Understand that you will probably have recurrent symptoms with ovarian cancer, and talk to your doctor about how to reduce the discomfort from these symptoms. Typical complaints to ask your doctor about include:
- Constipation. Constipation can occur if cancer returns after treatment. Your doctor can recommend stool softeners and laxatives.
- Nausea and vomiting. Your doctor will prescribe anti-nausea drugs to help with this typical side effect of chemotherapy.
- Pain. Most pain experts believe that it is easier to control pain before it becomes severe. Talk with your doctor about a plan for pain management.
Make sure you know how to deal with the psychological consequences of ovarian cancer, as well as the menopausal symptoms that occur if you have your ovaries removed.
- Depression or anxiety. Many women benefit from a support group. Some also find anti-anxiety or antidepressant medications helpful during this difficult time.
- Menopausal symptoms. Removing the ovaries in premenopausal women induces menopause, often causing hot flashes, vaginal dryness, sleep disturbances, decreased sex drive, and moodiness. In this case, hormone replacement therapy (HRT) can help to reduce symptoms. But HRT can also increase breast cancer risk. Women with a history of ovarian cancer should discuss HRT therapy with their doctors.
- Some women find relief from hot flashes by drinking cold water. Keep ice water by your bed to drink when you feel a hot flash coming on. Vaginal lubricants, such as Astroglide, can alleviate dryness. Exercise may help sleep problems and elevate mood
Your doctor is the best source of information on the drug treatment choices available to you.
Radiation has a less important role in the treatment of ovarian cancer, although it is used in some circumstances. Radiation is usually not advised for ovarian cancer. In many cases, the entire abdomen would require radiation to destroy the cancer; however, the normal liver and kidney cannot tolerate high levels of radiation. Radiation is sometimes used:
- to shrink the tumor before other treatments are given
- if cancer is limited to the pelvis
- to shrink brain metastases
Other experimental therapies include monoclonal antibodies, anticancer vaccines, and gene therapy. Experimental therapies for advanced disease include the development of monoclonal antibodies, which in this case are antibodies that are directed against the ovarian cancer cells, or against substances that are produced by the cancer cells.
Other research is attempting to develop vaccines against an individual’s unique cancer. For this procedure, tumor cells are removed from the patient and grown in a laboratory.
In gene therapy research, genetic material is introduced into the cells to make them more readily identifiable to the body’s immune system. They are then returned to the patient’s body in the hopes that the immune system will respond by killing cancer cells.
Surgery is the first step in the treatment of all types of ovarian cancer. The goal of surgery is to try to remove as much of the cancer as possible. Because not all the cancer may be visible, chemotherapy is advised in most cases following surgery. In stage I cancer, in which cancer is confined to the ovaries with no indication of spread, removal of the ovaries may be all that is required. Other women may need a total hysterectomy and removal of the omentum, a fatty padding covering the intestines.
If caught in the earliest stage, ovarian cancer has a good prognosis. Even in more advanced disease, many women can expect to undergo a period of remission or cure after initial treatment. Ovarian cancer caught in stage I has a good prognosis, with a five-year survival rate of around 93%. Unfortunately, the majority of cases are caught after the cancer has spread, when it is much harder to cure: the overall 5-year survival rate for all stages of ovarian cancer is only 42%. Women in stage III or IV have an average five-year survival rate of less than 25%—for African-American women, this figure is even lower. Many women with more advanced disease can achieve a complete remission of the disease following surgery and chemotherapy. During remission, no evidence of the disease can be detected. Because cancer cells remain hidden in the body, however, most women have disease recurrence within a few years.
Even after apparently successful treatment of ovarian cancer, regular follow-up is essential. After treatment of ovarian cancer, periodic CA 125 measurements allow the detection of cancer recurrence as early as possible. You may undergo follow-up CT scans as well. Contact your doctor for any symptoms of recurrence, such as changes in appetite, weight change, nausea, or vomiting.
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