Ovarian Cancer

Ovarian Cancer

Symptoms of Ovarian cancer

• Ovarian cancer is usually silent, It is only detected just on routine check-up or when investigated for a different reason
• Patients usually present with nonspecific abdominal pain
• Patients who has advanced ovarian cancer present with abdominal distension due to fluid accumulation in the abdomen

"You can hear Dr Anil Kamath speaking on various aspects of Ovarian Cancer:"

Which are the usual tests done for ovarian cancer

• Ultrasound abdomen
• CT scan of the abdomen
• PET scan as required
• A blood test which is known as CA 125 is usually elevated to very high levels in ovarian cancers
• The biopsy is not usually done in early cases of ovarian cancer where surgery is planned directly but biopsy is needed in advanced cases where chemotherapy is given first

How is ovarian cancer treated?

The two main modalities of treatment are

• Cytoreductive surgery: In cytoreductive surgery apart from the ovaries and uterus attempt is made to remove all the disease in the abdomen. This needed additional procedures like peritoneal lymph node dissection, stripping and omentectomy, the aim at the end of the procedure is to leave behind no visible disease in the abdomen. If this is achieved then it would be termed as “optimal cytoreduction” Every attempt must be made during surgery to achieve optimal cytoreduction as this is an important predictor of the outcome of treatment. Patients who undergo suboptimal surgery will have poor outcomes.
• Chemotherapy is a very important part and parcel of the treatment. Most ovarian cancers show a good response to chemotherapy. If the initial disease is too much extensive then the chemotherapy may be used before surgery in which case it is known as “neoadjuvant chemotherapy”

What is HIPEC? Is it useful in ovarian cancer?

HIPEC stands for Hyperthermic Intraperitoneal chemotherapy, It is a procedure in which following surgery, heated chemotherapy is circulated in the abdomen using a special machine. It works on the premise that when chemotherapy is directly circulated in the abdomen it penetrates the peritoneum better.

There are a few cases which have shown that HIPEC improves survival in advanced ovarian cancer patients. The exact role is still uncertain and will have to be individually discussed with the patient.