All cases of ovarian cancer can be treated. Treatments will depend on
the age of the patient, her desire to have children, the type of tumour
and the stage of the tumour. There are three types of treatment used for
ovarian cancer: surgery, radiation
therapy and chemotherapy.
If the disease is limited to one ovary, and occurs in a young woman who
wishes to retain her ability to bear children, then treatment would be
removal of the fallopian
tube and ovary on that side, as well as removal of the omentum
and lymph
nodes in the pelvis
and para-aortic
region on the same side as the tumour. A decision as to whether or not the
patient also received chemotherapy would have to await the pathology
report on this operation.
If the tumour was limited to the inside of the cyst
on that ovary, and there was no evidence of anything on the surface of the
tumour itself, the patient would not receive chemotherapy unless it was a clear
cell tumour.
If the disease has spread beyond one ovary (stage Ib or beyond) then
generally the treatment will be to leave the patient with no visible
evidence of tumour. This will usually require a hysterectomy,
removal of both tubes
and ovaries, removal of the omentum and multiple
biopsies. If it is an advanced disease (i.e. Stage III) then bowel
resections followed by chemotherapy may be required.
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
she recovers from the surgery and whether or not she receives her first
dose 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 medication may be given for pain relief, but by then the worst of
the pain will have 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:
