Ovarian cancer is the gynecological cancer with the highest mortality rate in Portugal – Health – SAPO.pt

Among all gynecological cancers, ovarian cancer “has the highest mortality rate in Portugal”, says Lúcia Correia, gynecologist oncology at the Portuguese Institute of Oncology in Lisbon and member of the Portuguese Society of Gynecology. According to the specialist, this event “comes from the fact that the majority (70-80%) of cases are diagnosed in advanced stages (III and IV), with the disease disseminated outside the pelvis”.

GLOBOCAN 2022 figures for Portugal point to the existence of 682 new cases of ovarian cancer that year, one of the most lethal cancers in females.

The symptoms, “very non-specific and insidious”, as Lúcia Correia explains, may be one of the reasons for late diagnosis. Furthermore, they can be symptoms easily associated with other causes, such as pelvic or abdominal pain, increased abdominal volume, feeling of fullness, easy tiredness, gastrointestinal or urinary complaints, weight loss, vaginal bleeding, among others. In rarer cases, patients may be “asymptomatic and the diagnosis may be made following examinations or surgeries for another reason”, says Mónica Pires, also a member of the Portuguese Society of Gynecology.

According to this specialist, “among all known risk factors, genetic mutations are responsible for 20-25% of ovarian cancer cases, with mutations in the BRCA 1 and 2 genes being the highest risk”. But, she adds, “having a BRCA mutation does not mean you have cancer.” “There are multiple genetic, environmental and individual factors that influence the risk of developing cancer, meaning that many carriers do not develop the disease. Women carrying a BRCA mutation can opt for risk reduction strategies, either through earlier and more intensive screening for breast cancer, or through risk-reducing surgeries such as prophylactic mastectomy or prophylactic salpingo-oophorectomy (removal of ovaries and tubes) after fulfilling its reproductive project. In women already diagnosed with cancer, particularly ovarian cancer, knowledge of the existence of a BRCA mutation allows the multidisciplinary team to adapt the treatment.”

As for ovarian cancer, the main reason for the lack of an effective screening program is related to the biology and natural history of the disease. In light of current knowledge, the precursor lesions described are not detectable by different imaging methods or biochemical markers. When malignant transformation appears, its evolution and metastasis, particularly intra-abdominal, is early and has little symptomatic, which is why the majority (>75%) of ovarian cancers are detected in advanced stages.

Mónica Pires also highlights that the lack of regular gynecological monitoring in Portugal is also a reality. “Recourse to emergency care turns out to be an alternative, often justified by the rapid progression of the disease, which often results in abdominal distension or pain.”

To improve early diagnosis, this specialist defends the need for “health literacy, education for prevention and the importance of valuing certain signs or symptoms.” Lúcia Correia agrees, reinforcing that “women who belong to high-risk groups, such as those with genetic mutations, must be monitored in specific units”.

CG/COMMUNICATE

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