Treatment of ovarian cancer
The treatment for ovarian cancer is said to be intense and there are different types of treatments, but the exact form of treatment depends on the stage of the cancer. The following kinds of treatment are used;
Surgery:
When ovarian cancer has been diagnosed, the presences of complex mass associated with an elevated serum of CA-125 are indication of surgical exploration. Ideally, surgery is performed first; this allows the cancer to be adequately stage and relieves the woman from the bulk of the tumour.
Types of surgery
(a) Removing of the primary tumour : This includes total hysterectomy (removal the uterus including the cervix) (fig. 15 A), bilateral salpingo-oophorectomy (removal of both ovaries and both fallopian tubes) (fig. 15 Bb) and omentectomy ( removal of the omentum- a piece of the tissue lining the abdominal wall). But in young women with an early tumour (IA or IB), consideration may be given to perform a conservative unilateral salpingo-oophorectomy (removal of one ovaries and one fallopian tube) to preserve fertility (saving the unaffected ovary and uterus)
- Surgery
- Chemotherapy
- Radiation therapy
- Biologic therapy
Surgery:
When ovarian cancer has been diagnosed, the presences of complex mass associated with an elevated serum of CA-125 are indication of surgical exploration. Ideally, surgery is performed first; this allows the cancer to be adequately stage and relieves the woman from the bulk of the tumour.
Types of surgery
(a) Removing of the primary tumour : This includes total hysterectomy (removal the uterus including the cervix) (fig. 15 A), bilateral salpingo-oophorectomy (removal of both ovaries and both fallopian tubes) (fig. 15 Bb) and omentectomy ( removal of the omentum- a piece of the tissue lining the abdominal wall). But in young women with an early tumour (IA or IB), consideration may be given to perform a conservative unilateral salpingo-oophorectomy (removal of one ovaries and one fallopian tube) to preserve fertility (saving the unaffected ovary and uterus)
(b) Debulking: This involves resection of the part of the small and large bowel and the excision of tumour from other areas of spread within the abdomen. There are two forms, the optimal and sub-optimal debulking. The optimal debulking is when a small deposit of the tumour is left, usually less than 2 cm in diameter, and this is associated with likelihood of the tumour responding to cancer drugs. Sub-optimal debulking is when the leaving tumour is greater than 2 cm in diameter or wide spread visible disease and this is associated with poor prognosis.
Note that:
Women left with minimal residual disease after primary surgery has a significantly longer survival than those left with bulky or suboptimal disease
Chemotherapy
This involves the use of drugs to stop the growth of the cancer cells, either by killing the cancer cells or by preventing them from dividing. This form of treatment can either be systematic or regional. In systematic chemotherapy, the drug is taken by mouth or injected into the vein (intravenous) or muscle (intramuscular). The drugs can enter the blood stream and reach the cancer cells throughout the body where they act. Regional chemotherapy requires injecting the anticancer drugs directly into the spinal column, an organ or a body cavity, and the drugs mainly affect cancer cells in those area. The most commonly employed regional chemotherapy for ovarian cancer is Intraperitoneal (IP) chemotherapy (in which the anticancer drugs is place in the space containing abdominal viscera)
Combination chemotherapy (use of more than one anticancer drug) is recommended for women with high risk early stage disease and for women with advanced disease. Therefore, for most women, combination chemotherapy is prescribed, usually paclitaxel and carboplatin. However, for elderly women a single drug might be preferred. The way the chemotherapy is given depends on the type and stage of the cancer being treated.
In most cases, women with ovarian cancer suffer from psychological distress because of the repetitive chemotherapy and poor prognosis associated with this disease. Similarly, the approach to managements of the disease has significant effects on their social wellbeing
Radiotherapy
This kind of treatment involves the use of radiation to kill the cancer cells or stop the cancer from growing. The radiation as well can cause the tumour to shrink. The manner and the amount of the radiation to be given depend on the type, size and the location of the ovarian cancer in the body.
There are two types of radiotherapy, External radiotherapy and internal radiotherapy. The external radiotherapy involves the use of machine outside the body to deliver the rays (radiation) to the cancer cells. While, internal radiotherapy, the radioactive agents is place in the body directly into or near the cancer cells
However, some women receive another form of radiotherapy called intraperitoneal radiotherapy, in which the radioactive substance is place directly into the abdomen via catheter. Systemic radiotherapy requires the use of radioactive substance via blood stream to reach the cancer cells.
Biotherapy
This is a rare form of ovarian cancer treatment; it is usually recommended when the cancer cells are at early stage. It involves boosting the immune system of the patient to fight and restore the body’s natural defences against the cancer cells. This
Note that:
Women left with minimal residual disease after primary surgery has a significantly longer survival than those left with bulky or suboptimal disease
Chemotherapy
This involves the use of drugs to stop the growth of the cancer cells, either by killing the cancer cells or by preventing them from dividing. This form of treatment can either be systematic or regional. In systematic chemotherapy, the drug is taken by mouth or injected into the vein (intravenous) or muscle (intramuscular). The drugs can enter the blood stream and reach the cancer cells throughout the body where they act. Regional chemotherapy requires injecting the anticancer drugs directly into the spinal column, an organ or a body cavity, and the drugs mainly affect cancer cells in those area. The most commonly employed regional chemotherapy for ovarian cancer is Intraperitoneal (IP) chemotherapy (in which the anticancer drugs is place in the space containing abdominal viscera)
Combination chemotherapy (use of more than one anticancer drug) is recommended for women with high risk early stage disease and for women with advanced disease. Therefore, for most women, combination chemotherapy is prescribed, usually paclitaxel and carboplatin. However, for elderly women a single drug might be preferred. The way the chemotherapy is given depends on the type and stage of the cancer being treated.
In most cases, women with ovarian cancer suffer from psychological distress because of the repetitive chemotherapy and poor prognosis associated with this disease. Similarly, the approach to managements of the disease has significant effects on their social wellbeing
Radiotherapy
This kind of treatment involves the use of radiation to kill the cancer cells or stop the cancer from growing. The radiation as well can cause the tumour to shrink. The manner and the amount of the radiation to be given depend on the type, size and the location of the ovarian cancer in the body.
There are two types of radiotherapy, External radiotherapy and internal radiotherapy. The external radiotherapy involves the use of machine outside the body to deliver the rays (radiation) to the cancer cells. While, internal radiotherapy, the radioactive agents is place in the body directly into or near the cancer cells
However, some women receive another form of radiotherapy called intraperitoneal radiotherapy, in which the radioactive substance is place directly into the abdomen via catheter. Systemic radiotherapy requires the use of radioactive substance via blood stream to reach the cancer cells.
Biotherapy
This is a rare form of ovarian cancer treatment; it is usually recommended when the cancer cells are at early stage. It involves boosting the immune system of the patient to fight and restore the body’s natural defences against the cancer cells. This
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(Copyright © 2011 by U. Bala)
(Copyright © 2011 by U. Bala)