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Ovarian cancer treatment: What options are there?



Treatment with Ovarian Cancer can lead to overwhelming treatment options, but if you suffer from this disease, this is part of the process.

There are five main forms of ovarian cancer treatment. However, the type of ovarian cancer that you have and how far you have progressed does matter in what form (or forms) the treatment is recommended by your doctor. Read all you need to know about ovarian cancer treatment options below.

. 1 Surgery

According to the American Cancer Society this is considered the cornerstone for the treatment of most types of ovarian cancer. Ovarian cancer is often diagnosed in later stages so the removal of as much as possible is crucial in the treatment of the disease.

The extent of the surgical procedure usually depends on the type of ovarian type on cancer you have. Here is a breakdown:

Epithelial ovarian cancer : This begins in the thin tissue layer that covers the outside of the ovaries, according to the Mayo Clinic . It accounts for about 90 percent of ovarian cancers, says the ACS .

If you suffer from this type of ovarian cancer, the surgery is likely to be "staggered" to see where the cancer has spread next to the ovary. Typically, this means that you need to remove your uterus in hysterectomy as the uterus is often affected at the time of diagnosis of this type of ovarian cancer. This includes the removal of ovaries and fallopian tubes (bilateral salpingo-oophorectomy). (Many ovarian cancers actually begin in the fallopian tubes, so these organs are removed.)

Epithelial ovarian cancer sometimes spreads to the omentum, a layer of fat that covers the abdominal contents, so that it is usually removed for staging purposes, such as there are some lymph nodes in the pelvis and abdomen, says the ACS . All tissue and fluid samples taken during the operation are sent to a lab to search for cancer cells.

Epithelial ovarian cancer surgery also debulks the remaining cancer with the goal of leaving no visible cancer. No tumors larger than one centimeter say ACS .

Germ cell ovarian cancer : This type of ovarian carcinoma begins in the ovarian cells that produce eggs, and makes less than 2 percent of total ovarian cancers .

It is less likely that germ cell ovarian cancer will spread to the uterus and surrounding areas such as the lymph nodes. Stephen Rubin, MD, chief of the Department of Gynecologic Oncology at Fox Chase Cancer Center, says SELF. However, the first-line treatment is often the same as in epithelial ovarian cancer, as shown in ACS : staging by removal of the uterus and both ovaries / fallopian tubes and possibly demystification.

Your doctor thinks the cancer is only in one ovary and you want to be able to physically carry a future pregnancy; you may be fine with removing the cancerous ovary and fallopian tube on the same side, says Dr , Ruby. You may recommend removing the other ovary, the fallopian tube and the entire uterus if you have not carried any pregnancies, according to ACS . However, if you have a BRCA gene mutation doctors will usually remove both the ovaries and fallopian tubes, as the cancer risk for the other ovaries is high, Dr. Ruby. Stromal.

Ovarian cancer: This begins in the ovarian tissue, which contains hormone-producing cells, and appears to make up about 1 percent of ovarian cancers, says the Mayo Clinic .

Ovarian stromal tumors are normally only present in one ovary, so surgery can only remove the ovary and fallopian tube, says the ACS . However, if the cancer has spread or if you have a BRCA gene mutation, you may need to remove more tissue, which may mean hysterectomy and bilateral salpingo-oophorectomy. Even if it has not spread and you do not have a BRCA gene mutation, your doctor may recommend removing the other ovary / fallopian tube and uterus as soon as you're done with the pregnancy, just like with germ cell ovarian cancer. ACS says.

A significant, potentially life-changing result of ovarian cancer surgery is that removing the uterus means you can not get pregnant. If you remove your ovaries, you will get into menopause if you have not had them yet. Both realities can also have emotional effects, so do not hesitate to discuss this with your doctor.

. 2 Chemotherapy

As you probably already know, chemotherapy involves the use of certain cancer treatments, explains ACS .

Chemo is usually a systemic treatment, meaning the drugs go into your bloodstream to reach almost all areas of your body. These drugs are usually injected into the vein or administered by mouth, but in some cases they can be injected through a thin tube directly into the abdominal cavity, says the ACS . In any case, chemotherapy aims to kill even small amounts of cancer cells that may still be in your body after surgery, to treat the spread of cancer, or to downsize large tumors for easier removal during surgery ,

"Chemotherapy is almost always used except at very early stages or in some slow-growing cancers," explains Robert Wenham, chairman of the Moffitt Cancer Center gynecological oncology program, to SELF. In these cases, surgery could be enough, he explains.

