Olive oil is beneficial when used as a tanning oil. Olive oil protects skin from harmful UVA rays and sunburns. Olive oil is also effective on peptic ulcers, bone development, nervous system development and lower the risk of cancer.
People who are consuming two or more cups of tea a day over a period of time may reduce the risk of ovarian cancer as compared with women who drank no tea. The Chinese people have long practiced the use of green tea to appease any form of disease. Studies have revealed effective phytochemicals contained in the tea that are known to fight cancer that comes in the form of leukemia, colon cancer, breast cancer, lung cancer, pancreatic cancer, ovarian and cervical cancer, and pelvic cancer.
Taking bitter melon and soy bean more oftenly can also lower the risk of cancer.
Wednesday, September 27, 2006
Monday, September 18, 2006
Ovarian cysts in women
Most often, cysts in early age in women are not cancerous. Women who are past menopause (ages 50-70) with ovarian cysts have a higher risk of ovarian cancer. At any age, if you think you have a cyst, it's important to tell your doctor.
they are usually found during a routine pelvic exam. During this exam, your doctor is able to feel the swelling of the cyst on your ovary. Once a cyst is found, the doctor may perform an ultrasound, which uses sound waves to create images of the body.
To find out if the cyst might be cancerous, your doctor may do a blood test to measure a substance in the blood called CA-125. The amount of this protein is higher if a woman has ovarian cancer. However, some ovarian cancers do not make enough CA-125 to be detected by the test.
After menopause, the risk of ovarian cancer increases. Surgery to remove an ovarian cyst is usually recommended in this case. Your doctor will probably want to do a biopsy to see if cancer is present.
You may not need any treatment, unless the cyst is very big or causing pain. Sometimes, taking birth control pills will make the cyst smaller. Surgery may be needed if the cyst is causing symptoms or is more than 2 inches across.
they are usually found during a routine pelvic exam. During this exam, your doctor is able to feel the swelling of the cyst on your ovary. Once a cyst is found, the doctor may perform an ultrasound, which uses sound waves to create images of the body.
To find out if the cyst might be cancerous, your doctor may do a blood test to measure a substance in the blood called CA-125. The amount of this protein is higher if a woman has ovarian cancer. However, some ovarian cancers do not make enough CA-125 to be detected by the test.
After menopause, the risk of ovarian cancer increases. Surgery to remove an ovarian cyst is usually recommended in this case. Your doctor will probably want to do a biopsy to see if cancer is present.
You may not need any treatment, unless the cyst is very big or causing pain. Sometimes, taking birth control pills will make the cyst smaller. Surgery may be needed if the cyst is causing symptoms or is more than 2 inches across.
Monday, September 11, 2006
ovarian cancer : High-risk groups
Groups at high risk for ovarian cancer include:
Women with a strong family history of breast and/or ovarian cancer (two or more first-degree relatives and/or a relative with cancer before menopause) are a high-risk group8 who may carry a mutation of the BRCA1 and BRCA2 genes. These women have a risk of ovarian malignancy of up to 50%.
Women with a strong family history of colon cancer (at least three affected family members in at least two successive generations, with one case below age 50 years) may be at increased risk for endometrial and ovarian malignancy because they carry a mismatch repair gene mutation. These women have a risk of up to 10% for ovarian cancer and 50% for endometrial cancer.
Studies exploring the value of screening these women for ovarian cancer are lacking and are urgently required. Even though population-based screening for ovarian cancer is not recommended, and although there is no level of evidence that this group of women should undergo screening, it seems prudent that, until evidence to the contrary is available, measurement of CA 125 levels and transvaginal ultrasound be undertaken at least on a yearly basis. Certainly, women who may have gene mutations should be referred to family cancer clinics for counselling.
New technologies
New technologies have increased the possibilities for ovarian cancer screening. The use of genomics and proteomics to identify specific proteomic patterns, gene expression and genetic alterations, using serum or urine, may revolutionise our ability to screen for this disease.9 These new developments will hopefully be of use in population screening.
