Ovarian cancer treatments
The treatment of ovarian cancer is based on the stage of the disease. Other factors that could play a part in choosing the best treatment plan might include your general state of health, whether you plan to have children, or other personal considerations. Older women can tolerate ovarian cancer treatments well. Be sure you understand all the risks and side effects of the various therapies before making a decision about treatment
Stage 1 - Generally women diagnosed with Stage 1 ovarian cancer have a total hysterectomy (removal of the uterus) or an omentectomy (biopsy of the lymph nodes and other pelvic and abdominal tissues). Unilateral salpingo-oophorectomy (removal of the affected ovary/ovaries and fallopian tube) may be performed for younger women without the need for a hysterectomy. There may be no further treatment if the cancer is low grade, or if the tumor is high grade the patient may receive combination chemotherapy.
Stage 2 – Recommended treatment is almost always hysterectomy and bilateral salpingo-oophorectomy. Surgeons also try to cut out as much of the tumor as possible and take sample tissues in locations where cancer is suspected. After surgery, doctors recommend combination chemotherapy with or without radiation therapy.
Stage 3 - Treatment is the same as for Stage 2 ovarian cancer. After surgery, doctors recommend combination chemotherapy possibly followed by additional surgery to find and remove any remaining cancer.
Stage 4 - Treatment will probably be surgery to remove as much of the tumor as possible followed by combination chemotherapy.
Chemotherapy involves using drugs to destroy cancer cells by preventing them from growing and dividing rapidly. Unfortunately, many normal cells can also be damaged by chemotherapy. Treatment may cause:
Clinical trials are performed to evaluate the benefits, safety, and side effects of new techniques to treat ovarian cancer. The results of clinical studies are not yet conclusive and have been variable and not particularly effective in the management of ovarian cancer. Some possible treatment options during clinical trials may include:
Gene therapy - Gene therapy may provide some control over cancer susceptibility and its treatment. Ovarian cancer results from genetic defects within cells which may be inherited or can be caused by exposures to environmental factors that damage genes. Genetic engineers hope to correct such damage by transplanting copies of normal genes into cells with genetic defects.
Hormone therapy - Hormone treatments may help women diagnosed with ovarian cancer whose bodies have not responded to conventional therapy. Hormones that might be targeted include:
- gonadotropin releasing hormone (GnRH)
Follow up treatment
All women diagnosed with ovarian cancer should make continuous follow-up visits and treatments, even if the disease is in remission after treatment. This is because ovarian cancer can reappear up to 20 years after initial treatment. Most patients are examined by their physicians every 3 months for the first 2 years. Follow-up visits are then scheduled every 4-6 months. During these visits, doctors heck the CA125 level in the blood. If CA125 levels have increased CT scans, biopsies and peritoneal lavage may be performed. Recurrent cancer may require additional chemotherapy and/or surgery
Diminished libido (sexual desire) and poor self image that can result after cancer treatment may be helped by psychological and/or sexual counselling.
Radiotherapy, or radiation therapy must include all cancer cells within the radiation field. This therapy is not often used for ovarian cancer, however, due to the proximity of abdominal organs (liver, kidneys, and bowel) to the ovaries. Radiotherapy may be an option if ovarian cancer is confined to one or both ovaries and has not spread to abdominal organs or pelvic lymph nodes.
Most women who are diagnosed with ovarian cancer undergo surgery in addition to chemotherapy and/or radiotherapy. Surgery helps doctors accurately stage the tumor, make a diagnosis, and remove as much tumor mass as possible (debulking). Debulking surgery and aggressive removal of cancerous tissue can improve survival rates.
Sexual intercourse may be painful after a hysterectomy because the vagina has been shortened. In addition, painful intercourse may be caused by vaginal dryness due to estrogen deficiency after ovary removal or irritation of the vagina's mucous membranes by chemotherapy. Vaginal moisturizers and lubricants are available to relieve this condition.