of body immunity, which may be a causative factor for the formation of ovarian tumor.
Therefore, women should learn to decompress and face each day with ease. Those who have serious endocrine disorder should go to professional and regular gynecological hospitals for treatment as early as possible.
10.What is the effect of ovarian tumor on fertility? The impact and effects of various contraceptive measures on ovarian health (for example, the pros and cons of IUD, pill and condom on ovarian health)
Ovarian tumor is one of the common tumors in gynecology, and is most common in women aged 30-40. There are many different types of ovarian tumors, both benign and malignant, which have a certain impact on fertility. This is due to.
(1) Tumors destroy or compress ovarian tissues, resulting in atrophy of ovarian tissues and diminished ovarian function.
(2) The presence of tumor changes the normal relationship between ovaries, fallopian tubes and other organs in the pelvis.
(3) The rupture, bleeding and torsion of the tumor cause necrosis of the ovary and disruption of the local anatomical relationship.
(4) The destruction of ovaries and erosion of surrounding tissues by malignant tumors and the deterioration of their systemic conditions seriously impair the ability to conceive.
(5) Some ovarian tumors have endocrine effects, such as mucinous complex adenoma, cystic fibroma, teratoma, granulosa cell tumor, follicular membrane cell tumor, etc., which cause endocrine disorders in the body and lead to ovulation or conception disorders.
(6) After pregnancy, due to the influence of tumor, the rate of full-term delivery is reduced and various pregnancy and obstetric complications are easily caused. Therefore, the ability of ovarian tumor patients to conceive is significantly reduced, but there are also a few patients who conceive and deliver normally, which are mostly seen in benign tumors of small size or occurring in one ovary.
In general, if one ovary is removed and the other ovary is functional, it does not affect fertility or sexual characteristics in any way. If the other ovary is also removed, but not the “whole ovary”, but only a wedge-shaped removal (i.e., leaving a little skin), the ovary has a great capacity for regeneration and compensatory capacity. These defective ovaries are still able to discharge egg cells, and the patient still has the possibility of having children, but the chance of having children is lower.
It is not necessary to remove both ovaries in all cases of ovarian tumors.
For example, in the case of benign ovarian tumors, all the diseased ovaries are removed while the healthy ovaries are preserved. It is also possible to remove only part of the ovarian cysts and keep the cortical part. This will preserve the function of the ovaries, allow normal menstruation in the future, and allow pregnancy and childbirth as normal. At the same time, the physical beauty of a woman will not be lost.
Ovarian cancer can preserve the uterus and the opposite ovary in some special cases.
Ovarian cancer can be divided into several common types, namely epithelial, germ cell, and gonadal interstitial. For epithelial ovarian cancer, only those ovarian cancers that are stage Ia, highly differentiated, non-mucinous, and non-clear cell can preserve the uterus and the opposite ovary. For germ cell tumors, they are the most suitable for preserving fertility as long as they are confined to one ovary, and it can be said that the preservation of fertility for these tumors is not limited by stage. The junctional tumor of ovary, as long as it is limited to the unilateral adnexa, can also preserve the reproductive function.
It is generally accepted that patients with preserved fertility should be treated aggressively with chemotherapy after surgery, and after completion of fertility, the uterus and contralateral ovary can be removed for regular observation if necessary.
When it comes to the effect of contraceptive measures on the ovaries, for women who use birth control devices and condoms, these measures are safe for the ovaries. I would like to remind women who use birth control pills that if they are not taken properly, they will not only not protect themselves, but they will harm their ovaries. If used correctly, oral short-acting contraceptive pills are not only highly effective in contraception, but can also restore fertility after discontinuation, reduce ectopic pregnancy, have the effect of adjusting menstruation, protect against endometrial cancer, ovarian epithelial cancer, ovarian cysts, and benign breast diseases, and do not affect the quality of life. For women who are worried about taking contraceptive pills to stimulate their appetite, they can control their dietary intake appropriately and enhance their exercise in general. The current new contraceptive pill is effective and does not increase weight. However, women with high blood pressure, diabetes, and a family history of breast cancer should use oral contraceptives carefully under the guidance of a doctor. But now oral short-acting contraceptives are indeed troublesome, and the busy pace of modern life often finds it troublesome, so many young people often take the emergency contraceptive pill as a regular contraceptive method, which is actually completely wrong! The so-called emergency contraception is a contraceptive remedy used for a short period of time when unprotected sex or contraceptive failure (such as condom breakage, slippage, missed pills, safety period miscalculation, etc.) may occur unwanted pregnancy, but it is never a conventional contraceptive method. Emergency contraception is not recommended as a last resort, and emergency contraception is only a one-time use, protecting only one unprotected sexual intercourse in a menstrual cycle, and not for previous or subsequent “intimate contact”. If emergency contraception is used after each “intimate encounter”, abuse will not only affect ovarian function, but also be detrimental to women’s health.
