As most of these tumours arise in relatively young women or teenagers,
maintenance of the woman's ability to bear children is a major issue.
Fortunately, these tumours tend to be very sensitive to chemotherapy.
This means that radical cancer operations which involve the removal of
both ovaries and the uterus
are often not needed, even if there is stage II, stage III or stage IV
disease. However, in women who have finished child bearing, removal of
both ovaries and the uterus is generally recommended.
After surgery, the patient should be treated with chemotherapy. The
choice of chemotherapy drugs is dependent on the tumour. Anywhere between
4 and 6 cycles of chemotherapy are generally given.
Recent studies on the reproductive potential of women who have been
treated for germ cell cancers show that a significant number go on to have
further children. Chemotherapy does not linger long in the body, so it is
perfectly safe for women to become pregnant a couple of months after
receiving treatment. It should also be noted that becoming pregnant does
NOT increase the risk of a recurrence.
Surgery
Surgery for ovarian cancer is a major operation. The patient will
generally be in hospital for anywhere from 7-14 days depending on how fast
they recover from the surgery and whether or not they receive their first
cycle of chemotherapy while still in hospital.
Pain relief after surgery is usually very good. Most patients will have
both an epidural
and a general
anaesthetic for their surgery. This means that they wake up quicker
and recover more easily. The epidural can be left in for 3 days, during
which time it will continue to provide pain relief. When it is removed,
other drugs may be given for pain relief, but by then the worst of the
pain has passed.
It is important that patients have proper follow-up after care following treatment for ovarian cancer. These check-ups will generally involve a physical examination and a laboratory blood test called a
CA 125
assay. Often the CA 125 level in a patient's blood is high before treatment and falls during surgery and chemotherapy. If the CA 125 level begins to rise again, it may be an indicator that the cancer has recurred. However, there may be other reasons, unrelated to cancer, for the CA 125 level to rise.
The usual follow-up protocol is to be seen:
