Gynaecological Cancer Treatment

Ovarian Cancer

Ovarian cancer is a growth of malignant cells that form in the ovaries. The cells multiply quickly and can invade and destroy healthy tissues.

The female reproductive system contains two ovaries, one on each side of the womb(uterus). The ovaries produce eggs (ova) and also secrete the hormones; estrogen and progesterone.

Ovarian cancer treatment usually involves surgery and chemotherapy.

SYMPTOMS

When ovarian cancer first develops, it might not cause any symptom. When ovarian cancer symptoms happen, they’re usually attributed to other, more common conditions.

Signs and symptoms of ovarian cancer are:

Abdominal bloating or swelling
Quickly full feeling
Weight loss
Discomfort in the pelvic area
Fatigue
Back and abdominal pain
Changes in bowel habits, such as constipation or diarrhea
A frequent need to urinate

RISK FACTORS

Factors that can increase the risk of ovarian cancer include:

Older age. The risk of ovarian cancer increases with age. It’s mostly diagnosed in older women.
Inherited genetic changes. A small percentage of ovarian cancers are caused by genetic changes you inherit from your father or mother. The genes that increase the risk of ovarian cancer include BRCA1 and BRCA2. These genes also increase the risk of breast cancer.

Several other gene changes are known to increase the risk of ovarian cancer, including gene changes associated with Lynch syndrome and the genes BRIP1, RAD51C and RAD51D.

Family history of ovarian cancer. Relatives who have been diagnosed with ovarian cancer may increase the risk.
Obesity. Being overweight or obese increases the risk of ovarian cancer.
Postmenopausal hormone replacement therapy. Taking hormone replacement therapy to control menopause signs and symptoms may increase the risk of ovarian cancer.
Endometriosis. Endometriosis may also increase the risk( Endometriosis is a disease in which tissue similar to the tissue that lines the inside of the endometrium grows outside the uterus.
Early menarche and late menopause. Beginning menstruation at an early age or starting menopause at a later age, or both, may increase the risk of ovarian cancer.
Never having been pregnant. This may also increase the risk of ovarian cancer.

DIAGNOSIS

Tests and procedures used to diagnose ovarian cancer include:

Pelvic exam. The doctor visually examines your external genitalia and then your vagina with a speculum. During the exam, your physician inserts his/her fingers into your vagina and simultaneously presses a hand on your abdomen in order to feel your pelvic organs.
Imaging tests. Tests, such as ultrasound or MRI / CT scans of abdomen and pelvis, may help determine the size, shape and structure of internal genitalia.
Blood tests. Blood tests might include organ function tests that can help determine your health.

The doctor might also test your blood for tumor markers that indicate ovarian cancer. For example, a cancer antigen (CA) 125 test can detect a protein that’s often found on the surface of ovarian cancer cells. These tests can’t tell whether the patient has cancer, but they may provide clues about diagnosis and prognosis.

Surgery. Sometimes doctors can not be certain of your diagnosis until you undergo surgery to take an ovarian sample and have it tested for signs of cancer.

Once it’s confirmed that you have ovarian cancer, your doctor will use information from your tests and procedures to assign your cancer a stage.. The lowest stage indicates that the cancer is confined to the ovaries. By stage 4, the cancer has spread to distant areas of the body.

TREATMENT

Treatment of ovarian cancer usually involves a combination of surgical operation and chemotherapy.

SURGERY

Operations to remove ovarian cancer include:

Surgery to remove one ovary. For early-stage cancer that hasn’t spread beyond one ovary, surgery may involve removing the affected ovary and its fallopian tube. This procedure may preserve your ability to have children.
Surgery to remove both ovaries. If cancer is present in both ovaries, but there are no signs of additional cancer, your surgeon may remove both ovaries and both fallopian tubes. This procedure leaves your uterus intact, so you may still be able to become pregnant using your own frozen embryos or eggs or with eggs from a donor.
Surgery to remove both ovaries and the uterus. If ovarian cancer is more extensive or if you don’t wish to preserve fertility, doctors will remove the ovaries, the fallopian tubes, the uterus, lymph nodes and omentum (a fold of fatty tissue in the abdomen).
Surgery for advanced cancer. If your cancer is advanced, your doctor may recommend surgery to remove as much of the cancer as possible. Sometimes chemotherapy is given before or after surgery in this situation.

CHEMOTHERAPY

Chemotherapy is a treatment that uses chemical drugs to kill fast-growing cells in the body, including cancer cells. Chemotherapy drugs can be injected into a vein or taken orally.

Chemotherapy is often used after surgery to kill any cancer cells that might remain. It can also be used before surgery.

In certain situations, chemotherapy drugs may be heated and infused into the abdomen during surgery (hyperthermic intraperitoneal chemotherapy). The drugs are left in place for a certain amount of time before they’re drained. Then the operation is completed.

TARGETED THERAPY

Targeted treatments focus on specific weaknesses present within cancer cells. By attacking these weaknesses, targeted drug treatments can cause cancer cells to die.

If you’re considering targeted therapy for ovarian cancer, your doctor may test your cancer cells to determine which targeted therapy is most likely to have an effect on your cancer.

HORMONE THERAPY

Hormone therapy uses drugs to block the effects of the hormone estrogen on ovarian cancer cells. Some ovarian cancer cells use estrogen to help them grow, so blocking estrogen may help control the cancer.

Hormone therapy might be a treatment option for some types of slow-growing ovarian cancers. It may also be an option if the cancer comes back after initial treatments.

IMMUNOTHERAPY

Immunotherapy uses the immune system to fight cancer. The body’s disease-fighting immune system may not attack cancer cells because they produce proteins that help them hide from the immune system cells. Immunotherapy works by interfering with that process.

Immunotherapy might be an option for treating ovarian cancer in certain situations.