women s health issues
Ovarian Cancer, Fallopian Tube Cancer, and Peritoneal Cancer
Treatment of Ovarian Cancer
Usually removal of ovaries, fallopian tubes, and uterus Removal of all tissue that appears affected (cytoreductive surgery) Usually chemotherapy The extent of surgery depends on the type of ovarian and fallopian tube cancer and the stage. When ovarian and fallopian tube cancers are first diagnosed, they have usually spread throughout the abdomen, so treatment typically involves one of the following: Surgery to remove as much of the tumor as possible, followed by chemotherapy Chemotherapy, followed by surgery and more chemotherapy For most ovarian and fallopian tube cancers, treatment involves removing the ovaries and fallopian tubes (salpingo-oophorectomy) and the uterus (hysterectomy). Treatment may be done first to determine whether more extensive surgery is a useful option. If it is not, chemotherapy is started. When cancer has spread beyond the ovary, nearby lymph nodes and surrounding structures that the cancer typically spreads to are also removed. This approach aims to remove all visible cancer. If a woman has stage I cancer that affects only one ovary and she wishes to become pregnant, doctors may remove only the affected ovary and fallopian tube. For more advanced cancers that have spread to other parts of the body, doctors usually remove as much of the cancer as possible to prolong survival. This type of surgery is called cytoreductive surgery. However, depending on where the cancer has spread and how much cancer is present, women may be treated with chemotherapy instead of or before and after surgery. After surgery, most women with less aggressive stage I epithelial carcinomas require no further treatment. For other stage I cancers or for more advanced cancers, chemotherapy may be used to destroy any small areas of cancer that may remain. Most women with germ cell tumors can be cured with removal of the one affected ovary and fallopian tube plus a combination of two or more chemotherapy drugs. Radiation therapy is rarely used. Advanced ovarian cancer usually recurs. So after chemotherapy, doctors typically measure levels of cancer markers (such as CA 125). Cancer marker levels that remain high usually mean that some of the tumor remains. If the cancer recurs after chemotherapy appeared to be effective, chemotherapy is repeated. Many different chemotherapy drugs or combinations of drugs may be used. 