Cleola Anderiesz and Michael A Quinn
Women with a strong family history of breast and/or ovarian cancer (two or more first-degree relatives and/or a relative with cancer before menopause) are a high-risk group8 who may carry a mutation of the BRCA1 and BRCA2 genes. These women have a risk of ovarian malignancy of up to 50%.
Women with a strong family history of colon cancer (at least three affected family members in at least two successive generations, with one case below age 50 years) may be at increased risk for endometrial and ovarian malignancy because they carry a mismatch repair gene mutation. These women have a risk of up to 10% for ovarian cancer and 50% for endometrial cancer.
Studies exploring the value of screening these women for ovarian cancer are lacking and are urgently required. Even though population-based screening for ovarian cancer is not recommended, and although there is no level of evidence that this group of women should undergo screening, it seems prudent that, until evidence to the contrary is available, measurement of CA 125 levels and transvaginal ultrasound be undertaken at least on a yearly basis. Certainly, women who may have gene mutations should be referred to family cancer clinics for counselling.
New technologies
New technologies have increased the possibilities for ovarian cancer screening. The use of genomics and proteomics to identify specific proteomic patterns, gene expression and genetic alterations, using serum or urine, may revolutionise our ability to screen for this disease.9 These new developments will hopefully be of use in population screening.
Cleola Anderiesz and Michael A Quinn
ovarian cancer : Screening for ovarian cancer
Abstract
Ovarian cancer is the leading cause of death from gynaecological malignancies.
No precancerous lesions have been identified.
Bimanual examination has not been proven to be of value as a screening test.
Transvaginal ultrasound examination, with or without measurement of CA 125 levels, is currently being evaluated for population screening.
Women at high risk of ovarian cancer should be screened annually — with measurement of CA 125 level and transvaginal ultrasound examination.
Women with early-stage ovarian cancer have a 5-year survival rate of over 80%, suggesting that early detection may improve survival. To date, it has not been established whether benign (assessed histologically as non-invasive) or borderline ovarian tumours are premalignant. In the absence of a precancerous lesion, the goal of screening is the detection of preclinical disease.
Screening tests
A number of screening tests have been evaluated or are being evaluated currently. These include bimanual pelvic examination, ultrasound examination (Box), with or without colour Doppler flow imaging, and measurement of various circulating proteins.
Bimanual pelvic examination as part of a "well-woman's screen" has not been found to be useful.2
Ultrasound examination alone has neither sufficient specificity nor sufficient predictive value to justify its use in community screening, and it is expensive. It is currently not known whether the addition of Doppler flow imaging substantially improves the sensitivity of ultrasound alone.3
The usefulness of measuring the level of high-molecular-weight glycoprotein CA 125 as a screening test depends on the screening strategy, the cut-off value used and the population of women studied. It is of more benefit when used as part of a multimodal strategy.
In particular, screening by measuring CA 125 level and performing transvaginal ultrasound examination appears to provide the highest specificity and positive predictive value for the detection of ovarian cancer.4
Current trials
The CA 125 plus ultrasound screening strategy is currently on trial in the United Kingdom and the United States.
In the United Kingdom, CA 125 level plus transvaginal ultrasound examination versus transvaginal ultrasound alone versus no screening is being evaluated in 200 000 postmenopausal women. Quality of life, morbidity and cost-effectiveness are included in the evaluation.5 In the United States, the National Cancer Institute's Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening trial is comparing 37 000 women (aged 55–74) having annual measurement of CA 125 level and transvaginal ultrasound examination, with an equal number of women receiving their usual medical care.6 A large European multicentre trial involves 120 000 postmenopausal women randomly allocated to no screening, transvaginal ultrasound at intervals of 18 months, or transvaginal ultrasound at intervals of 3 years, for a total of 8 years.7 The results of these trials will provide evidence for whether screening provides a survival advantage, and whether this is at an acceptable financial cost. Other important issues, such as age of commencing and discontinuing screening and optimal screening intervals, will need to be established before implementing population-based screening for ovarian cancer.
by Cleola Anderiesz and Michael A Quinn
Ovarian cancer is the leading cause of death from gynaecological malignancies.