11.What are the methods of early diagnosis and treatment? What is the effect? Is there any minimally invasive therapy?
How to diagnose ovarian cancer at an early stage and how to reduce the recurrence of ovarian cancer are the two major difficulties in the treatment of ovarian cancer.
The incidence rate of ovarian cancer is the second highest among gynecological tumors, but the death rate is the first. The reason for the high death rate is that ovarian cancer is hidden and cannot be seen directly, and most of the patients have already metastasized to the pelvic and abdominal cavities by the time they are found, and the cancer is already at an advanced stage. Therefore, we have nicknamed ovarian cancer as “silent killer”, which means it is difficult to be detected at an early stage.
In fact, there are some early symptoms of ovarian cancer, although they are not typical and easily confused with other diseases, but if we pay attention to them, we can still detect them early. For example, abdominal distension, stomach pain, back pain, distension or discomfort, increased abdominal circumference, constipation, fatigue, frequent or urgent urination, inability to eat normally, and unexplained weight loss. If a woman has one kind of stomach discomfort from time to time, that is, indigestion for a very long time, or the patient has urinary urgency and frequent urination, if this symptom, one kind of two persist more than two, should draw attention to the possibility of ovarian cancer. If women understand these symptoms, but go to professional hospital for consultation to rule out their disease when these symptoms appear, this is a particularly critical issue in treating ovarian cancer. For example, we often meet female patients who have stomach pain and abdominal distension, and they are not well with medication, but they cannot be detected by gastroscopy, so I would suggest ovarian examination. However, clinically, after excluding organic lesions, the untreated stomach pain and abdominal distension may be the early symptoms of ovarian cancer. I have seen many such delayed patients in my clinic because they did not take stomach pain and abdominal distension seriously and had been treated as digestive tract diseases, but their conditions had progressed to middle and late stages when they were discovered.
As early symptoms of ovarian cancer are hidden and not easily detected by patients, the best time for treatment is often missed. Therefore, for women after 30 years old, I recommend regular annual checkups:
Firstly, ultrasound should be done. Nowadays, digital ultrasound is very effective, so that a very small tumor on the ovary can be detected, and it can see whether there are papillae in the tumor parenchyma, which is very important for determining what kind of tumor is growing on the ovary.
This is very helpful in determining what kind of tumor is growing in the ovary.
The second thing is to do a gynecological examination, which not only can detect ovarian tumors, but also can find out whether there are implants in the pelvic floor.
The second is to have a gynecological examination, which can not only detect ovarian tumors, but also whether there are implants in the pelvic floor.
Thirdly, we should do some laboratory tests, which mainly include gynecological tumors, tumor markers, such as C125, HCJ and AFP, which are very helpful in diagnosing tumors.
These tumor markers are very helpful to diagnose tumors.
If the C125 test is over 1000, the diagnosis is fine. If it exceeds the normal value, it means that there must be something wrong inside the abdominal cavity, especially if it exceeds several hundred or five hundred, then most of them are ovarian cancer. Through these examinations, if further examinations are needed, CT and MRI can be done to detect implantation and metastasis in the upper part of the body.
This will determine whether ovarian cancer is present or absent and how extensive the lesion is.
Proper management of adnexal masses is an important measure for the prevention and early detection of ovarian malignancy. Timely surgery for adnexal masses can often catch early cases and get good treatment results. Ovarian diseases are complex and variable, and many ovarian masses can only be determined as benign or malignant after pathological examination after surgery. Therefore, it is important not to take ovarian masses, whether cystic or solid, lightly so as not to delay the best treatment time for early ovarian cancer. For common ovarian lesions, such as ovarian cysts, they cannot be easily determined as benign lesions and must be seen in a specialized oncology hospital for further treatment after systematic examination to rule out the possibility of malignancy. Puncture should be avoided as much as possible during this period and ovarian tumors should be removed as completely as possible for rapid pathological examination. If the tumor is confirmed to be malignant, standardized treatment is required.
Minimally invasive surgery” is a new and humane advanced surgical method. Due to the maturing technology, it has many advantages such as no abdomen opening, less trauma, less bleeding, less pain, faster recovery, less complications, less cost and less scarring. However, the indications must be strictly required, and laparoscopic surgery must be performed only when the benign ovarian tumor is clearly diagnosed before surgery.
