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Ovarian Colorado

Information for Patients

Types of Treatment

The course of treatment depends on several factors. It is important to know the stage and grade of the cancer as well as the particular cell type. Knowing if the cancer is confined to the ovary or has spread to distant sites can affect your treatment options. Treatment typically includes surgery, possibly chemotherapy and sometimes radiation therapy.

Surgery

It is extremely important that the patient is referred to a gynecological oncologist who has experience with the specific surgery (debulking) required for the diagnosis and staging of ovarian cancer. Tissue samples are taken and sent to pathology for evaluation and identification of the cell type. Numerous biopsies are taken from the abdomen and pelvic region to include the diaphragm. The appendix and abdominal lymph nodes are removed for examination of possible cancer spread. The omentum, a peritoneal tissue layer that connects or supports abdominal structures, is removed and examined. A peritoneal wash is done to see if there are microscopic cancer cells in the abdominal and pelvic region. Most often the reproductive organs (ovaries, fallopian tubes, uterus, cervix) are removed for examination. In some cases of early stage disease, and in younger women of child bearing age, it may be possible to only remove the cancerous ovary, leaving the rest of the reproductive organs for women who wish to have children.  In more advanced disease, it my be necessary for the patient to have chemotherapy to shrink the tumor before surgery can occur.

Staging is a result of the surgical process and informs the health care provider how early or how advanced the cancer is. This is an important part of surgery as it guides the type of treatment that is to follow.  There are 4 Staging groupings.
                      Stage I:        The cancer is confined to the ovary.
                      Stage II:       The cancer is in one or both ovaries and has spread
                                           to nearby organs in the pelvic area.
                      Stage III:      The cancer is in one or both areas and has spread beyond
                                           the pelvic region into the abdomen and/or the lymph nodes.
                      Stage IV:      The cancer has spread to distant organs in the body such as
                                           the liver and lungs. This is referred to as metastasis

In addition to the staging, grade categories describe the cell and can give an indication of spread of disease. There are also ‘N’ (node) categories that provide information about the spread of cancer to lymph nodes and ‘M’ (metastasis) that indicate where cancer has spread to distance sites. ‘T’ (tumor) describes the character of the tumor.

There are several ovarian cancer cell types that are important to discover as that too can influence the course of treatment. For example, clear cell carcinoma can be unpredictable, even when confined to the ovary and it can be aggressive in later stages.

For a more comprehensive description of staging and the categories of that process, go to the link for the American Cancer Society in the ‘Resource’ section of this website.

Chemotherapy

After surgery, the standard chemotherapy for many ovarian cancer patients includes 6 to 8 courses of a combination of drugs every 3 weeks. The drugs include a platinum drug, cisplatin or carboplatin and a taxane drug, such as paclitaxel.  These are delivered through a port, a devise inserted under the collar bone, so that the drugs can go into the blood stream and circulate throughout the body.

A relatively new drug regimen for women diagnosed with advanced disease is ‘Intraperitoneal (IP) Chemotherapy.’ A port is surgically placed so that the chemotherapy drug is injected directly into the abdomen.  Studies have shown that the survival rates of women can be increased using this method, however, the side effects can be increased.

More information can be accessed in the resource section of this website.