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Ovarian Cancer: Treatment, Procedure, Cost and Side Effects

What is the treatment? How is the treatment done? Who is eligible for the treatment? (When is the treatment done?) Who is not eligible for the treatment? Are there any side effects? What are the post-treatment guidelines? How long does it take to recover? What is the price of the treatment in India? Are the results of the treatment permanent? What are the alternatives to the treatment?

What is the treatment?

Ovarian cancer is the type of cancer that occurs in the female reproductive organs, the ovaries. There are many types of ovarian cancer. The three primary types of ovarian cancer are epithelial ovarian cancer, germ cell cancer and ovarian stromal cancer.

The epithelial ovarian cancer has six subtypes of its own; the cancer that develops in the serous tissues of the epithelial layer of the ovary is the most common type. Germ cells are the ones that produce the eggs in the ovaries and germ cell cancer is the most rare type of ovarian cancer. However, even that very little percentage of germ cell cancer can turn out to be fatal. Ovarian stromal cancer is also quite rare and develops in the connective tissues holding the ovaries together.

Ovarian cancer has four stages depending on the extent of the growth of the tumour. The stage of the tumour is determined after ovarian cancer has been detected. The cancer is said to be in Stage I if the tumour is restricted to the ovary or at least the fallopian tubes. If the cancer spreads beyond the two ovaries to the uterus and other pelvic organs, it is said to be stage || cancer. The cancer has reached stage ||| if cancerous cells are found in several regions and lymph nodes of the upper abdomen. The cancer is said to be in in its last stage or stage |V if it has spread to the liver, spleen and lungs.

The course of treatment for ovarian cancer depends on the stage the cancer is in along with the general health condition and age of the patients. The primary methods for treatment are surgery, chemotherapy, radiation therapy, targeted therapy and hormone therapy. Some patients choose to enroll themselves in experimental clinical trials as well, however there is no guarantee to their success.

How is the treatment done?

Surgery is the primary option for treating ovarian cancer as this is the process that is most effective in removing as many cancer cells as possible from the body. The extent of surgery, however, depends primarily on the stage of the cancer. The surgery seeks to remove any visible cancerous mass along with the lymph nodes and the omentum(the layer of fat surrouunding the intestines) as these are the most susceptible to the spread of cancer. In some cases, the cancer has spread so far to all the reproductive organs, like the uterus or fallopian tubes, that the surgeon removes them as well. But such a move has to be discussed with the patient prior to surgery and has to be performed with her consent as the patient may be a young woman interested to start a family and in that case, all reproductive organs cannot be removed from her body.

Chemotherapy is another effective way to treat ovarian cancer that is left in the body even after surgery. The powerful chemicals are usually injected into the body through IV but it may be better if the medications are injected directly into the abdomen in case of ovarian cancer. This makes sure that the cancer-affected part of the body gets in direct contact with the chemicals.

Radiation therapy involves the use of high-intensity x-rays to destroy leftover cancer cells in the pelvic region. Targeted therapy is the use of relatively new oral medications or ones that are injected into the body using IV to stop the metastasis of the cancer cells. Another somewhat effective way of dealing with ovarian stromal cancer is hormone therapy in which hormone-blocking medications are injected into the body that prevent the malignant cells from getting the hormones they need to grow.

Who is eligible for the treatment? (When is the treatment done?)

Women who have generally good health conditions are eligible to receive the invasive ovarian cancer treatment.

Who is not eligible for the treatment?

Ovarian cancer often does not have any symptom in its earliest stage. And even later, there are very generic symptoms like loss of appetite, weight loss and backache. So, it is often diagnosed in women in later stages and women go without any treatment in the initial stages.

Are there any side effects?

The treatment for any form of cancer is as unpleasant as having the consition itself. The surgical removal of cancerous cells carries the general risks that come as a part of the package with any other surgery. Chemotherapy brings its own share of side effects to the table. Some of the side-effects are hair loss, loss of appetite, diarrhoea, nausea, lethargy and reduced power of immunity. The side effects subside once chemotherapy stops. Radiation therapy also causes tirednes, skin soreness and loss of hair in the treated area.

What are the post-treatment guidelines?

All ovarian cancer patients must maintain a strict follow-up regimen with their respective doctors. Patients have to make healthier lifestyle choices after the treatment. Patients can cut down on their tobacco and alcohol intake to reduce the risk of recurrent ovarian cancer. Leading a relatively stress-free lifestyle also goes a long way in keeping an ovarian cancer patient healthy. The treatment for cancer often causes weight loss. But another side effect of the treatment is nausea that makes a patient feel like not eating anything. To deal with these two issues together, a patient can try having small meals 2-3 hours apart throughout the day. Another side effect of the treatment is extreme fatigue. So, patients must discuss with their team of healthcare professionals to come up with a safe lot of activities that will not tire them out and also keep them on on their feet.

How long does it take to recover?

Women who undergo ovarian cancer treatment need time to recover both physically and mentally. Surgical patients need at least 4-6 weeks of time before they can return to their normal routine. It has been seen that the road to emotional surgery is sometimes even longer. In a surgery for ovarian cancer, women often need a hysterectomy and get their uteruses removed. Even though the hyterectomy is performed with exclusive consent from the patient, women may find it very difficult to adjust to life without a womb. Even some women in menopause find it very hard to deal with. Most women discover that coming to terms with not having a womb is much more difficult than the physical healing process.

What is the price of the treatment in India?

The cost of the treatment depends on the way of treatment being followed. In India, a privately funded medical organisation may charge Rs. 50,000 to Rs.1,50,000 for one cycle of chemotherapy alone. Radiotherapy costs nearly Rs.2,00,000 lakhs in India and a surgery may cost upto Rs. 3,20,000. More often than not, the treatment of ovarian cancer involves a combination of all these. So, the total cost might go up to Rs.10,00,000.

Are the results of the treatment permanent?

The treatment for ovarian cancer can be effective if the cancer is diagnosed in stage I but there is no guarantee that the cancer won't return. In most women, the cancer returns within 2 years of treatment but it may come back as late as 20 years after initial treatment.

What are the alternatives to the treatment?

Alternative methods of treatment are only complementary in nature or are adopted as preventive measures or to combat the adverse side-effects of the actual pharmaceutical treatment. Shiitake mushrooms are consumed because these contain lentinan, a beta-glucan that is supposed to inhibit the growth of cancer cells. Soy products, peppermint tea, red onions are also seemingly packed with anti-cancer elements.

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