- Neoadjuvant chemotherapy
- Adjuvant chemotherapy
- Recurrence therapy
Ovarian cancer is an unpleasant and dangerous disease that can affect every woman in the world. There are many risk factors that can cause this condition, and the disease can easily affect other organs near the ovaries, including the womb, the bladder, and the colon. Fortunately, there are many options to treat ovarian cancer, and the choice of treatment depends on the condition of the patient and the stage of the disease. The most common treatments are surgery and chemotherapy. Many women that are diagnosed with ovarian cancer have worries about how the treatment will affect their fertility and sexual health.
Ovarian tumors find their origin from three kinds of tissue:
• Most of the tumors develop from epithelial cells. This cancer is based on the surface layer lining the ovary and is known as carcinomas. It occurs mostly in senior women.
• Very few tumors come from stromal cells that form the supportive ovarian tissue. This can occur at any age. Certain gynandroblastomas are even seen in adolescents.
• Next category is of tumors developing from the germ cells, which accounts for 3 to 4 percent of cases. These are more common in younger women.
Some rarer kinds of ovarian cancer also exist that do not fall into any of the above categories. This may occur in the connective tissue of the body that supports or separates different tissues or organs in the body.
Surgery is one of the most common treatments, and the procedure is done by a specialist called a gynecologic oncologist. After the examinations, the doctors will know how difficult the surgery will be and what the odds are that the ovaries will be saved. The surgeon will remove as much cancer tissue as possible, and, after that, the patient may undergo chemotherapy. The combination of the surgery and chemotherapy has shown the best results in the curing of ovarian cancer. These are the most common surgery interventions in cases of ovarian cancer:
- Salpingo-oophorectomy – when one or both ovaries are removed from the body. Sometimes, there is no need to remove the second ovary. In cases like this, the woman can plan a family in the future.
- Hysterectomy – when the whole womb is removed from the body. It can be a partial hysterectomy, where only the uterus is removed. If the uterus and cervix are both removed, the procedure is called a total hysterectomy.
There are also more types of surgeries, depending on the stage of ovarian cancer and how much the other organs are damaged. After the surgery, the patient will have a lot of pain, but the doctors will prescribe appropriate medications. Some women have difficulties emptying their bladder after the surgery. When the both ovaries are removed, the woman is no longer fertile, and she may feel some menopausal symptoms.
The chemotherapy stops the cancer cells from dividing and spreading around the organs. There are also a few types of chemotherapy, including:
- Neoadjuvant chemotherapy – this is a combination of drugs that are given to the patient before the surgery to reduce the size of the tumors. The neoadjuvant therapy is given intravenously over a period of three weeks.
- Adjuvant chemotherapy – this therapy destroys the remaining tumors after the surgery.
- Recurrence therapy – this therapy is given in cases when cancer comes back.
Chemotherapy usually involves combinations of drugs that can cause many side effects to the patient, such as fatigue, nausea, vomiting, hair loss, weight loss, constipation, and diarrhea. Sometimes, depending on the dose, the chemotherapy may slow the cognitive functions and cause nerve damage and memory loss. The women who were on chemotherapy may have to wait a few years until they can get pregnant, but some of them may lose their fertility during the treatment.
Depending on the stage of the diseases, the possible treatments for ovarian cancer are:
- Stage 1 – surgery combined with adjuvant chemotherapy for three to six cycles.
- Stage 2 – surgery and adjuvant chemotherapy for at least six cycles.
- Stages 3 and 4 – neoadjuvant therapy and surgery or a combination of both chemotherapies before and after the surgery.
Another therapy that is used in the treatment of ovarian cancer is the radiation therapy that uses high-energy x-rays to kill cells with uncontrolled growth. It can be compared to a regular diagnostic x-ray. Radiation therapy was used to treat ovarian cancer in the past, but now it is rarely used to treat ovarian cancer. Common side effects observed in the radiation therapy are skin discoloration, irritation in the vagina, fatigue, nausea, etc. The side effects eventually go away once the treatment ends.
Brachytherapy is a kind of radiation therapy in which radioactive material implant is placed at the site of cancer. However, it is a rare option for the treatment of ovarian cancer.
Radioactive phosphorus is another treatment in which a solution of radioactive phosphorus is used. The solution gets into tumor cells that line abdominal surface and kills them. Although this treatment comes with a fewer number of side effects, it causes scarring in the intestine and several digestive problems can develop, such as bowel blockage.
The doctors and the patients should be aware that not every treatment can be successful, and, if that happens, the disease is called incurable or terminal. The diagnosis itself is a stressful procedure, and learning that it is in advanced stages can be very difficult for both the family and for the patient. However, the healthcare team is specialized in dealing with the patients. Hospice care is recommended to the patients who are expected to live for only a few months. However, if a patient feels comfortable at home, then special equipment is designed that helps them to achieve this and stay in the comfort of their home. In these cases, the doctors can prescribe medications that will ease the pain and symptoms of the sick ones in the last days of their life.
Although ovarian cancer can be difficult to treat, there is a significant number of procedures and treatments available.