Chemotherapy For Ovarian Cancer
Ovarian cancer is a type of cancer that starts in a woman's ovaries, which are small, almond-shaped organs located on each side of the uterus. These ovaries are where eggs are produced and are a crucial part of the female reproductive system. Unfortunately, ovarian cancer can be sneaky, often not causing noticeable symptoms until it has spread within the pelvis and belly. When symptoms do appear, they might include things like bloating, pelvic or abdominal pain, difficulty eating, or feeling full quickly. Women must pay attention to their bodies and talk to their doctors about unusual changes. While ovarian cancer can be serious, early detection can improve the chances of successful treatment.
Ovarian cancer is a significant health issue in India, ranking as the third most common cancer affecting women's reproductive systems. Surprisingly, it often occurs in younger women, with many cases found in those under 55 years old. Unfortunately, most women (around 70% to 80%) are diagnosed at a late stage of the disease, where the chances of surviving for ten years are quite low, roughly between 15% and 30%. Treating ovarian cancer usually involves two main methods: surgery and chemotherapy. Let's dive deeper into how chemotherapy is used to treat ovarian cancer, exploring its types and effectiveness in battling this challenging disease.
Ovarian Cancer Chemotherapy: A Quick Guide
Before we explore chemotherapy for ovarian cancer in detail, let's answer some common questions you might have about this treatment:
1. What is chemotherapy?
Chemotherapy, often called "chemo," uses special drugs to fight cancer. It's a powerful treatment that works throughout your body, reaching almost all areas. For cancers like ovarian, fallopian tubes, or primary peritoneal cancer, chemo is a key treatment method.
2. When do I get chemotherapy?
Chemo can be given:
- After surgery, to lower the chance of cancer returning.
- Before surgery, to shrink the cancer cells and make surgery more effective.
- To treat cancer that can't be fully removed by surgery.
- As the main treatment if surgery isn't suitable for you or you cannot undergo a major operation.
3. Who needs chemotherapy?
The decision to use chemotherapy depends on your ovarian cancer's stage (how far it has spread) and grade (its appearance under a microscope). You might receive chemo if your cancer is,
- Stage 1c or higher.
- At an earlier stage (1a or 1b) with high grade.
- Recurrence.
4. How often is chemotherapy given?
You will undergo chemotherapy in a series of sessions, typically spaced out over one to three weeks, which is referred to as a cycle of chemotherapy. Each session of your chemotherapy will last a few hours. Afterward, you will have a rest period to recover from any side effects. You will usually receive chemotherapy once every three weeks, with the drugs administered on the first day of each cycle. This three-week period is one complete cycle of treatment. Your overall treatment will generally consist of around six cycles, although sometimes more may be needed.
Your treatment sessions will take place in the outpatient department and will last about three to four hours each. On rare occasions, the treatment may be given over 24 hours, in which case you would need to stay in the hospital overnight.
Chemotherapy Options for Treating Ovarian Cancer: Types
- Intravenous chemotherapy (injected into your vein)
- Oral chemotherapy (by mouth)
- Intraperitoneal chemotherapy (Injected through a catheter (thin tube) directly into the abdominal cavity)
a. Standard Intraperitoneal Chemotherapy
b. Hyperthermic Intraperitoneal Chemotherapy (HIPEC)
Chemotherapy drugs
Chemotherapy for ovarian cancer usually involves a combination of two types of drugs, as this approach often works better than using just one drug. The common combination includes a platinum compound (like cisplatin or carboplatin) and a taxane (such as paclitaxel or docetaxel). These drugs are typically given through an IV (intravenous) every 3 to 4 weeks.
Other chemotherapy drugs can be effective in treating ovarian cancer:
What is Intraperitoneal chemotherapy?
Intraperitoneal (IP) chemotherapy is a targeted ovarian cancer treatment where chemodrugs are pumped directly into your belly or peritoneal cavity. This method delivers a concentrated dose of chemotherapy right to the cancer cells, allowing for a more effective treatment over a longer period.
IP chemotherapy is different from the usual IV chemotherapy that goes into your bloodstream. Since it is administered only in your abdomen, it generally has fewer side effects on the rest of your body. Some of the chemo from the IP treatment also gets into your bloodstream through the lining of your stomach. This helps the drugs reach and fight any cancer cells that might have spread to other areas of your body.
Usually, IP chemotherapy is used along with standard IV chemotherapy. This is especially true for women with stage III ovarian cancer, where the cancer hasn't spread outside the abdomen and surgery has successfully reduced the tumors to a small size (no larger than 1 cm). In these cases, IP chemotherapy can be a powerful addition to the overall treatment plan, which often includes systemic chemo drugs like paclitaxel administered through a vein.
Standard Intraperitoneal Chemotherapy
In standard IP chemotherapy for ovarian cancer, the treatment is given through a small tube, known as a catheter, which is placed in your upper belly. This catheter connects to a soft, round disk called an IP port, surgically attached under your skin near your rib. You can feel this port as a small bump under your skin. It has a special opening on top called a reservoir.
For this treatment, doctors often use a combination of two different chemo drugs–cisplatin and paclitaxel, because it is more effective, particularly against the most common type of ovarian cancer, known as epithelial ovarian cancer. Your doctor will insert a needle into the port's reservoir to infuse these drugs directly into your abdomen. This direct delivery method precisely targets cancer cells, enhancing the efficiency of the treatment.
Hyperthermic Intraperitoneal Chemotherapy (HIPEC)
Hyperthermic Intraperitoneal Chemotherapy (HIPEC), also known as "hot chemotherapy," is a unique treatment performed right after surgery to remove ovarian tumors. In this procedure, your abdominal cavity is filled with a warm chemotherapy solution, specifically heated to 1030F, like the drug cisplatin. The warmth is thought to help the chemo work better in killing any cancer cells left after surgery.
HIPEC is a one-time procedure done in the operating room, so you don't need multiple sessions. After HIPEC, you will receive nutrition through a feeding tube or IV for about two weeks. This helps your gut rest and recover from the intense chemo.
Managing Side Effects of Chemotherapy
Chemotherapy for ovarian cancer can have side effects, but remember, they are usually manageable with medications and tend to disappear once the treatment is over. It is important to know that not everyone experiences the same side effects from chemotherapy. In fact, some people have very few. Your doctor or nurse will give you an idea of what you might expect. Before starting treatment, have a detailed chat with your healthcare team about all the possible side effects of chemotherapy. They will also guide you on handling and overcoming the side effects of chemo effectively. This way, you will be better prepared and know what to do if they occur.
The End Notes
In conclusion, chemotherapy for ovarian cancer, with its various types and approaches, plays a crucial role in battling this challenging disease. While the journey through chemotherapy can seem daunting, especially with the possibility of side effects, it is important to remember that these are typically manageable and temporary. The effectiveness of treatments like standard IP chemotherapy and innovative methods like HIPEC offers hope and a fighting chance against ovarian cancer. Always keep in mind that you are not alone in this journey – your healthcare team is there to guide, support, and help you through every step. Remember, each step you take in this treatment is a step toward healing and recovery.
"Conquer the Ovarian Cancer in Every Cycle"
