Why early detection is so crucial in ovarian cancer

NEW DELHI: Early stage detection of epithelial ovarian cancer can help prevent its relapse, a study conducted by AIIMS Delhi has found. Ovarian cancer is the third most commonly detected cancer type among Indian women. The study notes that it is a common gynaecological malignancy and the disease is detected at an early stage in only around 20% of the patients.
“Early diagnosis is still a problem in India. We analysed early stage patients at AIIMS over a long term and found the outcome to be good. The 10-year survival rate was 86%. In some patients, we could also do the fertility sparing surgery (FSS). Normally, in ovarian cancer, when diagnosed, the epithelial tumor is removed from the uterus and the ovaries as well. But these patients were either unmarried or had just married or didn't have children yet,” said Dr Lalit Kumar, professor and head, department of medical oncology, and co-author of the study.
“Early stage ovarian cancer constitutes about a fifth of all cases with EOC. Patients with stage II and high grade tumours are at a greater risk of relapse and need adjuvant therapy and closer follow-up. Histologic grade is an important prognostic factor for relapse and survival,” the study stated. For the study, 1,243 patients with ovarian cancer were registered. Of these, 1,054 (84.7%) had epithelial ovarian cancer. As many as 195 (18.5%) patients had early stage EOC. All women diagnosed and treated for early ovarian cancer at AIIMS between January 2010 and December 2018 were included in this retrospective study.
The study highlighted the issue of FSS in young ovarian cancer patients. According to oncologists, FSS may be considered especially if they have low-risk (stage IA or IB with low-grade and non-clear cell histology) ovarian cancer.
“The effected ovaries were removed and they the patients were given chemotherapy. After that was over, they could conceive and have children. This is a positive aspect that despite undergoing tumor removal and getting chemotherapy, women can bear a child if detected at early stage,” Dr Kumar said.
The recurrence rate after FSS in early ovarian cancer varies from 9.9% for stage IA/IB, 15.4% in stage IC to 4% in stage II. Among the reason reasons for such low success rates against this type of cancer is the fact that its diagnosis is made only during the advanced stages. Among the common symptoms at diagnosis were abdominal pain (66%), followed by abdominal distension (29%) and vaginal bleeding (26%). Serous histology (58%), endometrioid (17%) and mucinous (17%) were common histologic subtypes.