Ovarian Cancer

Ovarian Cancer. Common mutually exclusive statements:.

1- Statement: I do not believe in multicentricity, but bilateral ovarian tumors are stage I. 

Comment: Ovarian tumors that involve a few millimeters of periovarian soft tissue are considered stage II, but if they also involve the opposite ovary, they are stage I.

This means that they are independent primaries=multicentric.

Multicentricity is very important because explains why ovarian cancer is found at high-stage in close to 70% of the cases. Even with the most sophisticated detection tools it is very unusual to find low-stage cases. The explanation is that the submesothelial space is composed of the same tissue as the ovary, and it responds to the same hormonal stimulation. (Fere Ex Nihilo, Chapter 7)

2- Statement: I do not believe in the hormonal theory of ovarian cancer. 

Comment: But you use antihormones in some cases.

Response: Yes, because they work.

A common concept is that antihormonal treatment does not work in high-grade serous carcinoma. I believe that the problem is that we are only using aromatase inhibitors. There are 86 hormones in the steroid cycle and each hormone is metabolized by different enzymes. It is naive to think that aromatase is important in all the hormones. We need first to identify the abnormal hormones, then we will know what inhibitors to use.