Ovarian Cancer Treatment in Ahmedabad: Symptoms, Diagnosis and Advanced Treatment
By Dr. Ridham Shah
GI, HPB & Cancer Surgeon
Ahmedabad
Introduction
Ovaries , the organ which is responsible for the hormonal balance and reproduction. Ovaries are the tiny pelvic structures , size of which changes dynamically during menstrual cycle. Ovarian tumors have presentations which can vary from like having no specific symptoms to complex large masses of more than even 20 cm or even 30 in size , involving different other organs of abdomen .
Types of Ovarian Cancer
Epithelial Ovarian Cancer
Most common type, accounting for nearly 90% of ovarian cancers.
Germ Cell Tumors
Usually occur in younger women.
Sex Cord Stromal Tumors
Can produce hormones and are less common.
Risk Factors
- Increasing age
- Family history
- BRCA1/BRCA2 mutation
- Never having been pregnant
- Obesity
- Smoking
- Endometriosis
Diagnosis
To detect Cancer of ovary we must listen to our body . Anything which is persistent should be checked . Common symptoms are persistent bloating, persistent abdominal heaviness , persistent constipation , Abdominal fullness . These are all symptoms to which we don’t give more attention .
Most important investigations for diagnosis of Ovarian cancer is a CT scan of abdomen which will characterize the ovarian masses, their relation to the surrounding structures and also guide the possible treatment options .
Some times in real world scenario to differentiate between benign and malignant tumors of ovary can be difficult, in those cases we can use live biopsy which is known as frozen section in which pathologist guides surgeon in the diagnosis
For advance cases in which cancer has spread to the other parts of abdomen and body PET CT scan can be used for staging purpose
There are some blood reports which are known as tumor markers are also useful in the diagnosis and management of ovarian cancer , they are Ca 125, AFP, B hcg and seum LDH levels which are used in different types of cancer.
Treatment
To understand the treatment of ovarian cancer , I would like to share a new concept with you , The word PERITONEAL SURFACE MALIGNANCY. Ovarian cancer is grouped in that. You will be surprised to know that if ovarian cancer has spread to other parts in abdomen it is still staged as stage 3 because it has a special propensity for the peritoneum . In the Picture given below it is showing the movement of the peritoneal fluid inside the peritoneal cavity and it also shows the way of spread of ovarian cancer.
Surgery
Ovarian cancer treatment has 2 options 1st is surgery and 2nd is chemotherapy . They are used separately or in combination depending upon the what is the stage of the tumor . In early cases surgery is only required
Ovarian cancer surgery has a wide spectrum and to simplify it the word which is used is cytoreductive surgery which means that remove all the disease which is visible.
Earlier the diagnosis , it is better why because we requires less surgery and it can also be performed with key hole surgeries like laparoscopy and robotic techniques.
In advance cases more than one organ resection which means multiple organ resection is required to remove all the visible disease from the body in the below picture usual specimen of a cytoreductive surgery is shared .
Chemotherapy
Systemic therapy , means chemotherapy has 2 components one which is given intravenously and one which is given during Surgery .
Intra venous chemotherapy is used either before surgery or after surgery and purely depends upon the stage of the disease .
Chemotherapy which is used during surgery is called HIPEC , in which a machine is used to heat and transfer the chemotherapy drugs during surgery.
All said and done the treatment of ovarian cancer is complex and it requires good hospital infrastructure, good surgical team and support of the patient for long treatment.
Final Message
Listen to your body. Persistent symptoms should never be ignored. Early diagnosis, timely treatment, and expert surgical care can significantly improve outcomes. Trust science, follow your treatment plan, and seek expert medical advice without delay