No precancerous lesions have been identified.
Bimanual examination has not been proven to be of value as a screening test.
Transvaginal ultrasound examination, with or without measurement of CA 125 levels, is currently being evaluated for population screening.
Women at high risk of ovarian cancer should be screened annually — with measurement of CA 125 level and transvaginal ultrasound examination.
Women with early-stage ovarian cancer have a 5-year survival rate of over 80%, suggesting that early detection may improve survival. To date, it has not been established whether benign (assessed histologically as non-invasive) or borderline ovarian tumours are premalignant. In the absence of a precancerous lesion, the goal of screening is the detection of preclinical disease.
Screening tests
A number of screening tests have been evaluated or are being evaluated currently. These include bimanual pelvic examination, ultrasound examination (Box), with or without colour Doppler flow imaging, and measurement of various circulating proteins.
Bimanual pelvic examination as part of a "well-woman's screen" has not been found to be useful.2
Ultrasound examination alone has neither sufficient specificity nor sufficient predictive value to justify its use in community screening, and it is expensive. It is currently not known whether the addition of Doppler flow imaging substantially improves the sensitivity of ultrasound alone.3
The usefulness of measuring the level of high-molecular-weight glycoprotein CA 125 as a screening test depends on the screening strategy, the cut-off value used and the population of women studied. It is of more benefit when used as part of a multimodal strategy.
In particular, screening by measuring CA 125 level and performing transvaginal ultrasound examination appears to provide the highest specificity and positive predictive value for the detection of ovarian cancer.4
Current trials
The CA 125 plus ultrasound screening strategy is currently on trial in the United Kingdom and the United States.
In the United Kingdom, CA 125 level plus transvaginal ultrasound examination versus transvaginal ultrasound alone versus no screening is being evaluated in 200 000 postmenopausal women. Quality of life, morbidity and cost-effectiveness are included in the evaluation.5 In the United States, the National Cancer Institute's Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening trial is comparing 37 000 women (aged 55–74) having annual measurement of CA 125 level and transvaginal ultrasound examination, with an equal number of women receiving their usual medical care.6 A large European multicentre trial involves 120 000 postmenopausal women randomly allocated to no screening, transvaginal ultrasound at intervals of 18 months, or transvaginal ultrasound at intervals of 3 years, for a total of 8 years.7 The results of these trials will provide evidence for whether screening provides a survival advantage, and whether this is at an acceptable financial cost. Other important issues, such as age of commencing and discontinuing screening and optimal screening intervals, will need to be established before implementing population-based screening for ovarian cancer.
by Cleola Anderiesz and Michael A Quinn
Tuesday, September 05, 2006
ovarian cancer : Epithelial Cancer Stage 4 -
Stage 4 - Epithelial Cancer
This type of ovarian cancer is managed by tumor debulking surgery to remove as much cancerous tissue as possible, followed by combination chemotherapy. The benefit of postsurgical therapy is not well-established for patients with advanced (Stage 3 or 4), borderline cancers. However, because of the risk of distant relapse, some form of systemic therapy should be considered.
Stage 4 - Germ Cell Tumor
If the germ cell tumor is a dysgerminoma (the most widespread germ cell tumor, representing nearly half of all cases), treatment begins with surgery, including total hysterectomy, bilateral salpingo-oophorectomy, and tumor debulking, followed by chemotherapy. If some tumor remains after chemotherapy, additional forms of chemotherapy may be needed.
If the patient has cancer in only one ovary and she wants to have children in the future, her treatment may consist of modified surgery (unilateral salpingo-oophorectomy), followed by chemotherapy.
