Ovarian Cancer: Why the Vast Majority of Patients Discover the Disease Late, Like Bianca Balti (And What Can Be Done)

Only after going to the emergency room for lower abdominal pain, Bianca Balti she discovered she had stage III ovarian cancer, which had already spread to other nearby organs. Unfortunately, like her, there are many women who develop this type of tumor (70%) and who realize it late. But why?

«The symptoms of this neoplasm are subtle, late and always very vague», explains the Professor Massimo Di Maio, Director of University Oncology Molinette Hospital – City of Health of Turin. «They can present themselves as general malaise, swelling abdominal pain, lower abdominal pain and irregular discharge.”

And there’s more. «Ovarian cancer does not have a particularly high frequency on the types of neoplasms that affect women: let’s say that it is placed between seventh and eighth place, certainly after breast, lung and colorectal cancer”, adds the Professor Francesco Rivelli, President of LILT – Italian League for the Fight against Tumors – Bologna and Head of Chemotherapy at the Oncology Service San Camillo Polyclinic in Bologna. «The incidence of this type of tumor, which often develops (as in the case of Bianca Balti, but also of Angelina Jolie), in women with BRCA1 and BRCA2 genetic mutationhas not increased in recent years», adds Rivelli «however it affects rather large age groups transversal: in women who are not carriers of the mutation it can arise around the age of sixty, while in women who are BRCA-carriers the age drops to before the age of thirty».

What does stage 3 ovarian cancer entail?

Professor Di Maio emphasizes: «Even this tumor, the sooner it is caught in time the better: if in the first stage the disease is limited to the ovary, in the third stage – that of Bianca Balti, precisely – the neoplasia is already at the abdominal level. In her case, however, we still have a good chance of recovery, provided that the surgery is performed in the most careful way possible. For ovarian cancer there are particular protocols to follow, it is not a simple removal of tumor mass. The second pillar for a good recovery the treatments to follow are; that is, the chemotherapy treatmentwhich involves a combination of Carboplatin and Paclitaxel (this is a rather demanding chemotherapy that causes hair loss and sometimes neuropathies that are not easy to treat), followed by so-called “maintenance” treatments with PARP inhibitor drugs which are also taken orally and which are very effective in cases of BRCA mutations: these therapies can be done for months or years. It is also important, to guarantee a personalized and effective therapy for ovarian cancer, to perform the genetic test of BRCA mutations».

The role of preventive surgery

For women who are carriers of a genetic mutation and are therefore exposed to a cancer risk quite high, ranging from 40 to 60%, a is also proposed preventive intervention which includes the mastectomy and the removal of the ovaries.

While Bianca Balti, although she had announced, in 2022, that she would also undergo a preventive removal of tubes and ovaries, had then only undergone a mastectomy, while we know that the BRCA1 genetic mutation increases the risk of contracting both breast and ovarian cancer. However, Di Maio specifies, «it must be said that Even with these operations the tumor can still appear, for example in the peritoneal area».

But for prevention, screening is not based

For the prevention of ovarian cancer an ultrasound screening program is not enoughindeed this is a risky belief. Di Maio warns: «We think with an ultrasound we have done an effective check and that we are fine, while perhaps the ovarian tumor has already developed. So what is most effective is to pay attention to the symptoms and signals of your body», advises the oncologist. Furthermore, Professor Rivelli adds in conclusion «undergoing regular gynecological visits to be repeated annually.”