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Overview

Ovarian Cancer: Treatment, Procedure, Cost and Side Effects

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.

Safety: Medium Effectiveness: Medium Timeliness: Medium Relative Risk: Low Side Effects: High Time For Recovery: Medium Price Range:

Rs.50,000-Rs.10,00,000

Popular Health Tips

Ovarian Cancer - What The News Medication Trends?

MBBS, DM - Oncology, MD - General Medicine
Oncologist, Nashik
Ovarian Cancer - What The News Medication Trends?

When a mutation occurs in the gametes or germ cells which later becomes sex cells, the mutation is referred to as germline mutation. The germline mutation, in the majority of cases, causes harmful genetic disorders or diseases like ovarian cancer that may have a potential of being passed on to offspring.

Considered to be one of the most lethal forms of all the gynecological malignancies that are there, ovarian cancer is a serious threat that can make people succumb to death. However, with modern genetic drugs being discovered, such as rucaparib and olaparib, treating BRCA germline as well as somatic ovarian cancer has been possible to a great extent. Let’s take a closer look at these anti-cancer drugs here.

What are these drugs used for?
The drug rucaparib is used for treating patients who have had two or more sessions of chemotherapy for adverse somatic or germline BRCA mutation which is associated with ovarian cancer. On the other hand, the drug olaparib is used for patients who are suspected or have cancer due to germline BRCA mutation and have been treated with 3 or more chemotherapies before. These are both indicated as monotherapy.

Are there any side effects?
Patients taking rucaparib or olaparib are not meant to feel side effects. However, based on the duration of the treatment and the severity of the condition sometimes people may experience side effects like constipation, nausea, fatigue, kidney issues, decreased appetite, anemia, etc. The chances of experiencing skin rash, breathlessness, photosensitivity, heartburn and decreased the count of platelets are very less.

Are there any necessary precautions?
Before starting treatments with olaparib or rucaparib, patients are strongly suggested to tell their doctors about other medications they are taking presently, in case there's any. And, also, patients are advised against taking any vaccination or immunization or drugs containing aspirin without consulting their doctors. Both breastfeeding a child and conceiving during the treatment are strongly prohibited.

How do these drugs work?
Just like many other targeted therapies that are there for treating cancer, both rucaparib and olaparib primarily work by killing the malignant or the fast-dividing cells associated with ovarian cancer. However, finding out more about the other features of the cancer cells is also its purpose. The PARP enzymes these two drugs include, induce the formation of the double-stranded DNA complexes which results in the death of the cancer cells.
People having either BRCA1 or BRCA2 germline mutations stands at greater risk of developing certain cancers, such as ovarian cancer or the breast cancer than other people. However, research has shown promising chances of targeted therapies such as the rucaparib or olaparib to play an effective role in treating germline mutations caused cancers. You can always talk to your healthcare professional to know more about these targeted therapies if at risk.

4 people found this helpful

3 Surefire Ways To Prevent Ovarian Cancer!

MBBS, DNB (Surgical Oncology), MS - General Surgery
Oncologist, Delhi
3 Surefire Ways To Prevent Ovarian Cancer!

If it runs in your family, you are at risk to get it too. Yes, we are talking about cancer and the debilitating effect that cancer has, on not only the victim but also his/her immediate relatives. However, the idea that this malady is passed on to progeny unquestioningly and runs from generation to generation like a curse is but a myth.

Ovarian Cancer is one of the cancers that affect a woman’s ovaries whereby abnormal cell growth takes place in one of these places: on the tissue within the ovary, on the surface of the ovary, in egg-forming germ cells within the ovary. Studies show that 85% of the patients who had developed Ovarian Cancer had no family record of the disease. Thus it can be attested that one is not compelled to follow the footsteps of the forefathers. Bifurcation is possible and prevention can be accomplished if these guidelines can be followed.