Chemo can cause side effects such as nausea and vomiting, hair loss, tiredness, mouth sores, constipation, diarrhea and more. Here is some information on Dealing with Side Effects of Chemotherapy .

. 3 Radiation

High-energy x-rays or particles are used to kill cancer cells, ACS . Radiation is not as effective as chemotherapy for ovarian cancer, which is why it is not usually the main treatment for someone who is dealing with the disease. However, it may be helpful in treating areas in which the cancer has developed beyond the ovary, says [ACS.

It is not uncommon for epithelial ovarian cancer (the most common form) to be disseminated . in the entire abdominal and pelvic area of ​​a person and even in the lining of the organs in the chest like the lungs, reports Dr. med. Caryn St. Clair, a gynecological oncologist at the New York Presbyterian / Columbia University Irving Medical Center, opposite SELF. "That's why the treatment must reach the chest, abdomen and pelvis," she says. Although radiotherapy would require the treatment of these specific areas, chemotherapy works at a stroke on your bloodstream. In addition, there are many sensitive organs in your pelvis that could be inadvertently damaged during radiation therapy. Ruby. For example, pelvic irradiation can sometimes lead to long-term difficulties, says ACS .

When you receive radiation, the effect on your body may vary depending on the position Treatment is being used. In general, side effects after the ACS can include problems such as hair loss, nausea, and diarrhea. Some side effects, such as fatigue, can occur wherever you seek treatment.

. 4 Hormone therapy

In hormone therapy, hormones or alternatively hormone blockers are used to fight cancer, says ACS .

The drugs used may be luteinizing hormone-releasing hormone (LHRH) agonists that shut down the production of estrogen in the ovaries (this hormone may stimulate cancer development). LHRH agonists can cause menopausal symptoms such as vaginal dryness and hot flushes, and over time they can weaken bones and possibly lead to osteoporosis, as in ACS .

Hormone therapy with the drug tamoxifen is also common. It works to prevent estrogens circulating in your body, stimulating the growth of cancer cells. This can also cause symptoms of menopause, but because it has the effect of a weak estrogen, it does not affect bone strength, says the ACS . However, it may increase the risk of blood clots in the legs as estrogen increases the coagulation factors in your blood .

The definitive type of hormone therapy relies on aromatase inhibitors, which are drugs that block an enzyme called aromatase, which converts other hormones into estrogen. The most common side effects include hot flushes, joint and muscle pain and thinning of the bones, says ACS .

. 5 Targeted Therapy

As the name implies, targeted therapeutic drugs target targeted cancer cells while leaving normal cells largely alone, ACS . This form of therapy confuses the way a cancer cell grows, separates, improves, and interacts with other cells.

There are several options here, including the drug bevacizumab, which binds to a protein called VEGF. ACS explained. VEGF requires the formation of new blood vessels, but tumors can use these blood vessels to grow. Thus, by acting on VEGF, bevacizumab can reduce or completely stop the growth of cancer cells, according to ACS . Common side effects of this type of targeted therapy include hypertension, fatigue, mouth sores, headache and anemia. It can also cause more serious blood-related side effects such as blood clots and heavy bleeding. Bevacizumab seems to work even better when combined with chemotherapy, says ACS which may add its own side effects.

Another treatment uses poly (ADP) ribose polymerase inhibitors (PARP inhibitors). , PARP enzymes usually help to repair damaged DNA in the cells, which sounds like a good thing – but it's not that these enzymes help the tumor cells repair themselves after they've been damaged. Therefore, PARP inhibitors block this pathway and make it difficult for tumor cells to repair damaged DNA. As a result, these cells usually die. These drugs can be particularly helpful in people with BRCA gene mutations says ACS because they can kill mutant cells that promote ovarian and breast cancer.

PARP inhibitors can cause the same problems as many of these other medications, such as nausea, vomiting, diarrhea, and muscle and joint pain, according to ACS . PARP inhibitors have been associated with blood cancers much less often, but do not be put off. Instead, weigh the risks and benefits of this type of treatment with your doctor.

Depending on your cancer and advanced cancer, your doctor may recommend one or more treatment options. Wenham says, "A mix of surgeries to remove as much cancer as possible, and chemo to kill off remaining cancer cells." Even then, the specificity of your condition will determine whether to undergo chemotherapy or surgery first.

If you are not sure whether your BRCA gene status exists, your doctor may also recommend a genetic test if you have a mutation that affects the onset of ovarian cancer. It all depends on your specific case.

"Number one is that you are being treated by a doctor with an ovarian cancer experience," Dr. Ruby. "You can best recommend using treatment strategies."

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