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Diseases & Conditions

Ovarian Cancer

Cancer of the ovary is one of the most common gynecologic malignancies. The most common type of ovarian cancer arises from the cells covering the surface of the ovary and is known as epithelial carcinoma. Two other major kinds of ovarian cancers are; germ cell, arising from the eggs, and ovarian stromal tumors, which arise from supportive tissue. These are relatively uncommon and account for less than 10% of ovarian malignancies.

Symptoms

An ovarian cancer can grow to considerable size before it causes any symptoms. The first symptom may be vague discomfort in the lower abdomen, similar to indigestion. Uterine bleeding is not a common symptom. Enlarged ovaries in a postmenopausal woman may be an early sign of ovarian cancer, although they can be caused by cysts, non-cancerous growths, and other conditions. Fluid may accumulate in the abdomen. Eventually, the abdomen may swell because of the enlarging ovaries or accumulating fluid. At this stage, a women may feel pain in her pelvis, may be anemic, and may lose weight. Rarely, ovarian cancers secrete hormones that cause excessive growth of the uterine lining, enlargement of the breasts, or increased hair growth.

Therapy

Chemotherapy for platinum-sensitive disease

Patients who had a good response to initial platinum-based chemotherapy and recur six months or more after completion of therapy are considered to have platinum-sensitive or drug-sensitive disease and have the greatest likelihood of responding to the same or similar treatment again.

In general, the longer the chemotherapy-free interval (CFI), the greater the response to second-line chemotherapy, although the duration of this second response may not be as lengthy as the first. The goals of second-line chemotherapy for recurrent ovarian cancer include improving quality of life, delaying the time to further cancer progression and development of symptoms, and possibly prolonging survival.

Chemotherapy for platinum-resistant disease

Patients that did not respond favorably to initial chemotherapy or with disease that recurred within six months of completion of initial platinum-based chemotherapy (a short chemotherapy-free interval, CFI), are considered to have platinum-resistant or drug-resistant disease. The goals of second-line chemotherapy for recurrent ovarian cancer include improving quality of life, delaying the time to further cancer progression and development of symptoms, and possibly prolonging survival.

Tamoxifen therapy (hormone therapy)

Hormone therapy treatment for recurrent ovarian cancer. Tamoxifen is an "anti-estrogen" drug that is commonly used to treat breast cancer. Ovarian cancer can also respond to hormone therapy and Tamoxifen may be an effective treatment for some women with recurrent ovarian cancer.

Secondary cytoreductive surgery

Secondary cytoreductive surgery refers to surgery performed to remove persistent cancer that has not responded favorably to initial chemotherapy or recurrent cancer (cancer that returns after complete disappearance or remission following primary treatment). Secondary cytoreduction is usually performed in patients with advanced ovarian cancer, stage III or IV.

Some early stage ovarian cancers, stage I or II, can also recur and require a second surgery but recurrence of true early stage disease is far less common than in stage III or IV ovarian cancer. The goal of secondary cytoreductive surgery is to remove as much tumor as possible, to relieve symptoms, and in prolong survival to the greatest extent possible.

Treatment of disease complications

Medical or surgical treatments performed to relieve distressful or detrimental symptoms from the complications of a disease or treatment. Complications are secondary medical problems (added difficulties) that develop following a medical procedure, treatment, or illness. Complications are usually related, directly or indirectly to a procedure (risk of the procedure), treatment (side effect or toxicity), or the illness itself.

Stem cell transplant (SCT)

This involves the use of high dose therapy (chemotherapy) to attack any cancer cells in the body. This is followed by a "rescue" of stem cells to replace the old bone marrow that is harmed by the high dose therapy. This replacement will allow the new bone marrow to create new blood cells.