New detection methods should be promoted, such as transvaginal ultrasound
One of the reasons why ovarian cancer is diagnosed in advanced stages is that its manifestations are often confused with gastrointestinal symptoms, nervous colitis, or pelvic inflammatory disease, which delays diagnosis, complicating the prognosis of patients. Now, with the help of transvaginal ultrasound, this neoplasia can be detected in its early stages, speeding up the diagnosis and applying treatment in the early stages, thus reducing mortality.
Ovarian cancer represents the third cause of death by tumor in women in Mexico, with a higher lethality than breast or cervical cancer. According to data from the Ministry of Health, five thousand new cases of this neoplasia are reported each year and between 70 and 80% of them are diagnosed in advanced stages. Globally each year about 300,000 new cases of this disease are diagnosed.
The medical oncologist at the Gral. Ignacio Zaragoza Regional Hospital, of the ISSSTEKarina Murillo Medina, explained that it is a silent disease, because its initial symptoms are non-specific and there is no screening in Mexico or in the world.
“So far, studies such as ultrasound, tumor markers, among which are the CA-125 or a tomography have not been shown to reduce mortality, so they are not considered for detection of massive risk in national or international guidelines”, he pointed out.
It recommended that women of reproductive age be attentive to possible warning signs. “Any woman who starts with pain in the abdomen or pelvis, changes in bowel habits such as recurrent diarrhea or constipation, who presents some intermenstrual or postcoital bleeding, or if they notice an increase in the abdominal perimeter, go immediately for a medical check-up and do not self-medicate, because there is a risk of delaying the start of a study protocol”, he explained.
The main risk factors for ovarian cancer are menarche or first menstruation at an early age, late menopause and nulliparity, that is, never having been pregnant. On the other hand, the average age of women with this diagnosis is over 50 years.
Murillo Medina indicated that statistics from the Global Cancer Observatory (Globocan) 2020 indicate that ovarian cancer in Mexico is located in the 14th place of oncological conditions; During this year, 4,963 cases have been diagnosed, but mortality is very high, around 3,000, and this is very focused on the fact that most are detected in stages II and IV..
“Ovarian cancer is curable, especially in its early stages. in stadiums II and IV. It has treatment, but the patients present a high percentage of recidivism (65 percent). Disseminating the behavior of this neoplasia is a priority to increase timely detection, for the benefit of the prognosis and quality of life of the women entitled, “said the specialist.
Although currently between 30 and 50% of cancer cases can be avoided, reducing risk factors as indicated by the World Health Organization (WHO), in many countries of the Americas, cancer-associated mortality continues to increase. In Mexico alone, between 2010 and 2021, the death rate from malignant tumors increased from 6.09 to 7.06 cases per ten thousand people.
Data from Globocan indicate that while breast, prostate, colorectal, and thyroid cancers have a higher prevalence among the Mexican population, lung, stomach, leukemia, and ovarian cancers have the highest mortality rates.
“One of the reasons why this type of cancer is diagnosed in advanced stages is that its manifestations are often confused with gastrointestinal symptoms, nervous colitis or pelvic inflammatory disease, which delays diagnosis, complicating the prognosis of patients”, said Dr. Sigfrido Rangel, medical director of GSK Mexico.
To the above, let us add that in advanced stages of ovarian cancer, with adherence to treatment, plus chemotherapy, five-year survival is only 20 to 30%. New treatment alternatives have shown a significant increase in progression-free survival among ovarian cancer patients after platinum-based chemotherapy.
“For this reason, we highlight the importance of timely diagnosis as one of the pillars, which, added to scientific advances, improves the life expectancy of people living with this disease,” Rangel pointed out.
For his part, Alberto Hegewisch, Medical Director of AstraZeneca commented that “in order to encourage awareness about ovarian cancer, it is essential to unite various actors such as public institutions, the private initiative and civil society associations; Only then can we adopt a culture of prevention that allows us to detect a greater number of cases and save many more lives.”
In addition, Adela Ayesa Alonso, general director of Salvati – an association that has been working with women with cancer for a decade – recommends being alert.
“The signs depend on each woman; For this reason, it is necessary to encourage awareness of regular and complete check-ups, since common studies are not enough to detect ovarian cancer”, indicated Alonso.
Finally, he warned that studies such as pap smears do not allow finding alerts that indicate the possibility of ovarian cancer, therefore, within the general medical check-up, the need to resort to transvaginal ultrasound should be promoted in case of risk factors or suspicious symptoms every year and after 45 years.