Germ cell tumors that are not dysgerminomas (e.g., an embryonal carcinoma, immature teratoma, choriocarcinoma, polyembryoma, or mixed germ cell tumor) may require one of the following treatment programs:
surgery, including total hysterectomy, bilateral salpingo-oophorectomy, and tumor debulking, followed by chemotherapy, with/without additional surgery and additional chemotherapy to remove remaining cancerous tissue, or
chemotherapy, followed by surgery, including total hysterectomy, bilateral salpingo-oophorectomy, and tumor debulking, with/without additional chemotherapy.
If the patient has cancer in only one ovary and she wants to have children in the future, her treatment may consist of modified surgery (unilateral salpingo-oophorectomy), followed by chemotherapy.
Recurrent - Epithelial Cancer
Reappearing epithelial ovarian cancer is problematic. To date, there is no standard treatment, although a number of clinical trials are underway to test the pros and cons of different programs. Some of these trials include:
chemotherapy, with follow-up surgery;
new chemotherapeutic drugs;
new combination chemotherapies; and
surgery to relieve symptoms caused by ovarian cancer.
Comfort and pain-relieving care are always options. The patient should discuss these alternatives with her physician, since open communication is very important and will help her to receive the best care.
Recurrent - Germ Cell Tumor
The treatment of recurrent germ cell tumor is based on tumor type. Recurrent dysgerminomas usually are managed by chemotherapy, with/without radiotherapy.
Recurrent germ cell tumors that are not dysgerminomas (e.g., an embryonal carcinoma, immature teratoma, choriocarcinoma, polyembryoma, or mixed germ cell tumor) usually are managed by chemotherapy.
© 1998-2006
by Healthcommunities.com, Inc. All rights reserved.
This type of ovarian cancer is managed by tumor debulking surgery to remove as much cancerous tissue as possible, followed by combination chemotherapy. The benefit of postsurgical therapy is not well-established for patients with advanced (Stage 3 or 4), borderline cancers. However, because of the risk of distant relapse, some form of systemic therapy should be considered.
Stage 4 - Germ Cell Tumor
If the germ cell tumor is a dysgerminoma (the most widespread germ cell tumor, representing nearly half of all cases), treatment begins with surgery, including total hysterectomy, bilateral salpingo-oophorectomy, and tumor debulking, followed by chemotherapy. If some tumor remains after chemotherapy, additional forms of chemotherapy may be needed.
If the patient has cancer in only one ovary and she wants to have children in the future, her treatment may consist of modified surgery (unilateral salpingo-oophorectomy), followed by chemotherapy.
Germ cell tumors that are not dysgerminomas (e.g., an embryonal carcinoma, immature teratoma, choriocarcinoma, polyembryoma, or mixed germ cell tumor) may require one of the following treatment programs:
surgery, including total hysterectomy, bilateral salpingo-oophorectomy, and tumor debulking, followed by chemotherapy, with/without additional surgery and additional chemotherapy to remove remaining cancerous tissue, or
chemotherapy, followed by surgery, including total hysterectomy, bilateral salpingo-oophorectomy, and tumor debulking, with/without additional chemotherapy.
If the patient has cancer in only one ovary and she wants to have children in the future, her treatment may consist of modified surgery (unilateral salpingo-oophorectomy), followed by chemotherapy.
Recurrent - Epithelial Cancer
Reappearing epithelial ovarian cancer is problematic. To date, there is no standard treatment, although a number of clinical trials are underway to test the pros and cons of different programs. Some of these trials include:
chemotherapy, with follow-up surgery;
new chemotherapeutic drugs;
new combination chemotherapies; and
surgery to relieve symptoms caused by ovarian cancer.
Comfort and pain-relieving care are always options. The patient should discuss these alternatives with her physician, since open communication is very important and will help her to receive the best care.
Recurrent - Germ Cell Tumor
The treatment of recurrent germ cell tumor is based on tumor type. Recurrent dysgerminomas usually are managed by chemotherapy, with/without radiotherapy.
