Ovarian Cancer Treatment

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What is Ovarian Cancer?

Ovarian cancer occurs when there is an abnormal growth of cells in the ovaries (female reproductive gland). These cells grow uncontrollably and accumulate to form tumors. However, this tumor can metastasize to other parts of the body. 

Ovaries are the part of the female reproductive system that produce women’s eggs and female hormones. There are two ovaries on each side, which are the size and shape of an almond. 

Ovarian cancer most commonly occurs in women after menopause. This type of cancer can be fatal. It is not a commonly occurring cancer, and can be treated with a good cure rate if diagnosed early. However it is hard to be detected early, and shows proper symptoms only in the advanced stage of disease. 

In today’s article, we will tell you in detail about the treatment of ovarian cancer.

• What are the causes of Ovarian Cancer?
• What are the symptoms of Ovarian Cancer?
• How to prevent getting Ovarian Cancer?
• How to diagnose Ovarian Cancer ?
• What are the treatments for Ovarian Cancer?
• What are the steps of care after Ovarian Cancer Treatment?
• What are the side effects of Ovarian Cancer Treatment?
• What are the risks of Ovarian Cancer Treatment?
• What is the cost of Ovarian Cancer Treatment in India? 

What are the causes of Ovarian Cancer?

The exact cause of ovarian cancer is not clear. Although, doctors diagnose the disease by identifying certain risk factors.

Following are the risk factors that may cause ovarian cancer in females-

• Females in their middle age or old age ( after menopause)
• Family history ( mother, grandmother, sister, aunt ) of ovarian cancer exists. ( Know more about- What is Cervical Cancer? Causes, Symptoms, Diagnosis, Treatment, Cost )
• Have any genetic abnormality or genetic disease present, in relation to genes like BRCA1, BRCA2.
• Have had a history or treatment of other cancers – breast, uterine or colon cancer
• Certain races like Eastern europeans or jewish communities have high risk 
• Females with Endometriosis ( a female condition where the uterus lining tissue grows in other parts of the body )
• Females who have never been pregnant, or had difficulty in getting pregnant are prone to getting ovarian cancers.

Cancer usually begins when a cell develops mutations in its DNA. The changes cause the cell to grow rapidly, forming a tumor in abnormal cells. Let me tell you, abnormal cells live until healthy cells die. Abnormal cells can attack the surrounding tissue and spread anywhere in the body by breaking off from the tumor. 

What are the symptoms of Ovarian Cancer?

The following are the signs and symptoms of ovarian cancer that can be seen-

• Feeling of heaviness in the pelvic region
• Abdominal swelling
• Bleeding from the vagina (unexplained), especially in women after menopause
• Loss of appetite
• Feeling full too quickly after taking meals
• Weight gain or loss ( without any other reasoning )
• Irregular and abnormal menses or periods
• Lower back pain that increases and has no cause
• Nausea
• Vomiting
• Bloating or gas in the stomach
• Pain or feeling of pressure in the pelvic region and lower abdomen
• Frequent urination
• Change in bowel pattern
• Uncontrolled bowel movements
• Constipation ( Know more about- What is Blood in Stools? Causes, Symptoms, Treatment, Prevention )

If the above symptoms become severe or continue for more than 2 weeks, one must immediately see a Gynecologist. 

How to prevent getting Ovarian Cancer?

There is no specific way to prevent the ovarian cancer from occuring, however by doing the following things one can reduce the risk of developing ovarian cancers-

• Regular screening and checkups after the age of menopause should be done.
• Females who use birth control pills for more than 5 years of age show less chance of developing ovarian cancers. However this must be followed after consulting a doctor, as these pills have shown to increase the risk of breast cancers.
• Tubal ligation ( procedure to tie the fallopian tubes ) , ovaries getting removed, uterus removal, cervix removal, etc has shown to reduce the risk in aged women.
• Females who give birth have less risk. ( Know more about- Uses and Benefits of Birth Control Pills )
• Breastfeeding- Studies show that women who have breastfed for more than a year have less risk.

How to diagnose Ovarian Cancer?

There is no specific test that can diagnose ovarian cancer at an early stage. Females should go for regular screening tests and pelvic examinations to their gynecologist, from time to time. 

In case there are above symptoms, one should make a note of these, see the duration, intensity of these symptoms and get checked immediately. 

Ovarian cancer can be diagnosed by using the following methods-

• Retrovaginal pelvic examination- The doctor suggests a routine pelvic examination to the patient to check the vagina, cervix, uterus, fallopian tubes, ovaries and also the rectum. It involves examining the genitals both externally and internally. 

The doctor or the nurse inserts gloved and lubricated fingers of one hand into the vagina and the other hand is placed over the lower abdomen, to feel and check the position,shape and size of the uterus and the ovaries. The rectum, is also examined similarly.

Internally, the doctor inserts a speculum inside the vagina to obtain images of the ovaries, vagina and uterus to detect all the defects. 

• CA-125 assay- A blood test is done to determine the presence of a specific protein known as CA-125, present on the ovarian cancer cells.
• Transvaginal Ultrasound (TVU )- In this procedure, an ultrasound probe ( transducer ) is inserted through the vagina, and is gently moved inside. The sound waves create images of the uterus, ovaries, fallopian tubes and bladder, on the computer attached known as sonogram.  ( Know more about-What is Ovarian cyst removal surgery ? Purpose, Procedure, Aftercare, Cost)
• Other imaging tests like CT scans can be done to find out the size, location, and severity of the tumor.

What are the treatments for Ovarian Cancer?

