Ovarian Cancer Treatment in India

              Ovarian Cancer Treatment In India

Ovarian cancer is a type of cancer that begins in the ovaries. Women have two ovaries, one on each side of the uterus. The ovaries - each about the size of an almond - produce eggs (ova) as well as the hormones estrogen, progesterone. Ovarian cancer often goes undetected until it has spread within the pelvis and abdomen. Ovarian cancer is a type of cancer that begins in the ovaries. Women have two ovaries, one on each side of the uterus. The ovaries — each about the size of an almond — produce eggs (ova) as well as the hormones estrogen, progesterone and testosterone. Ovarian cancer often goes undetected until it has spread within the pelvis and abdomen. At this late stage, ovarian cancer is difficult to treat and is often fatal.

                                Stages Of Ovarian Cancer

Stage I

The cancer is completely contained within the ovary or ovaries:

•  Stage IA- One ovary involved

•  Stage IB- Both ovaries involved

•  Stage IC- One or both ovaries involved, but with cancer on the surface of an ovary, rupture of an ovarian cyst malignant ascites or positive abdominal washings.

Stage II

The cancer is in one or both of the ovaries and has spread to additional organs located in the pelvis such as the bladder, colon, rectum or uterus.

• Stage IIA - Spread to uterus or fallopian tubes

• Stage IIB - Spread to pelvic peritoneum

• Stage IIC - Confined to the pelvis, but with malignant ascites or positive abdominal washings

Stage III

The cancer is in one or both ovaries and has spread to one or both of the following: the lining of the abdomen or the lymph nodes.

• Stage IIIA - Microscopic spread to the upper abdomen

• Stage IIIB - Cancer nodules less than 2 cm in the abdomen

• Stage IIIC - Nodules more than 2 cm, or positive pelvic or aortic lymph nodes

Stage IV

The most advanced stage of cancer. The cancer has spread from one or both ovaries to additional organs such as the liver or lungs, or there may be cancer cells in the fluid surrounding the lungs.

       

                               Diagnosis Of Ovarian Cancer

• Exploratory Surgery : This surgery is performed for confirming the diagnosis of ovarian cancer.

• Ultrasound : High-frequency sound waves are produced in order to get precise images of the structures inside the body.

• Blood Tests: CA 125 blood test is performed for those women who are suspected of having ovarian cancer or previously had ovarian cancer. This blood test helps in detecting a protein antigen that can be found at abnormally high levels in the blood serum of those women who have ovarian cancer.

• Positron Emission Tomographic Scan (PET) : This test helps in defining those areas that altered blood supply and also helps in identifying cancer.

• Upper G.I. and Lower G.I. Scopy: It helps in ruling out the primary cancer present in G.I. tract.

• CT scan: This helps in generating two dimensional images of the body that may show whether the cancer has spread.

• Mammography: Metastatic tumors can be ruled out with this test.

• Magnetic Resonance Imaging (MRI): Magnetic energy is used for generating highly detailed images of the anatomy such as tumors.

                            Ovarian Cancer Treatment In India  

Surgery

Three types of surgeries are involved in treating ovarian cancer such as:

• Laparoscopy : Gynaeoncologist perform laparotomy through a large abdominal incision, most often removing your ovaries, uterus, fallopian tubes, nearby lymph glands, a fold of fatty tissue called the omentum and as much of the tumor as possible.

• Frozen Section Tissue Analysis : The rapid analysis of the tissue is done under a microscope. The nature of the tumor is determined as whether it is cancerous or non-cancerous that also helps surgeons to perform a suitable procedure during the first surgery.

• Laparotomy : This procedure is used by making a large abdominal incision. This incision is done for removing uterus, ovaries, Fallopian tubes surrounding lymph glands, omentum (a fold of fatty tissue) and tumor. Cytoreductive or debulking surgery is another name for this surgery.

Chemotherapy

After surgery, you'll most likely be treated with chemotherapy - drugs designed to kill any remaining cancer cells. Chemotherapy may also be used as the initial treatment in some women with advanced ovarian cancer. Chemotherapy drugs can be administered in a vein (intravenously) or injected directly into the abdominal cavity, or both methods of administering the drugs can be used.

