World Ovarian Cancer Day is celebrated on 8 May, the date to raise awareness of this disease, which, as is often diagnosed in advanced stages because it has no specific symptoms, represents the second deadliest gynecological tumor, both worldwide and in Argentina.
While one of the main risk factors for ovarian cancer is age — most originate after menopause — family history (mother, grandmother, or sister with ovarian or breast cancer and a parent or brother who have or have had prostate or pancreatic cancer), obesity and genetic predisposition play an important role in their development. In fact, approximately 20% of high-grade serous ovary cancers have a BRCA gene mutation. Today, the mutated BRCA1 and BCRA2 genes predispose to both breast and ovarian cancer. In this sense, the advancement of precision medicine provides a great tool to avoid late diagnoses: today there are tests to determine the presence of these altered genes, which helps the approach of the disease. It is that knowing the mutation not only improves the treatment of the patient, but also contributes to the decrease in the risk of women for ovarian cancer, and men for the aforementioned types of cancers: those women who have mutations in the BRCA1 or BRCA2 genes are up to a 54% more likely to develop the disease. “All healthy women with a family history should do genetic counseling for prevention, and all women with ovarian cancer, even without a family history, should also do genetic counseling as targeted therapies exist today that can significantly improve the prognosis of the disease,” explains Dr. Bella, President of the Argentine Association of Oncology. Treatment options vary depending on the stage of the cancer, the patient’s physical condition, and other characteristics that the treating physician should consider. Traditional alternatives (surgery, chemotherapy, radiation therapy and hormone therapy) have also been added in recent years to targeted therapies that have fewer adverse effects and are more effective against certain specific types of tumors. It was recently approved in Argentina, a new targeted therapy that attacks cancer cells that have specific mutations without affecting healthy ones and prolongs progression-free survival by a median of more than 4 and a half years in newly diagnosed patients. Unlike cervical cancer, which can be detected early through pap smears and colposcopy, there is no evidence for early diagnosis of ovarian cancer. That’s why it’s important to know the risk factors for the disease and make routine gynecological appointments. Ovarian cancer is usually confirmed in advanced stages, as it has no specific symptoms, diagnosis and initiation of treatment are usually delayed. A patient with this disease may have no or no symptoms, or may be nonspecific so they often delay diagnosis and subsequent treatment. Some of these include abdominal or pelvic pain, vaginal bleeding, constipation, bloating, diarrhea, fatigue and frequent urination. In the most advanced stages it can also include increased abdominal circumference, swelling, nausea, anorexia, dyspepsia, respiratory symptoms, early satiety/difficulty eating and abdominal masses.
Considering that since 2020 the coronavirus pandemic has taken place in health centers, without a doubt the fear of contracting the virus in hospitals and clinics deterred patients from seeking medical attention for new symptoms, rescheduling checkups and/or avoiding routine checkup appointments. Even those patients who had been diagnosed with cancer discontinued their treatment for fear of contracting COVID-19 in medical centers specializing in these pathologies. According to research conducted between 2 and 8 April 2020 by the World Health Organization on the implications of COVID-19 in the treatment of cancer, in Argentina, during the period of strict isolation, consultations were reduced by 97% and the number of patients initiating treatments decreased by 72%. 52% of respondents believed that their health system could take 1 to 3 months to resume treatments and surgeries for patients who postponed their treatments, while 35% argued that it would take 4 to 6 months to return to treatments. The remaining 23% was even more time thanspera. AstraZeneca continues to work on pathology awareness, partnering with patient associations and medical societies around the world to disseminate the “New Normality, Same Cancer” initiative, a global awareness and awareness campaign that aims to encourage cancer patients to return to cancer services, continue their treatments, and encourage suspected cases to approach medical centers for medical testing and checkups.
