Ovarian Cancer: Treatment Options for the Most Common Type

There are a variety of treatment options available to women with ovarian cancer. Treatment consists of surgery and chemotherapy. In this blog post, we will explore these treatment options in more detail.

What is Ovarian Cancer?

Ovarian cancer is a type of cancer that begins in the ovaries. The age-adjusted incidence rate of ovarian cancer in India is about 15.65/100000. The risk of developing ovarian cancer is about one in 70. There are several types of ovarian tumors; some are benign (noncancerous), some are borderline, and some are malignant (cancerous). Benign tumors do not spread to other parts of the body and recommended treatment is surgery. Malignant ovarian tumors can spread to other parts of the body and they need immediate evaluation and treatment.

What are the Types of Ovarian Cancer?

Ovarian cancers are classified in three types:

• Epithelial ovarian tumour: This is the most common type. It accounts for about 90% of all cases. These tumours are derived from ovarian epithelium. The most common subtype is called serous ovarian cancer.
• Germ cell ovarian tumour: This type of ovarian tumor in germ cells of ovaries. Malignant germ cell tumours account for about 5% of all malignant ovarian tumours.
• Sex cord-stromal cell ovarian tumour: These ovarian tumours are derived from sex cords and ovarian stroma. It accounts for approximately 5-8% of all ovarian malignancies.

Introduction to Epithelial Ovarian Cancer

Epithelial ovarian tumours arise from either fallopian tubes or from ovarian surface epithelium. The most common subtype of epithelial ovarian cancer is high grade serous ovarian tumours. Other subtypes include low grade serous ovarian cancer, endometrioid ovarian cancer, clear cell ovarian cancer, brenner ovarian cancer, mucinous ovarian cancer and undifferentiated cancers.

Symptoms of epithelial ovarian cancer may include:

• Abdominal bloating or swelling
• Abdominal or pelvic pain
• Early satiety (Quickly feeling full when eating)
• Weight loss
• Discomfort in the pelvis area
• Changes in bowel habits, such as constipation
• An increased urge for urination and increased frequency of micturition

These symptoms are suspicious if they present for less than 1 year and longer than 12 days a month. Most ovarian cancers are usually diagnosed at advanced stage. They spread to other parts of the body, such as the lining of the abdomen (the peritoneum), or to distant organs, such as the liver or lungs.

The peak incidence of epithelial ovarian cancers is around 55-65 years of age. 30% of ovarian cancers in postmenopausal women are malignant compared to ovarian cancers in premenopausal women.

Most women with early-stage serous ovarian tumors can be treated successfully with surgery and chemotherapy. However, women with the late-stage disease often have a recurrence (come back).

If you have symptoms of ovarian cancer, it is important to see your doctor for a complete evaluation. Early detection is key to successful treatment.

Treatment for epithelial ovarian cancer usually begins with chemotherapy, which may be administered in several rounds. After chemotherapy, surgery may be recommended to remove as much of the tumor as possible. Radiation therapy and hormone therapy may also be used in some cases.

Risk Factors for Epithelial Ovarian Cancer

• Family history: Women with a family history of ovarian, breast, or colorectal cancer have an increased risk of developing ovarian cancer.
• Obesity: Obesity is a risk factor for many types of cancer, including ovarian cancer.
• Late menopause and early menarche (first occurrence of menstruation)
• Fertility drugs: Ovarian cancer risk associated with fertility drugs is controversial.
• Nulliparity
• Hormone replacement therapy: Ovarian cancer risk is more in women who take estrogen replacement treatment without progestins.
• Smoking: Smoking is a risk factor for many types of cancer, including ovarian cancer.

Protective against Ovarian Cancer

• Pregnancy
• Breastfeeding
• Use of combined oral contraceptives for more than 5 years
• Tubal ligation

Symptoms of Ovarian Cancer

The symptoms of ovarian cancer are non-specific and may not appear until the disease is in the advanced stages. The most common symptom is abdominal bloating, abdominal pain, and distension. Other symptoms may include: 

• Quickly feeling full when eating
• Weight loss
• Discomfort in the pelvis area
• Changes in bowel habits, such as constipation
• An increased urge for urination and increased frequency of micturition

These symptoms are suspicious if they present for less than 1 year and longer than 12 days a month. If you have any of these symptoms, it is important to see your doctor for a complete evaluation. Early detection is key to successful treatment.

Treating Epithelial Ovarian Cancer

Surgery and Chemotherapy are the preferred treatment for epithelial ovarian cancer. Chemotherapy works by killing cancer cells. Ovarian cancer surgery is known as cytoreductive surgery.

Treatment for ovarian cancer can be complex and should be determined by your doctor based on the stage of the disease, your overall health.

Conclusion

If you are having above mentioned symptoms, it is important to approach your doctor for proper evaluation to detect ovarian cancer early to start treatment early. There are different treatment options as because treatment modalities for ovarian cancer are constantly evolving. Ovarian cancer is a serious disease, but it is important to remember that many women are successfully treated and go on to live long, healthy lives. With early detection and treatment, the outlook for women with ovarian cancer is very good. If you have any concerns about your risk of developing this disease, please talk to your doctor.

Apollo Cancer Centres Approach to Cancer Treatment

Apollo Cancer Centres have ushered in international standards in cancer care wherein the focus is on early diagnosis of the ailment and adoption of structured approach for the treatment. Along with advanced diagnostics, this also involves application of molecular pathology, and organ specific tumor board approach to arrive at a consensus among clinicians on what can be the best course of treatment for the patient under the available modalities at Apollo Cancer Centres viz. Surgical Oncology, Medical Oncology, Radiation Oncology & Nuclear Medicine. The Tumor Board consists of a panel of clinicians with significant experience in Medical, Surgical and Radiation oncology, who are supported by Onco-Radiologist & Histo-Pathologist to win over cancer.

At Apollo Cancer Centres, we aim to bring together the best minds in Oncology to discuss and deliberate the emerging trends in cancer management and their impact on clinical practice. Each of our patient care teams combine the skills and experience of several healthcare professionals, who specializes in diagnosing and treating a particular type of cancer associated with an organ. This has led to the development of ‘Clinical Management Teams’ (CMT). Our team members meet regularly to discuss diagnostics and treatment related support for patients, meaning that each patient benefits from a wide range of expertise. Having clinicians of many different disciplines involved in your care, ensures that you will receive the best possible treatment for your specific needs.