  1. Exercise well and eat better: This is a fool-proof tip that works behind the cure of almost all severe ailments, whether it is about prevention or post-treatment care. In this case, exercise and healthy eating habits reduce the risk of developing Ovarian Cancer. Fatty fish, orange juice, milk, nuts, beans, eggs, fortified cereals, carrots, sweet potato, broccoli, leafy vegetables, flax, whole grains are some of the food products that prevent cancer. For better results, you can seek advice from a physician. Intake of food rich in Vitamin D is another measure. Regular exercise and maintaining a sound BMI are keys to staying healthy and cancer-free.
  2. Birth Control Pills: According to research conducted by the American Cancer Research Institute women who have consumed birth control pills are less likely to develop ovarian cancer so much so that the risk reduces by 30% to 50%. However, one who wishes to opt for this as a preventive measure must consult a physician beforehand.
  3. Surgery: Post-menopausal women can undergo surgeries that remove ovaries & tubes alongwith uterus. These surgeries reduce the risk of ovarian cancer by 90% in post-menstruating women and by 60% in pre-menstruating women. However, a person opting for such surgeries as preventive measures of ovarian cancer owing to a genetic disorder must consult a specialist before undergoing surgery.

These methods are not fool-proof and do not warrant the elimination of one’s possibility of developing cancer. But like they say it’s better to be safe than sorry. Therefore, maintain a healthy lifestyle and who knows, maybe you will succeed in becoming one of those who eliminate that possibility!

2940 people found this helpful

Ovarian Cancer - The Silent Killer!

Post Doctoral Fellowship In Gynecologic Oncology, MS - Obstetrics & Gynaecology, MBBS Bachelor of Medicine & Bachelor of Surgery
Oncologist, Bangalore
Ovarian Cancer - The Silent Killer!

Cancer is that word that many people dread to hear, yet it is a real scourge and can have deadly effects. One such type of cancer is ovarian cancer, which claims countless lives in India every year, yet is not talked about because of social taboos. Because cancer cells are regular cells whose growth is uncontrolled, it is important to know what ovarian cancer is, what causes it, and how to prevent it.

Ovarian cancer is cancer of the ovarian cells. Ovaries are the reproductive glands containing eggs, which only women have.  Women usually have one ovary on each side, and the ovaries produce the hormones estrogen and progesterone, which is necessary for ovulation and pregnancy to occur. Three different cells comprise the ovaries, all of which can develop cancerous (malignant), and non-cancerous (benign) tumors. The cells covering the ovarian walls are called epithelial cells, which can become cancerous - most types of ovarian cancer are epithelial. Germ cell cancer grows in the cells producing the eggs, and stomural cancer grows in the cells that hold the ovaries together and produce reproductive hormones. 

The good news is that in the majority of cases, the tumors are benign and never spread (metastize). These tumors are non cancerous and can easily be removed.  Malignant tumors, however, are cancerous.  These can, and often times, do spread to other parts of the body (metastize) and can kill the women having them. 

A risk factor is any action people take to increase their likelihood of getting a certain type of cancer. With ovarian cancer, age is a big factor, with older women more likely to develop this type of cancer than younger women. Ovarian cases are rare in women under age 40, with the bulk of patients being post-menopausal. About 50% of ovarian cancer cases are in women who are 63 or older.  

More obese women (those with a BMI of 30 or higher) are more likely to develop ovarian cancer than skinnier women. Women who had a successful pregnancy before age 26 are less likely to develop ovarian cancer.  By contrast, women who had their first kid after age 35, or who have never had children, are more likely to develop ovarian cancer.  

Also, while there is no direct correlation, there is thought to be a link between breastfeeding and lower rates of ovarian cancer.

Women who use oral contraceptives have a lower risk of developing ovarian cancer. The risk lowers dramatically after 3-6 months of using the pills, and remains low long after the pills are taken, or even stopped.
Also, getting a tubal ligation, or having a hysterectomy lowers the risk of developing ovarian cancer.  

While there is no known cause of ovarian cancer, certain women carrying the BRCA1 and 2 genes will develop ovarian cancer, so it can be genetic.

Most women only have one risk factor for ovarian cancer, which in itself is not significant. However, since no woman wants to develop this type of potentially deadly cancer, she needs to know how to prevent it.  Taking oral contraceptives for a long period of time has been shown to lower the risk of ovarian cancer. Tubal ligation has also shown a decreased risk.

While there is no one magic bullet for completely preventing ovarian cancer, lifestyle choices can definitely mitigate one’s risk of developing this dangerous cancer. In case you have a concern or query you can always consult an expert & get answers to your questions!

