Ovarian Cancer – Everything you need to know about it

Ovaries are the reproductive organs in women which produce eggs. Ovarian cancers occur when the normal cells in the ovary change into abnormal cells and grow out of control.

Ovarian cancer most often occurs at the age of 50-65 yrs but can happen anytime. Sometimes ovarian cancer runs in the families.

Symptoms of ovarian cancer can include

Stomach getting bigger or feeling bloated, Stomach pain, feeling full or having trouble while eating, needing to urinate often etc. Most women tend to ignore these symptoms and relate them to indigestion.

Diagnosis of ovarian cancers

Various tests including ultrasound abdomen, blood tests, tumor markers like CA 125, CECT abdomen pelvis, MRI abdomen, PETCT scan are used in the diagnosis and staging of ovarian cancers. The doctors choose whichever test is suitable for each patient depending on the stage and symptoms.

Stages of Ovarian Cancer and Treatment Measures

Stage 1 ovarian cancer is the earliest stage and is characterised by cancer limited to one or both ovaries. The cancer cells have not spread beyond the ovaries, and there are no visible signs of ovarian cancer spread in the abdomen or pelvis. Treatment options for stage 1 ovarian cancer typically include surgery to remove the affected ovary and fallopian tube with pelvic and para aortic lymph nodes, omentum, peritoneal biopsy etc., to exactly stage the disease.

Stage 2 ovarian cancer, cancer has spread beyond the ovaries to other pelvic organs, such as the uterus, fallopian tubes, or bladder. Ovarian cancer treatment options for stage 2 may include surgery to remove all cancerous tissue, followed by chemotherapy to destroy microscopic cancer cells.

Stage 3 ovarian cancer, cancer has spread beyond the pelvis to the lining of the abdomen, lymph nodes, or other organs, such as the liver or lungs. Treatment options for stage 3 ovarian tumours may include surgery to remove all cancerous tissue followed by chemotherapy to destroy microscopic cancer cells. Name of the surgery is called cyto-reductive surgery. In some cases, targeted therapy may be used to treat stage 3 ovarian cancer.

As stage 3 ovaraian cancers have high risk of recuurence some patients may also require HIPEC where intra-abdominal heated chemotherapy is administered during surgery.

Stage 4 ovarian cancer, cancer has spread to distant organs, such as the lungs or liver. Treatment options for stage 4 ovarian cancer typically include chemotherapy to destroy cancer cells and improve the patient’s quality of life. In some cases, targeted therapy may also be used to treat stage 4 ovarian cancers. Selected patients with stage IV ovarian cancer may benefit with surgery.

PIPAC is a novel treatment approach in treating advanced ovarian cancers where chemotherapy is sprayed inside the abdomen in aerosolised form. It has maximum penetration with minimum side effects. These are highly specialised and major surgeries requiring immense skill and experience

Surgery is the primary treatment for ovarian cancer, and the extent of surgery depends on the stage of the cancer. With major advancements in technique and understanding of disease biology it is now possible to treat almost all stages of ovarian cancers with good results.

Radiation therapy has no role in treatment of ovarian cancers.

Germline and somatic testing of tumor tissue to identify targetable mutations now plays a major role in ovarian cancers treatment. Targeted therapy is a newer type of cancer treatment that targets specific proteins or genes that contribute to cancer growth. It may be used in certain patients. Newer drugs like PARP inhibitors can be used to prolong the survival.

Conclusion

Ovarian cancer is a serious disease that requires prompt treatment in experienced hands. Women who have a family history of ovarian cancer or other risk factors should speak to their doctor about screening and preventive measures. If you or a loved one has been diagnosed with ovarian cancer, it is essential to work with a healthcare team that specialises in cancer treatment to develop a personalised treatment plan that meets your unique needs. It is prudent to treat ovarian cancer in a specialised centre with maximum experience and facilities to get the most appropriate treatment. Early detection and treatment can improve the chances of successful treatment and increase the patient’s quality of life.