Cancer refers to diseases where abnormal cells divide uncontrollably, infiltrating and destroying normal body tissue. Serous cancer represents a specific type of malignancy that originates from serous cells. These specialized cells form membranes that line various body cavities and organs, producing a thin, watery fluid. This article explores the nature of serous cancer, its identification, and treatment strategies.
What Serous Cancer Is
Serous cancer arises from serous epithelial cells lining organs within body cavities, such as the ovaries, fallopian tubes, and peritoneum. While most commonly associated with ovarian cancer (approximately 50% of cases), it can also originate in the fallopian tubes, peritoneum, or less frequently, the uterus.
Serous cancers categorize into two main subtypes: high-grade serous carcinoma (HGSC) and low-grade serous carcinoma (LGSC). HGSC is the more prevalent form (60-80% of ovarian epithelial carcinomas), characterized by rapid growth and aggressive behavior. HGSC often originates in the fimbria, finger-like projections at the end of the fallopian tubes, before spreading to the ovaries or peritoneum.
In contrast, LGSC is a less common subtype (about 2% of epithelial ovarian cancers), presenting as a less aggressive disease. LGSC grows more slowly and often develops from precursor lesions like serous borderline tumors. Both types originate from serous cells, but their distinct molecular pathways and clinical behaviors guide different approaches to diagnosis and treatment.
Identifying Serous Cancer
Serous cancer symptoms can be vague and non-specific, making early detection challenging. Common indicators include persistent abdominal bloating, pelvic discomfort or pain, a feeling of fullness after eating small amounts, or changes in bowel habits. Other symptoms include frequent urination or urgency, and sometimes abnormal vaginal bleeding. Since these symptoms can be attributed to many other less serious conditions, they often do not prompt immediate medical investigation until the disease progresses.
Diagnosis of serous cancer involves a combination of methods to confirm cancerous cells and determine disease extent. Imaging techniques like ultrasound, computed tomography (CT) scans, and magnetic resonance imaging (MRI) visualize abnormal growths in the abdomen and pelvis. Blood tests for cancer antigen 125 (CA-125) may also be performed. Elevated levels can indicate ovarian cancer, though this marker is not definitive. Definitive diagnosis relies on a biopsy, where a tissue sample is removed and examined by a pathologist to identify cancer cells and their specific characteristics.
Treating Serous Cancer
Treatment for serous cancer involves a multidisciplinary approach, combining modalities to target the disease. Surgical intervention is often the initial and primary treatment, aiming to remove as much visible tumor as possible. This procedure, known as debulking surgery, reduces tumor burden, improving the effectiveness of subsequent therapies.
Following surgery, systemic therapies address any remaining cancer cells throughout the body. Chemotherapy, particularly platinum-based and taxane regimens, is a standard treatment that destroys rapidly dividing cancer cells. For high-grade serous carcinoma, response rates to platinum-based chemotherapy can be high, potentially reaching 90%.
Targeted therapies focus on specific molecular pathways or genetic mutations within cancer cells. For instance, PARP inhibitors are used for patients with specific genetic mutations like BRCA1 or BRCA2, found in approximately 20% of high-grade serous ovarian cancer cases. Other targeted agents, including MEK, CDK 4/6, and PI3KCA inhibitors, are emerging as options, particularly for low-grade serous carcinoma.
Immunotherapy harnesses the body’s immune system to fight cancer. These therapies help the immune system recognize and destroy cancer cells by boosting immune cell production or locating hidden cancer cells. While research is ongoing, immunotherapy, sometimes combined with tyrosine kinase inhibitors, shows promise in clinical trials, offering new avenues for managing serous cancer.