3314 people found this helpful

Ovarian Cancer - Things You Need To Know!

MBBS, Md - Radiation Oncology
Oncologist, Hyderabad
Ovarian Cancer - Things You Need To Know!

On each side of the uterus, two ovaries are present. It is the size of an almond and produces ova or eggs in simple terms, along with the release of hormones like oestrogen and progesterone. When a cancerous growth or a tumour grows in the outer lining (epithelium) of the ovary, it is known as ovarian cancer. Ovarian cancer occurs in women who are aged above 65 years.

There are three types of tumour
Ovaries are made up of three kinds of cells and each kind is capable of developing different types of tumour.

  • Epithelial tumour- It develops from the cells that cover the ovary’s outer surface.
  • Germ cell tumour- It develops from the cells that produce ova.
  • Stromal tumour- It develops from the tissue cell which is the structure holding the ovary together and produces oestrogen and progesterone.

Some tumours are non-cancerous and never spread beyond the ovary. Cancerous or ovarian tumours that are less malignant can metastasize to other body parts. The signs initially would be mistaken with premenstrual syndrome or poor bowel movement or a bladder problem, but if the problems are persistent then one must get an expert opinion. Ovarian cancer often goes undetected till it spreads within the abdomen or the pelvis. 

Causes of ovarian cancer
Cancer develops when the cells of the body divide and multiplies in an unregulated manner. Mutations that are genetic like BRCA1 and BRCA2 can be the cause often or if an individual is diagnosed with any other type of cancer before like breast, colon or uterine. There is a higher risk of being affected by this type of cancer if the person had undergone fertility treatment or is suffering from infertility. Hormone Replacement Therapy (HRT) is another cause of this type of cancer. Experts say that longer the HRT, higher the risk. Women who are obese or are overweight has more chances of being affected. Endometriosis or the disorder in which the growth of the tissue occurs outside the uterus, in such a case the risk is 30% higher.


The signs or symptoms of ovarian cancer differ from one woman to another. Some of the symptoms given below might as well be non-cancerous because since the ovaries are situated near the intestines and bladder, it might be often mistaken to be symptoms of gastrointestinal issues. It is advisable to consult a doctor if the symptoms are persistent.

Symptoms that occur at an early stage
Pelvic pain, Abdomen pain, Indigestion issues, Loss of appetite, Painful sexual intercourse, and Changed bowel movement are a few of the symptoms that occur during the early stages of the development of an Ovarian cancer.

Signs at a progressive stage
Loss of weight, Fatigue, Short of breath, and Nausea are the predominant symptoms when the Ovarian cancer has progressed more. Early diagnosis may lead to complete cure

Symptoms of ovarian cancer are similar to that of ovarian cysts. These ovarian cysts are often non-malignant but women with such cysts have a higher risk of being affected by cancer. Ovarian cancer can begin silently and are often detected at a later stage. Thus any individual undergoing these symptoms can avail medical assistance for further diagnosis. In case you have a concern or query you can always consult an expert & get answers to your questions!

 

2780 people found this helpful

Cancer - How Can It Be Prevented?

MBBS, DGO, MRCOG
Gynaecologist, Mumbai
Cancer - How Can It Be Prevented?

As we make many advances in the medical field, it can be safely estimated that almost one-third of cancers are avertable. This holds true for gynaecologic cancers and cervical cancer as well. With proper care and by making important lifestyle changes, these cancers can be prevented at an early stage, thus improving the longevity of a healthy person’s life.

Let us take a look at some of the cancer prevention and detection in the field of gynecology.

