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As the name implies, ovarian cancer is a cancer that develops in the ovaries and is one of the most lethal and aggressive malignancies in women. Most ovarian malignancies (between 75 and 80 percent) are diagnosed in their advanced stages, such as stages 3 and 4. Only 22 to 25% of ovarian tumours are usually discovered in the early phases. There are several types of ovarian cancer, with epithelial ovarian cancer being the most aggressive and typically affecting elderly people. Younger women are still susceptible to developing ovarian cancer, but we typically see a distinct form in them that has a better prognosis. They are therefore completely treatable, even if they are discovered at an advanced stage. Epithelial ovarian cancers are often seen in advanced stages, and the risk factor is that ovarian cancers are more common in families with a history of breast or ovarian cancers. It is advisable to have genetic testing performed where there is such a strong family history.
Symptoms of Ovarian Cancer
In the early stages, ovarian malignancies are typically asymptomatic. Rarely, a person suffering from an ovarian tumour may experience lower abdomen pressure, pain, problems while passing urine, or even painful defecation. However, if the ovarian tumour is an advanced one, there may be a buildup of fluid in the abdominal cavity, which can cause bloating, nausea, constipation, and other abdominal symptoms like heaviness and indigestion. They may also experience additional gastrointestinal symptoms like dyspepsia or indigestion, as well as symptoms like heartburn, and bloating.
Diagnosis and Treatment
A typical method of diagnosis includes an ultrasound, followed by a CT scan or MRI, and possibly a blood test for tumour markers. They will be used to aid in diagnosis as well as a marker for therapy response. In advanced cancer, we often end up performing a core biopsy from a metastatic site and tissue diagnosis. After the diagnosis, we decide if the patient can have surgery immediately or if chemotherapy must be given first, followed by surgery. Though, the standard procedure is surgery followed by six rounds of chemotherapy.
When a ovarian cancer specialist in Mysore determines that a case cannot be operated on up front, chemotherapy must be administered in an effort to shrink the tumour. All said, the rationale of surgery in advanced ovarian cancer is to remove all visible (macroscopic) disease and leave behind no residual tumour (Cytoreductive surgery or CRS). After around three cycles of chemotherapy, the operation (CRS) is usually performed, followed by another three cycles of chemotherapy. This approach is considered as standard practice especially in older women and other comorbidities such as diabetes, heart disease, hypertension, etc. Despite all the efforts and all the treatments that have been developed over the past several years, it has been seen that recurrences continue to occur, and overall survival is not that satisfactory. It has been observed that only 40 to 50 percent of women who undergo surgery survive for the next five years.
For younger girls who are diagnosed with ovarian cancer, the idea is that if it is caught early enough, a procedure known as fertility-sparing surgery can be performed. It keeps the uterus and one of the ovaries while removing the affected ovary and other structures that need to be removed from the body. In the case of advanced cancer in young women sometimes a whole cytoreductive surgery may have to perform, where the whole ovary gets removed as well as any other necessary connected tissues.
In such instances, it is advised that women undergo fertility preservation by attempting to stimulate their ovaries prior to beginning chemotherapy or having surgery. Here the ovaries can be stimulated with injections to try to collect eggs and freeze them, which can then be later used for In-vitro fertilization (IVF) surrogacy to give her a biological child. If you are looking for treatment procedures for ovarian cancer and infertility, visit Manipal Hospitals near you for an expert consultant.
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