The following are the treatment options for the ovarian cancer patients-

Standard treatment methods-

• Surgery- This is the standard treatment method, where the tumor tissue is surgically removed. These are types of surgeries done for ovarian cancer treatment-
• Hysterectomy- This is the surgery to remove the uterus and cervix. Either only the uterus is removed (  partial hysterectomy ) or both the uterus and cervix are removed ( total hysterectomy ). 

When hysterectomy is done via vagina, it is known as Vaginal Hysterectomy. When the hysterectomy surgery is done by making a long incision (cut) in the lower abdomen, i.e., via abdomen, it is known as Total Abdominal Hysterectomy. If the hysterectomy is done by making a small incision (cut ) in the lower abdomen, it is called Total Laparoscopic Hysterectomy. 

1. Unilateral salpingo- oophorectomy (where only one ovary and one fallopian tube is surgically removed)
2. Bilateral salpingo- oophorectomy (where both the ovaries and both the fallopian tubes are removed )
3. Omentectomy (where the tissues of the abdomen like blood vessels, lymph nodes, nerves, etc present in the surroundings are removed )
4. Lymph node removal or biopsy- Here the nearby lymph nodes of the adjacent pelvic areas are removed. This is done along with the hysterectomy procedure. 

• Chemotherapy- The type and method of chemotherapy depends upon the stage of ovarian cancer or the size of the tumor, the spread of the tumor. ( Know more about- What is Chemotherapy? Types, Purpose, Procedure, Side effects, Cost )

1. In systemic chemotherapy, the drugs are taken by mouth or injected into the veins and muscles. These move in the blood and reach the cancer cells, killing them or stopping their cell division. This stops the growth and spread of the tumor/cancer.
2. In regional chemotherapy, the drugs are directly placed in the specific ovarian cancer tissue. This attacks the cancer cells in that area.

For ovarian cancer, Intra peritoneal chemotherapy is used where the anticancer drugs are injected into the abdomen via a thin tube. Hyperthermic intraperitoneal chemotherapy (HIPEC) is another method, which is done after the surgical removal of the cancer tissue.

Combination chemotherapy is used for ovarian cancer treatment where more than one anticancer drug is used.

• Targeted Therapy- In this method, certain drugs or substances are given that identify and target to kill the specific cancer cells. They cause less harm to nearby healthy cells, than chemotherapy or radiation therapy. Bevacizumab is the monoclonal antibody, used with chemotherapy, that is injected to treat ovarian cancers. These attack the ovarian cancer cells, kill or block their growth and also prevent the spread. 

Newer treatment methods-

• Radiation therapy– Here high energy X rays or radiation energy is directed to kill the ovarian cancer cells. Intraperitoneal  radiation therapy is used for ovarian cancer treatment, where radioactive liquid is placed in the abdomen via a tube. 
• Immunotherapy– Also known as biologic cancer therapy, in this the body’s immune system is made strong to kill the cancer cells. Vaccine therapy is used where substances are injected into the body, which enhance the immune system and kill the ovarian cancer cells. This therapy is used for advanced cases of ovarian cancer. 

What are the steps of care after Ovarian Cancer Treatment?

Follow up care-

After the surgery, the woman is allowed to go home within a week. Before discharge, doctors advise the following things:

• Avoid any physical activity for at least a week after surgery.
• The woman needs to rest for a few weeks. ( Know more about- Diet chart for women after 40 years age )
• If there is any health abnormality, then contact your doctor.

What are the side effects of Ovarian Cancer Treatment?

Following are the side effects females may have after or during the ovarian cancer treatment-

• Urination problems or painful urination
• Bladder related problems
• Sleep may get disturbed or lack of sleep
• Skin and nail related problems
• Sexual health gets affected and decrease in sexual desires
• Abdominal and pelvic pain ( mainly after surgery, which can be managed by painkillers )
• Multiple organ swellings
• Tingling in the legs and hands
• Other nerve related problems
• Nausea and Vomiting
• Mouth sores or ulcers
• Lymphedema ( lymph fluid gets filled leading to swellings in different body parts )
• Decreased memory power
• Increased infections in parts of body
• Cold and flu like symptoms
• Hair Loss
• Tiredness
• Constipation
• Bleeding in different body parts and easy bruising
• Loss of appetite
• Anemia

What are the risks of Ovarian Cancer Treatment?

You may experience the following complications during or after ovarian cancer treatment.

• There is a risk of infection and high temperature for some time.
• Vaginal bleeding
• Red/brown discharge from the vagina
• Sometimes there may be a lot of blood loss.
• There is a chance of damage to the bladder during surgery.

What is the cost of Ovarian Cancer Treatment in India? 

The total cost of ovarian cancer treatment in India can range from around INR 4,00,000 to INR 6,00,000. Although, there are many big hospitals and experienced doctors in India who provide ovarian cancer treatment. But the cost of ovarian cancer treatment may vary across different hospitals.

If you are coming from abroad, then apart from the cost of your ovarian cancer treatment, there will be some other expenses, including hotel accommodation and local travel. Also, after the procedure, the patient is kept in the hospital for 10 days and in the hotel for 10 days for recovery. So, the total cost of ovarian cancer treatment in India comes to be around INR 6,00,000 to INR 8,00,000.

We hope that we could answer your questions regarding ovarian cancer treatment through this article.

If you want to get more information and treatment of ovarian cancer, you can contact an Oncologist/Cancer Specialist.

We only aim to provide you with information through this article. We do not recommend any medicine or treatment to anyone. Only a doctor can give you the best advice and correct treatment plan.