Recurrent germ cell tumors that are not dysgerminomas (e.g., an embryonal carcinoma, immature teratoma, choriocarcinoma, polyembryoma, or mixed germ cell tumor) usually are managed by chemotherapy.
© 1998-2006
by Healthcommunities.com, Inc. All rights reserved.
ovarian cancer : Epithelial Cancer Stage 3
Stage 3 - Epithelial Cancer
Like Stage 1 and Stage 2 epithelial cancers, Stage 3 epithelial cancer initially is treated by surgery, including total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, lymphadenectomy, and tumor debulking.
Postoperative management may include combination chemotherapy with/without follow-up surgery to remove any remaining cancerous tissue.
Stage 3 - Germ Cell Tumor
If the germ cell tumor is a dysgerminoma (the most widespread germ cell tumor, representing nearly half of all cases), treatment begins with surgery, including total hysterectomy, bilateral salpingo-oophorectomy, and tumor debulking.
If the remaining post-operative tumor is small, surgery will be followed by radiotherapy of the abdominal region. If the remaining postoperative tumor is large, surgery will be followed by systemic chemotherapy.
Germ cell tumors that are not dysgerminomas (e.g., an embryonal carcinoma, immature teratoma, choriocarcinoma, polyembryoma, or mixed germ cell tumor) may require one of the following treatment programs:
surgery, including total hysterectomy, bilateral salpingo-oophorectomy, and tumor debulking, followed by chemotherapy, with/without additional surgery to remove remaining cancerous tissue; or
chemotherapy, followed by surgery, including total hysterectomy, bilateral salpingo-oophorectomy, and tumor debulking, with/without additional chemotherapy.
If the patient has a non-dysgerminatous tumor on one side and she wants to have children in the future, her treatment may consist of modified surgery (unilateral salpingo-oophorectomy) followed by chemotherapy.
Recent studies have shown that intraperitoneal chemotherapy may increase survival in patients with Stage III ovarian cancer who have undergone surgery. In this treatment, high doses of chemotherapy drugs are infused directly into the abdominal cavity through a catheter to destroy remaining cancer cells. These drugs eventually enter the bloodstream and may destroy any cancer cells that have spread.
Intraperitoneal chemotherapy usually is administered in 6 cycles, approximately every 3 weeks. Side effects of treatment, which can be severe and include abdominal pain, bloating, fatigue, and infection, may prevent patients from completing all 6 cycles.
© 1998-2006
by Healthcommunities.com, Inc. All rights reserved.
Like Stage 1 and Stage 2 epithelial cancers, Stage 3 epithelial cancer initially is treated by surgery, including total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, lymphadenectomy, and tumor debulking.
Postoperative management may include combination chemotherapy with/without follow-up surgery to remove any remaining cancerous tissue.
Stage 3 - Germ Cell Tumor
If the germ cell tumor is a dysgerminoma (the most widespread germ cell tumor, representing nearly half of all cases), treatment begins with surgery, including total hysterectomy, bilateral salpingo-oophorectomy, and tumor debulking.
If the remaining post-operative tumor is small, surgery will be followed by radiotherapy of the abdominal region. If the remaining postoperative tumor is large, surgery will be followed by systemic chemotherapy.
Germ cell tumors that are not dysgerminomas (e.g., an embryonal carcinoma, immature teratoma, choriocarcinoma, polyembryoma, or mixed germ cell tumor) may require one of the following treatment programs:
surgery, including total hysterectomy, bilateral salpingo-oophorectomy, and tumor debulking, followed by chemotherapy, with/without additional surgery to remove remaining cancerous tissue; or
chemotherapy, followed by surgery, including total hysterectomy, bilateral salpingo-oophorectomy, and tumor debulking, with/without additional chemotherapy.
If the patient has a non-dysgerminatous tumor on one side and she wants to have children in the future, her treatment may consist of modified surgery (unilateral salpingo-oophorectomy) followed by chemotherapy.