At present, laparoscopy is mainly used for the diagnosis and clinical staging of ovarian cancer. It is still in the exploratory stage in the surgical treatment of early-stage ovarian cancer. This is because for early-stage ovarian cancer, the surgery requires complete removal of the ovarian mass as much as possible to prevent the spread of cancer cells and thorough abdominopelvic exploration biopsy to obtain the correct surgical pathological stage, which is the key to the treatment and prognosis of early-stage ovarian cancer. However, laparoscopic surgery is highly prone to rupture of the mass during operation, resulting in tumor implantation in the abdominal cavity, thus limiting the application of laparoscopy in the surgical treatment of early-stage ovarian cancer. However, laparoscopic surgery will have a great impact on the surgical management of gynecologic malignancies.
Therefore, I suggest that patients with ovarian masses must be cautious and not blindly choose minimally invasive surgery before ovarian cancer is completely ruled out, so as not to regret it afterwards!
12.Many patients choose to “keep” the tumor because they are afraid, what is the danger of this practice?
The key to a good prognosis of ovarian cancer lies in early diagnosis and early treatment, and there is a significant difference in the treatment effect and prognosis between early-stage ovarian cancer and late-stage ovarian cancer.
The direct consequence is that benign ovarian tumors may become malignant in the long run, and some of them may develop into ovarian cancer, which is a curable benign ovarian disease that eventually becomes cancer. For ovarian cancer patients who are originally malignant, the consequence of delayed treatment may be that early or operable ovarian cancer becomes advanced ovarian cancer or the chance of surgery is completely lost.
The result of delayed ovarian cancer is disease progression, significantly reduced treatment efficacy, increased financial cost, etc.! Therefore, I advise patients not to be afraid of the disease, only to actively face and cooperate with the treatment is the right choice, only to be responsible for oneself and one’s family!
13. What are the symptoms and treatment methods for patients in the middle and late stages of the disease, and is there any hope for treatment? How long is the survival period?
Symptoms of mid- and late-stage ovarian cancer.
Ovarian cancer is a common gynecological malignancy, and it is the gynecological tumor with the worst prognosis. The five-year survival rate for early-stage ovarian cancer can reach 90%, but for advanced cases, even with all-out treatment, the five-year survival rate is still only 30-40%. An important reason for the poor prognosis of ovarian cancer
One important reason for the poor prognosis of ovarian cancer is that it is often diagnosed at an advanced stage because of its insidious onset.
Ovarian cancer usually has no obvious discomfort in the early stage, but only in the late stage will there be obvious symptoms, including: abdominal (gastrointestinal) discomfort, belching, indigestion, bloating or pain; nausea, vomiting, diarrhea, constipation, frequent urination; poor appetite; bloating even with little food; unexplained weight gain or loss; and abnormal vaginal bleeding. These symptoms
Although these symptoms can be caused by ovarian cancer or other diseases, it is important to have them checked by a doctor as soon as they are detected. We often encounter patients who are misdiagnosed with ovarian cancer for various reasons. Some patients come from gastroenterology department for treatment of “liver cirrhosis” for a long time, while others are diagnosed with benign ovarian cysts, which delay the best time for treatment.
Surgery is the most important means of treating ovarian malignant tumors, unless the tumor is clinically estimated to be unresectable and there are contraindications to surgery, surgery should be performed first, which is now collectively called tumor reduction internationally. Chemotherapy based on ovarian cancer tumor cell reduction surgery is still sensitive and effective in the beginning for most ovarian epithelial tumors. Although surgery is the first choice, some patients are found to have extensive abdominopelvic tumors with ascites and pleural fluid at the time of consultation, and their physique is poor to withstand surgery. We mean to put this chemotherapy before surgery, when we find that the patient cannot be operated immediately, through one or two courses of neoadjuvant chemotherapy, so that the tumor shrinks significantly, and after the chemotherapy, the patient’s condition is re-evaluated and surgery is performed. In this way, the tumor shrinks significantly, the trauma caused by surgery is reduced significantly, and the degree of tumor reduction is more satisfactory, thus benefiting the patient to the greatest extent.
However, not all patients can regain the hope of surgery after preoperative neoadjuvant chemotherapy, the neoadjuvant chemotherapy mentioned earlier can make about 80% of patients regain the hope of surgery.
For patients who still have no chance of surgery after neoadjuvant chemotherapy, through our continuous adjustment of chemotherapy regimen combined with some TCM treatments, we can still achieve the method of prolonging life cycle while focusing on patients’ quality of life.