  1. Cervical cancer: This is one of the common cancers in women. In the developed world, one in every two individual is at the risk of being diagnosed with it. HPV is the main cancer causing agent of cervical cancers and a majority of these cancers can be prevented via HPV vaccination and many more types are preventable by early screening and diagnosis.
    • HPV vaccination: One of the effective ways to prevent cervical cancer is by vaccination. While a majority of the vaccines are done under the age of 5, HPV vaccines are inoculated to girls aged between 9 to 13 years. In all technicalities, they are done before a girl reaches puberty. HPV vaccination is for girls before they are sexually active.
    • Screening: Screening is also one more important step that helps in the early detection of cancerous cells and aids in the prevention. Screenings and diagnosis can be safely had by women who reach their puberty age and it is extremely important to have this check-up periodically.
  2. Uterine Cancer: Uterine Cancer is also one of the common types of cancer women experience and it is the 5th most common cancer among the women population. Just like other types of cancer, it can be completely cured if detected at an early stage. However, there is no definite way to screen uterine cancer, other than routine ultrasonography of pelvis. They are mostly related to obesity and high estrogen exposure. Uterine cancer is most common at the age of menopause and sometimes also found in reproductive age group.
  3. Ovarian CancerOvarian cancer is a rare type of cancer, but is one of the most hyperactive types of gynaecological cancers. There are no fool-proof screening methods available for it and it and in case if it is diagnosed at an early stage can be cured. It depends on a number of factors such as estrogen levels and in many cases; genetics seem to play an important role in such cancers. Also, women who have a family history of ovarian or colorectal cancer should be more careful in their approach and should be screened for cancerous cells periodically.

Conclusion
There are many screening programs and vaccination procedures where the cancerous cells can be safely eradicated. Awareness is extremely crucial for all types of cancer and gynaecological cancers are no different either. Get periodic health check-ups as a part of your routine and seek medical attention immediately in case of any abnormalities.

In case you have a concern or query you can always consult an expert & get answers to your questions!

4144 people found this helpful

Popular Questions & Answers

My mother did test few days ago and results are as follow Stage of ovarian cancer %positivity of ca 125 Stage 1 50 Stage 2 50 Stage 3 4 >90 Test name (ca 125, ovarian cancer marker. Serum) RESULTS 16.50 Bio. Ref. Interval <35.00 Please sir explain is there any thing of worry and explain this issue in detail and future problems and what precautions to do?

MBBS, M.S. General Surgery, M.R.C.S. England, M.Ch. Surgical Oncology, DNB Surgical Oncology, FEBS Surgical Oncology, DNB General Surgery, MNAMS, FMAS, FIAGES, FAIS, FICS, FEBS Breast Surgery, FACS, Fellowship IFHNOS & MSKCC USA, Fellowship in breast and oncplastic Surgery
Oncologist, Mumbai
Result is less than 35 (16.50) hence normal. But why was the test done. It is not recommended as a screening test for ovarian cancer. If any symptoms then investigate accordingly. Feel free to contact me directly if you want to discuss this further.
3 people found this helpful

In stage 3c ovarian cancer second operation (cytoreduction) possible or not? When CA125 is 12.5 after first surgery. Is it fully curable n ths stage? Waiting for your answer. Thank u.

MBBS Bachelor of Medicine and Bachelor of Surgery, MD - Internal Medicine, DM - Oncology
Oncologist, Mohali
Do not worry Stage 3c cancer is curable and second surgery is possible if complete removal could not be done in first surgery after chemotherapy. Your CA 125 is also in normal limits.
1 person found this helpful

What are chances of survival in ovarian first stage cancer? We took first 2 kemo and we are going through all procedures and my mom is fit and fine we cannot even understand that she cancer.

MBBS, MD(General Medicine), Fellowship Hemato - Oncology (Hemat-Oncology), DM(Medical Oncology), DNB(Medical Oncology)
Oncologist, Howrah
Survival of stage 1 ovarian cancer is 95 percent provided it's properly staged and you complete the prescribed adjuvant therapy.

My mom has ovarian cancer and done first kimo and they not allowing her to live her life like not allowing her to walk outside even she is not allowed to go to public places .she is kept in home 24/7 is all these restrictions needed.

MBBS, MD(General Medicine), Fellowship Hemato - Oncology (Hemat-Oncology), DM(Medical Oncology), DNB(Medical Oncology)
Oncologist, Kolkata
After chemotherapy is given, side-effects usually start by 7 to 10 days and subside by 15th day. During this period she is likely to have low wbc and hence it is advisable not to go to crowded places. She can have all foods including fresh fruits and vegetables which are hygienic. If you get any fever after chemotherapy please contact your doctor andvstart injectable antibiotics within an Hour.

Table of Content

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?