Ascites in ovarian cancer
Ascites is the accumulation of fluid (exudate, transudate) in the abdominal cavity. This condition is a secondary process, as a complication of the underlying disease.Ascites in ovarian canceris observed at 3-4 stages due to the progression of the disease and lesion of the peritoneum.
Ovarian cancer is diagnosed in 5% of cases among all cancers, and in gynecological practice it is less common than cancer of the body and cervix. As for the complication of ascites, it is registered in almost 90% of cases in the late stages of ovarian cancer, of which 60% is the cause of death.
What complications is dangerous for ascites in ovarian cancer?
The danger is directly related to the volume of the transudate in the abdominal cavity. The larger it is, the higher the intra-abdominal pressure that acts on the diaphragm and raises it towards the chest cavity.
As a consequence, the respiratory excursion of the lungs decreases, their ventilated area is reduced, respiratory failure develops. Symptomatically, it manifests itself as shortness of breath, "cyanosis" of the skin, dizziness and weakness.
In addition, cardiac activity is disrupted, blood circulation is slowed and organ dysfunction is noted. Because of the accumulation of a large volume of transudate in the bloodstream, the concentration of protein decreases, which provokes the appearance of edema. Also, water-electrolyte disturbances are observed.
Ascites in ovarian cancer
The abdominal cavity is lined with the peritoneum, which normally produces a small amount of fluid. It is necessary to ensure the motor activity of intestinal loops and to prevent clumping of organs. Then it is absorbed back by the peritoneum, as a result of which its constant circulation is observed.
Thus, the peritoneum has a secretory, suction and protective functions that under certain conditions change or are completely lost.
With malignant disease of the ovaries, the predominance of secretory processes is noted with cancer intoxication and lesion of the peritoneum with metastases. The pathogenesis of ascites is caused by a complex complex of metabolic, inflammatory and hemodynamic disorders, which causes the swelling of the transudate and its accumulation.
The causes of ascites in ovarian cancer
The causes of excess production and the accumulation of transudate in women with ovarian cancer are:
- change in the permeability of blood vessels;
- damage to lymphatic vessels;
- metastatic lesion of the peritoneum;
- abdominal dysfunction.
All of the above conditions develop due to the progression of the malignant process in the ovaries.
The first signs of fluid accumulation in the peritoneum in women
When ascites occurs, the patient begins to feel pain in the abdomen. She notices that the stomach has increased in volume (visually or at attempt to fasten trousers, a skirt). Also, weakness and shortness of breath may be of concern.
Based on these signs, we can conclude that the cancer process is progressing and has already reached stage 3.
Precise symptoms of ascites in women with ovarian cancer
A woman is concerned about the pain syndrome associated with both the accumulation of the transudate and the spread of the malignant tumor to neighboring organs.
In addition, dysfunction of the digestive tract is observed in the form of swelling, nausea and constipation. It is possible to join the dysuric signs (frequent painful urination) and raise the temperature to 38 degrees.
Despite the fact that in cancer diseases weight loss is observed, in ascites, on the contrary, the weight increases in proportion to the liquid volume. So, there is pronounced dyspnea, swelling and motor activity is hampered. Also, it is possible to form an umbilical hernia, hemorrhoids and prolapse of the rectum.
The volume of ascitic fluid can exceed 10 liters.
To what doctors to address and when?
Treatment of ascites due to ovarian cancer is performed by oncologists and gynecologists. With an increase in the circumference of the abdomen, increased pain, swelling and weakness, it is necessary to consult a doctor. These symptoms indicate a progression of the disease, which requires correction of therapeutic therapy.
Thanks to additional instrumental techniques (ultrasound, tomography), the doctor evaluates the prevalence of the oncological process, the volume of the transudate and the state of the surrounding organs. In addition, it is possible to perform a puncture to examine the fluid for the presence of cancer cells and determine the amount of protein lost.
Treatment of ascites in ovarian cancer in women
The main treatment is to eliminate the cause, that is - the treatment of ovarian cancer. To this end, surgery is performed at stages 3 and 4, removing part of the tumor conglomerate, and chemotherapy courses.
To reduce the fluid volume prescribed diuretics ("Veroshpiron "Furosemide"), hepatoprotectors, solutions of albumin and amino acids ("Gepasol").
Also, puncture aspiration of a liquid (laparocentesis) is possible, for one session of which evacuation is allowed not more than 5 liters. If necessary, peritoneovenous shunts are installed, portocaval anastomoses are applied, the spleen is removed or a liver transplant is performed.
Forecast and how many live such patients
The appearance of ascites significantly worsens the prognosis and aggravates the course of cancer. It can lead to peritonitis (with infection), bleeding, cardiac or respiratory insufficiency.
The process of treatment is complicated by the age of the patient over 60, low blood pressure (below 80/50), renal insufficiency, diabetes, cirrhosis and widespread metastatic damage.
When diagnosedascites in ovarian cancer, the prognosis depends on the oncological stage, the morphological structure and the degree of differentiation of the tumor. So, in the 3 stages of oncology with the presence of ascites, the 5-year survival rate is about 11%, and on 4 - it does not exceed 5%..