GYN Cancer - Ovarian

Ovarian cancer, occurring in a woman's ovaries, can be difficult to diagnose as the symptoms can be subtle or mimic other problems. However, ovarian cancer is the fifth leading cause of cancer death among women in the United States. Northside Hospital diagnoses and treats more cases of gynecological cancers, including ovarian, than any other hospital in Georgia. In addition to Northside's expertise, experience and team approach, patients and their families receive educational and emotional support.

Risk Factors

Women have a lower risk if they have more children and have given birth at an early age. Women with a personal history of breast cancer, or a family history of breast or ovarian cancer have an increased risk. Older women are at highest risk and about two-thirds of the deaths from ovarian cancer occur in women age 55 and older.

Symptoms

Women with ovarian cancer report that symptoms are persistent. The frequency and/or number of such symptoms are key factors in diagnosing the disease. Women who have the symptoms almost daily for more than a few weeks should see their doctor, preferably a gynecologist. Prompt medical evaluation may lead to detection at the earliest possible stage and is early associated with an improved prognosis.

  • Bloating
  • Pelvic or abdominal pain
  • Difficulty eating or feeling full quickly
  • Urinary symptoms (urgency or frequency)

Secondary Symptoms:

  • Unexplained changes in bowel habits
  • Unexplained weight gain or loss
  • Fatigue
  • Pain during intercourse
  • Abnormal menstrual cycles
  • Vaginal bleeding
  • Unexplained back pain that worsens over time

Exams and Tests

Contrary to what some women believe, a Pap test does not detect ovarian cancer. A physical examination may reveal increased abdominal girth and fluid within the abdominal cavity. Pelvic examination may reveal an ovarian or abdominal mass. Tests may include:

  • CA125
  • General blood test
  • Urinalysis
  • Colposcopy
  • Exploratory laparotomy
  • Ultrasound
  • Abdominal CT scan or MRI of abdomen

Treatment

Treatment for ovarian cancer depends on several factors including the stage and type of the disease. Most women have surgery and chemotherapy.

Surgery
If ovarian cancer is discovered during surgery, the surgeon removes both ovaries, fallopian tubes, uterus, omentum, nearby lymphnodes and samples of tissue. Debulking, or removing as much of the cancer as possible, occurs if the cancer has spread.

Patients having surgery at Northside benefit from an experienced robotic surgery program, whose surgeons are experts in minimally invasive surgery, having worked together for years. Robotic surgery offers an alternative to traditional surgery. Patients can benefit from shorter hospital stays, less pain and scarring, and faster recovery times. Procedures such as hysterectomies, oophorectomies and staging can be done with the daVinci robotic system.

Heated intraperitoneal chemotherapy (HIPEC) is an integral part of treatment for many patients with ovarian cancer. HIPEC delivers chemotherapy, which has bene heated to a temperature lethal to cancer cells, directly into the abdomen at the time of surgery. HIPEC provides an alternative to improve prognosis for patients with metastatic ovarian tumors. Combining HIPEC and minimally invasive robotic surgery, Northside performed the first robotic HIPEC surgery for ovarian cancer in 2011.

Who can be treated with HIPEC?

  • Patients who have been diagnosed with ovarian cancer for the first time with a biopsy of a mass or with a sample of fluid from the abdomen
  • Women with recurring ovarian cancer
  • Women whose cancer originated in the peritoneum
  • Women with pseudomyxoma peritonei, a mucus-producing cancer of the appendix

Chemotherapy
Chemotherapy is a form of treatment used to stop cancer cells from growing.

Radiation
Radiation kills cancer cells by delivering beams of irradiation. Radiation may be used before the surgery to shrink a tumor or after surgery to kill remaining cancerous cells.

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