70% of the cases were discovered in the late stage... Both mother and daughter were diagnosed! High mortality rate in gynecology | tumors | mortality rate

Recently, the hot topic of "both mother and daughter diagnosed with advanced ovarian cancer" has sparked widespread discussion, bringing another round of concerns about the inheritance of cancer.

Both mother and daughter diagnosed with ovarian cancer

These tumors are easy to inherit!

According to the Ningbo Evening News, the "hero" of this case is a mother and daughter in Zhejiang. The daughter in her 30s has been diagnosed with advanced ovarian cancer and breast cancer, and then liver metastasis. Two years later, her mother also suffered from the same disease.

According to a report from Life Times, Zhou Qi, the head of the Gynecological Oncology Center at Chongqing University Affiliated Cancer Hospital, said in an interview that ovarian cancer is the malignant tumor with the highest mortality rate in the female reproductive tract. 70% of diagnosed cases are advanced, 70% recur within 3 years of treatment, and the 5-year survival rate is around 40%. Early detection and diagnosis are the key to improving the cure rate. About 20%~25% of high-grade serous epithelial ovarian cancer is related to genetic factors, so it is not uncommon for mothers, daughters and sisters to suffer from ovarian cancer together in clinical practice, but it is relatively rare for daughters to develop ovarian cancer first.

Zhou Qi introduced that from a genetic perspective, tumors can be divided into three categories: sporadic, familial clustering, and hereditary tumors. If multiple members of a family suffer from the same tumor or multiple types of tumors, it belongs to the family aggregation tumor; A specific tumor caused by a genetic mutation generally belongs to hereditary tumors, which have the characteristics of early onset and high malignancy. This daughter suffers from ovarian cancer and breast cancer in her 30s, which is presumed to be familial inherited ovarian cancer syndrome. Her family has a high risk of ovarian cancer and breast cancer.

Individuals with genetic susceptibility to tumors or carriers of genetic tumor genes are more sensitive to external stimuli and more prone to inducing tumors under the same environmental conditions. "However, at present, tumors caused by some genetic factors can be identified early and intervened." Zhou Qi said that it is recommended that first-degree relatives of breast cancer or ovarian cancer patients with BRCA1/2 gene mutation should go to the oncology department to receive genetic counseling and necessary gene testing, and insist on regular pelvic examination, combined screening of blood CA125 and transvaginal ultrasound from the age of 35. At the same time, intervention treatment should be carried out at an appropriate age, such as drug intervention, preventive salpingectomy or ovarian resection, to reduce the risk of ovarian cancer. Although men have no worries about ovarian cancer, men with BRCA1/2 mutation also have an increased risk of prostate cancer, pancreatic cancer and breast cancer than other men.

In addition to ovarian cancer, some colorectal cancer, breast cancer and endometrial cancer also have certain heritability. It is recommended that cancer genetic counseling should be carried out in the following cases——

1. Many people in the family suffer from the same or different kinds of tumors, or ≥ 1 of the first, second and third blood relatives clearly carry harmful mutations, or ≥ 1 of the first and second blood relatives meet at least one of the following abc, or ≥ 2 of the third blood relatives meet at least one of abc.

2, I meet at least one of the following abc, or clearly carry harmful mutations.

a. The age of diagnosis of tumor is less than or equal to 50 years old;

b. Diagnosed with multiple primary tumors simultaneously or not simultaneously;

c. Diagnosed bilateral primary tumors simultaneously or not simultaneously.

Ovarian cancer has a high mortality and recurrence rate

Low probability of early detection

Yang Lingling, Director of Gynecology at Li Huili Hospital of Ningbo Medical Center, stated that in the field of gynecological tumors, ovarian cancer is truly the "number one killer" of gynecology. It has the characteristics of "two highs and one low": high mortality rate, high recurrence rate, and low early detection rate.

She introduced a case where a woman sought medical attention due to diarrhea. During her visit to the gastroenterology department, she was found to have ascites in her abdomen, and the CA125 index of the carbohydrate antigen test was too high. So she was referred to the gynecology department. The gynecological director Yang Lingling arranged for Ms. Fan to undergo an ultrasound examination, and it was found that there was a tumor with a diameter of 3 centimeters in the ovary. Abdominal CT revealed a large amount of fluid accumulation in the abdomen, and ovarian cancer with extensive pelvic and abdominal metastasis.

And the patient said that they participate in the unit's physical examination every year, and the routine gynecological examination results show normal. How could it be so serious all of a sudden?

"The ovaries are deep organs that are difficult to detect, and patients with epithelial ovarian cancer progress very quickly. This type of cancer spreads in the abdominal cavity in the early stages, metastasizes in the omentum, and rapidly produces a large amount of ascites. Currently, there is no good screening method for ovarian cancer," explained Yang Lingling.

The Yang Lingling team performed surgery on the patient. The surgical scope was relatively large, and the uterus, bilateral fallopian tubes and ovaries, omentum, and retroperitoneal lymph nodes were removed, achieving a surgical effect of R0. After the surgery, she underwent chemotherapy again.

Yang Lingling said that the reason why ovarian cancer has a high mortality rate is because it cannot be diagnosed early like cervical cancer. The early symptoms of ovarian cancer are not specific, and the ovaries are located in the pelvic cavity, which cannot be seen or touched. 70% of patients are diagnosed in the advanced stage.

As one of the three major gynecological cancers, breast cancer and cervical cancer have long been included in the national "two cancer screening" program, but there is no effective means of early screening for ovarian cancer worldwide. This also explains why even if TCT and HPV are tested during routine physical examinations, no abnormalities are found.

Ovarian cancer also has a characteristic of being particularly prone to metastasis, and the range of metastasis is particularly wide. As the condition progresses, the first stage tumor may grow on the ovary, while the second stage has already spread to the pelvic cavity, affecting pelvic organs; The third stage tumor has already run into the abdominal cavity; The fourth stage tumor may have already spread to the outside of the abdominal cavity, or even to the chest cavity.

Yang Lingling reminds female friends with a family history to pay special attention and undergo genetic testing in advance, and intervene in treatment if necessary. Although ovarian tumors are not easily detected in the early stages, women can carefully observe changes in their bodies, such as abdominal bulges, thickened waist circumference, menstrual disorders, irregular vaginal bleeding after menopause, unexplained weight loss, lower limb and external genital edema, etc. Please be vigilant and seek medical attention at the hospital's gynecology department as soon as possible to rule out the possibility of ovarian cancer.

Beijing Daily Comprehensive Ningbo Evening News, Life Times, Qianjiang Evening News