Ovarian cancer focuses on early detection and early treatment. The earlier the detection and timely treatment, the better the prognosis. This can be seen from the following figures: the 5-year survival rate of ovarian cancer patients with stage I is over 90%, the 5-year survival rate of stage II is about 70%, and the 5-year survival rate of patients with stage III-IV is only 2.4%-23%. Therefore, I suggest that after middle age, it is better for women to have a gynecological examination once or twice, and not to delay more than three years at the latest. As modern people, it is important to bring a scientific and healthy lifestyle into the 21st century. It not only reflects the progress of human civilization, but also is beneficial to health and prevention of cancer.
14.What are the precautions during treatment and how to prevent recurrence?
Psychological guidance is the most crucial.
Most of the ovarian cancer patients are already in advanced stage at the time of consultation, and they are prone to metastasis and recurrence. Most of them have already experienced surgery and repeated chemotherapy, and some of them do not have enough confidence in treatment due to poor efficacy. It is a heavy blow to the beauty-loving psychology of female patients. Through 20 years of clinical experience, I think psychological guidance for chemotherapy patients is the key to help them overcome cancer. The clinician should introduce the effect of paclitaxel treatment at home and abroad and introduce successful cases to the patients to build up their confidence to overcome the disease. At the same time, they should explain to the patients the way of chemotherapy drug administration and the possible adverse reactions after treatment and their treatment, so that the patients have enough psychological preparation to cooperate with the treatment. At the same time, patients must have good nutritional support during the treatment period, and also maintain a happy mood, avoid long-term and excessive mental tension and adverse stimulation, and carry out appropriate exercises to improve the immunity of the body.
How to reduce the recurrence of ovarian cancer is another major difficulty in the clinical treatment of ovarian cancer.
Ovarian cancer is easy to metastasize and spread widely, and about 3/4 of the patients are already in advanced stage when they are diagnosed, and the 5-year survival rate still hovers around 30% after comprehensive treatment mainly by surgery. Even after thorough surgery and standardized chemotherapy, ovarian cancer still has the possibility of recurrence. About 50% to 80% of patients who have achieved clinical cure will have recurrence in the near or distant future after stopping treatment.
Treating recurrent cancer is more difficult than the primary one. Therefore, the problem of recurrence must be given high priority after cancer is controlled or cured. What can be done to prevent or reduce the recurrence of cancer?
First of all, treatment of primary cancer should be as thorough as possible and followed up with anti-relapse treatment after healing. Surgical treatment of ovarian cancer is the key in treatment. Very early studies have demonstrated that the thoroughness of surgery is the most important prognostic factor affecting the prognosis. So what should surgery for ovarian cancer include? After decades of debate, the scope of surgery for ovarian cancer is now relatively certain, which mainly includes: total hysterectomy + bilateral adnexal resection, large omentectomy, and resection of all metastases in the pelvic and abdominal cavities, and it is generally believed that the appendix should also be removed, especially for epithelial tumors. In this respect, surgery for ovarian cancer is the most challenging. In early stage ovarian cancer, it is likely to be cured by surgery alone. However, for advanced ovarian cancer, it is difficult to completely remove the remaining cancer cells from the body through one-time or surprise treatment. If chemotherapy is not administered immediately after surgery, it can be said that the surgery loses its meaning, or the effect of chemotherapy is based on the success of surgery. If the tumor has been diffuse, you can do one or two courses of chemotherapy first to make the tumor shrink before undergoing tumor cell reduction, and then chemotherapy after the surgery. After the regular treatment, it is important to grasp the anti-recurrence treatment to inhibit the further development of the originally undetected cancer.
Secondly, eliminate or avoid various factors that contribute to the recurrence of cancer and actively treat chronic diseases associated with cancer. Special attention should also be paid to some intrinsic cancer-causing factors. All cancer patients should maintain a happy mood and avoid long-term and excessive mental tension and adverse stimulation. Chronic diseases that may induce cancer will reduce the immune function of the body and affect the patient’s local or systemic disease prevention ability, and should be given active treatment. Some traditional Chinese medicine can be taken for regulation, which is good for the recovery of immunity.
Again, strengthen physical exercise to improve the immune function and disease resistance of the body. During the recovery process of cancer patients, they should carry out some exercises such as qigong, taijiquan and jogging to promote the recovery of the whole body function, improve the immune function of the body and reduce the chance of cancer recurrence.
Finally, it is necessary to conduct frequent self-examinations and regular checkups at hospitals. Patients should pay attention to observe whether there are new swellings, nodules, ruptures, etc. in and around the original lesion site and whether there are new pain sensations. In addition, attention should also be paid to systemic changes, any gradually increasing weakness, loss of appetite, weight loss, anemia and other manifestations. Once the above situation occurs, you should go to the hospital for a comprehensive examination and take remedial measures as soon as possible.