Rak jajnika – drogi poprawy efektywności leczenia

Abstract

Author(s): ELŻBIETA KUTARSKA

At present there are neither typical symptoms nor diagnostic methods (USG and serum CA 125 level) to detect early ovarian cancer and therefore this disease is named „silent killer”. Screening for women at high risk, BRCA 1 or BRCA 2 mutation and hereditary breast or ovarian cancer in at least 2 closed relatives is recommended. Women older than 40 years with abdominal complaints and ovarian disorders in history should be screened, either. The importance of comprehensive surgery has been proved, extent surgery for early cancer and cytoreduction for advanced. Macro- and microscopic findings are important to stage disease and to determine histologic types. Following surgery first line chemotherapy with paclitaxel and platinum is introduced. Interval surgery can be performed after 3 or 6 cycles of chemotherapy. Consolidation therapy with cytotoxic drugs or radiotherapy is an option for patients with objective complete response. Recurrence of tumor can be treated with surgical cytoreduction, chemotherapy (topotecan, caelyx, gemzar) and hormonotharapy. To improve curability of ovarian cancer patients: 1) screening for high risk women should be recommended 2) woman and her doctor should be aware of suspected symptoms and validity of gynecological examination 3) adequate surgery for patients with ovarian carcinoma performed by experienced gynecologic oncologist – consists the key points. Supplementary chemotherapy is important, but the patient’s lot is determined mostly by early diagnosis and adequate operation.

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