Radiation therapy

Radiation therapy uses high-energy beams to kill cancer cells. The use of radiation therapy to treat ovarian cancer has declined in recent years, but Gyneconcologist use it in certain cases, such as when patient have a recurrence of cancer at the original site or if she can't tolerate chemotherapy. Gyneconcologist may use whole abdominal radiation to tre

Ovarian Cancer Treatment in India - Best Cancer Hospital India

Ovarian Cancer  Treatment in India 

It is one of the most common cancers in women after breast and cervix cancer. It is called a 'silent killer' as it is asymptomatic in early stages and 75 per cent of cases are diagnosed in the advanced stage. A woman's lifetime risk of dying from ovarian cancer is 1.1 percent.

What constitutes ovarian cancer?

It largely means tumours of epithelial origin, but it can also arise from other elements namely germ cells and stroma. Epithelial ovarian cancers typically occur in postmenopausal women and are in advanced stage at the time of diagnosis, whereas germ cell tumours occur at a young age, are detected in the early stages and are completely curable.

Who are at risk?

The majority of women with ovarian cancer have no known risk factors. Early menarche, late menopause, being over the age of 30 at first childbirth, and nulliparity are said to increase the risk.

What are the protective factors?

Childbirth, breast-feeding, oral contraceptives, tubal ligation, bilateral removal of ovaries (bilateral oophorectomy), and hysterectomy.

What are the symptoms?

Symptoms are non-specific like pelvic pain, back pain, abdominal discomfort, bloating, early satiety, vaginal bleeding, and frequent urination. Ovarian masses are sometimes detected on pelvic examination.

How is it diagnosed?

Transvaginal Ultrasound (TVU) is an important diagnostic tool in evaluation

of patients with pelvic mass. Computed Tomography (CT) and Positron Emission Tomography (PET scan) help in defining the extent of the disease. MRI is sometimes helpful. Tumour markers like CA 125 are adjunct to imaging and useful in follow up.

Are all ovarian masses cancers?

All masses in the ovary are not cancers. TVU helps distinguish benign from malignant ovarian cysts. Complex cysts, defined as cysts with both solid and cystic components, septations and echogenicity, are malignant and require exploration. In contrast simple cysts that are thin walled, less than 5-10 cm and without septations are usually benign.

Can we detect  early?

Screening for ovarian cancer has not been successful as natural history of ovarian cancer is not well understood. There is no well-defined precursor lesion and the length of time from localised tumour to dissemination is unknown. Multiple efforts are underway to develop effective screening methods. Pelvic examination, CA 125, and TVU with Doppler are studied as screening methods in high-risk individuals.

Is ovarian cancer genetic?

Around 5-10 per cent of patients carry germline mutation. Breast-ovarian cancer syndrome accounts for approximately 90 per cent of hereditary ovarian cancer and is suspected whenever there are multiple affected family members with , bilateral or early onset breast cancer, both breast and ovarian cancer in the same individual, or a male relative with breast cancer.

What are the treatment of Ovarian Cancer modalities?

Ovarian Cancer Treatment depends on the age, stage, tumour type and the desire to preserve fertility. Surgery and chemotherapy is the mainstay of treatment.

What complications can I expect after chemotherapy?

The most common early complications are loss of hair, nausea and vomiting. There can be reactions during infusion of chemotherapy, which are prevented with good premedication. Late complications include tingling and numbness in fingers and toes.

How do I prevent?

Chemoprevention is by oral contraceptives. Surgical prevention is by bilateral oophorectomy, tubal ligation and hysterectomy. Risk-reducing bilateral  oophorectomy is strongly recommended in women who carry germline mutation for hereditary ovarian cancer, because of high mortality of ovarian cancer and lack of effective screening and preventive approaches. Fortunately, risk of ovarian cancer does not rise dramatically until the late 30s in women with germline mutation, so women have the opportunity to complete their family prior to surgery. Since ovarian cancer is one of the common cancers in women and there are no effective population screening methods, high index of suspicion is necessary for early diagnosis. With the new trends in chemotherapy, survival is increasing in ovarian cancer patients and awareness is necessary among the public for seeking early medical attention.

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