ovarian cancer : Treatment

There are three main forms of treatment for ovarian cancer:

Surgery to remove cancerous tissue.
Chemotherapy to destroy cancer cells using strong anti-cancer drugs.
Radiotherapy to destroy cancer cells by high-energy radiation exposure.
There are also many combinations of these treatment methods and it is usually worthwhile to get a second opinion about treatment before entering into a specific program. Treatment depends upon a number of factors (e.g., stage and grade of the disease, the histopathologic type, and the patient's age and overall health).

Surgery
Surgery usually is required to treat ovarian cancer. Most patients undergo surgery in addition to another form of treatment (e.g., chemotherapy and/or radiotherapy). Surgery helps the physician to accurately stage the tumor, make a diagnosis, and perform debulking (removal of as much tumor mass as possible). Debulking surgery is especially important in ovarian cancer because aggressive removal of cancerous tissue is associated with improved survival. Patients with no residual tumor mass, or tumor masses that measure less than 1 cm, have the best opportunity for cure.

The surgeon usually performs a laparotomy (through an abdominal incision) or laparoscopy (using a tube containing a light and camera that is inserted into the pelvic cavity through a small incision). A sample of the tumor (called a frozen section) is examined immediately under a microscope to confirm ovarian cancer and rule out metastasis from another site. If the cancer is a metastasis from another organ, the surgeon searches for the primary tumor within the abdominal cavity.

Once ovarian cancer is confirmed, a total hysterectomy (removal of the uterus [womb]), bilateral salpingo-oophorectomy (removal of the fallopian tubes and ovaries on both sides), omentectomy (removal of the fatty tissue that covers the bowels), lymphadenectomy (removal of one or more lymph nodes) may be performed. Tissue removed during debulking is sent for histopathological examination.

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