The ovary is a female organ that is part of the reproductive system. It is the reservoir of primordial follicles. These follicles are responsible for the release of an egg, ready to be fertilized by a sperm, into the fallopian tubes each month. This meeting will give rise to the embryo, which will implant itself in the uterus, thus starting a pregnancy. The ovary can be affected by active lesions called cysts. Among these, some are related to the normal functioning of the ovary: they are called functional cysts. Others are classified as organic. Among these organic cysts, some may have a benign character, while others are malignant. Initially, it is not possible to predict the benign or malignant nature of a cyst, because the symptoms are the same. However, this distinction should be made as soon as possible to consider the optimal treatment. Malignancy is often suspected in a menopausal patient, as ovarian cancer mainly concerns women over the age of 50.
Symptoms may be numerous. Patients suffering from ovarian tumors and, a fortiori, of ovarian cancer may have:
- lower abdominal pain described as pelvic pain;
- a feeling of heaviness in the lower abdomen called pelvic heaviness;
- vaginal bleeding occurring outside of menstruation or in a postmenopausal woman, who has no menstrual cycle.
Sometimes, the ovarian tumor is asymptomatic, which explains its late discovery.
The discovery of ovarian cancer is fortuitous, typically during an examination for another reason, when an ultrasound is performed. This can be done externally at the lower part of the abdomen, but sometimes with a vaginal probe: this latter technique is called an endo-vaginal ultrasound. An ultrasound allows us to study the tumor's size, shape, and contour, as well as to determine its benign or cancerous nature. It can be complemented by a CT scan or MRI. In the case of a functional cyst, a new ultrasound, performed three months later, will often show its disappearance. In the case of persistence or suspected cancer, the ovary must be removed: this is called oophorectomy. The tumor must be analyzed to identify its nature and progression. This analysis consists of several tests to find out whether the cancer has spread to other organs.
The treatment of ovarian cancer is surgical. Following the staging, the ovary can be removed, and sometimes the entire uterus is removed. A total hysterectomy with oophorectomy is when both fallopian tubes and ovaries are also removed. The lymph nodes involved are also subject to a treatment called flushing. Often, chemotherapy is prescribed and, more rarely, radiotherapy.
Prevention is only possible for some forms of hereditary ovarian cancer: the removal of both ovaries and both fallopian tubes can be performed in these conditions
Original article published by
. Translated by Jeff