Ovarian cancer is common cancer in women in India. The most common age of presentation is 60 yrs.
Some ovarian tumors are benign (not cancerous). Malignant (cancerous) ovarian tumors can originate from the surface epithelium (cells covering or lining the ovaries), germ cells (cells that are destined to form eggs), or sex cord-stromal cells (cells that secrete hormones and connect the different structures of the ovaries).
Common Epithelial Tumors:
The majority of ovarian cancers include the following:
- Serous: This is the most common type of ovarian cancer and accounts for about 40% of common epithelial cancers. It occurs most often in women between the ages of 40 and 60.
- Endometrioid: This type of ovarian cancer accounts for about 20% of common epithelial cancers and is associated with endometriosis in 5% and endometrial carcinoma (cancer of the womb) in 20% of cases. It occurs most often in women between the ages of 50 and 70.
- Mucinous: Mucinous cancers account for 6-10% of common epithelial ovarian cancer and most often affect women between 30 to 50 years of age.
- Clear Cell Carcinoma: Clear cell carcinomas account for about 5% of common epithelial tumors and most often affect women between ages of 40 and 80.
- Undifferentiated Cancers
- Borderline Ovarian Tumors
Most often ovarian tumours are asymptomatic. symptoms usually develop in an advanced stage. Furthermore, many of the symptoms of
ovarian cancer are hard to differentiate from symptoms experienced by women who do not have ovarian cancer, such as back pain, fatigue, abdominal bloating, constipation, vague abdominal pain, and urinary symptoms. Ovarian cancer is often suspected when there is
postmenopausal ascites and in women when their physician finds an abnormal pelvic growth during an internal pelvic examination. Ovarian cancer may cause symptoms such as swelling of the
abdomen, pain, irregular bowel movements or difficulty breathing when fluid places pressure on the lungs. The optimal treatment of ovarian cancer requires a combination of surgery, chemotherapy and, in some rare cases, radiation therapy.
USG or CT scan of abdomen and CA 125 are the usual tests done. Sometimes CECT Chest and Bone scan / WBPET CT may be required based on symptoms.
Accurate
surgical evaluation of ovarian cancer is necessary for nearly all patients and can only be accomplished during a laparotomy to determine the stage of the cancer and to remove as much cancer as possible. Patients who have already
undergone surgery for ovarian cancer and know their stage of
cancer may select from the options below.
Staging is surgical.
Stage I: Cancer is found only in one or both of the ovaries.
Cancer cells may also be found in abdominal fluid, or ascites.
Stage II: Cancer is found in the ovaries and has spread to the uterus (womb), the fallopian tubes, or other areas within the pelvis. Cancer cells may also be found in abdominal fluid, or ascites.
Stage III: Cancer is found in the
ovaries and has spread to other body locations within the abdomen, such as the surface of the liver, intestine or lymph nodes.
Stage IV: Cancer is found in the ovaries and has spread outside the abdomen or inside of the liver.
Recurrent or Refractory: Recurrent disease means that cancer has returned (recurred) after it has been treated.
Refractory disease means the cancer is no longer responding to treatment.
Treatment options -
CHEMOTHERAPY
PACLITAXEL AND CARBOPLATIN for 6 cycles after surgery (or)
3 cycles of chemotherapy followed by surgery and then 3 more cycles of chemotherapy
BRCA status :
If BRCA gene is mutated then PARP inhibitors are given as
maintenance tablets to increase survival.
Targeted therapy :
Bevacizumab, Olaparib are treatment options that will be better explained by your treating oncologist.