Recent studies have shown that intraperitoneal chemotherapy may increase survival in patients with Stage III ovarian cancer who have undergone surgery. In this treatment, high doses of chemotherapy drugs are infused directly into the abdominal cavity through a catheter to destroy remaining cancer cells. These drugs eventually enter the bloodstream and may destroy any cancer cells that have spread.
Intraperitoneal chemotherapy usually is administered in 6 cycles, approximately every 3 weeks. Side effects of treatment, which can be severe and include abdominal pain, bloating, fatigue, and infection, may prevent patients from completing all 6 cycles.
© 1998-2006
by Healthcommunities.com, Inc. All rights reserved.
ovarian cancer : Germ Cell Tumor
Ovarian cancer Stage 2 - Germ Cell Tumor
If the germ cell tumor is a dysgerminoma (the most widespread germ cell tumor, representing nearly half of all cases), treatment may start with surgery, including total hysterectomy and bilateral salpingo-oophorectomy, followed by radiotherapy.
However, if the patient's cancer is limited to one ovary and its corresponding fallopian tube, and if she wants to bear children in the future, modified surgery may be performed to remove only the cancerous ovary and fallopian tube on the same side (unilateral salpingo-oophorectomy), followed by chemotherapy.
If the germ cell tumor is another, nondysgerminomatous variety, treatment will begin with surgery, including total hysterectomy, bilateral salpingo-oophorectomy, and tumor debulking, or modified surgery (unilateral salpingo-oophorectomy). Surgery is followed by chemotherapy, and/or follow-up surgery to remove as much remaining cancerous tissue as possible.
© 1998-2006
by Healthcommunities.com, Inc. All rights reserved.
If the germ cell tumor is a dysgerminoma (the most widespread germ cell tumor, representing nearly half of all cases), treatment may start with surgery, including total hysterectomy and bilateral salpingo-oophorectomy, followed by radiotherapy.
However, if the patient's cancer is limited to one ovary and its corresponding fallopian tube, and if she wants to bear children in the future, modified surgery may be performed to remove only the cancerous ovary and fallopian tube on the same side (unilateral salpingo-oophorectomy), followed by chemotherapy.
If the germ cell tumor is another, nondysgerminomatous variety, treatment will begin with surgery, including total hysterectomy, bilateral salpingo-oophorectomy, and tumor debulking, or modified surgery (unilateral salpingo-oophorectomy). Surgery is followed by chemotherapy, and/or follow-up surgery to remove as much remaining cancerous tissue as possible.
© 1998-2006
by Healthcommunities.com, Inc. All rights reserved.
Monday, September 04, 2006
ovarian cancer : Treatment Options by Stage
Stage 1 - Epithelial Cancer
Several options exist for limited, Stage 1 epithelial cancer, which occurs in approximately 15% of women (see also Types of Ovarian Cancer)
Surgery should be performed in women who have finished childbearing. This includes total hysterectomy, complete removal of the uterus; bilateral salpingo-oophorectomy, removal of the fallopian tubes and ovaries; omentectomy, removal of the fatty tissue that covers the bowels; and lymphadenectomy, removal of one or more lymph nodes.
Modified ("conservative") surgery - surgery that leaves tumor-free reproductive organs intact - may be conducted in women who still wish to still have children if (1) the tumor is confined (usually not serous or endometriotic in type, which tend to be bilateral tumors), and (2) wedge biopsy of the opposite ovary shows no evidence for disease involvement. Such a procedure carries an increased risk of relapse; therefore, total hysterectomy and salpingo-oophorectomy should be performed immediately after childbearing is complete.
The role of adjuvant, or additional, treatment in patients with early epithelial ovarian cancer remains controversial. Yet results from a patient's histopathology report may suggest additional care, such as:
radiotherapy plus chemotherapy;
combination chemotherapy; or
participation in a clinical trial that evaluates immediate versus delayed chemotherapy.
Some studies suggest that systemic (whole body) chemotherapy may be less hazardous than radiotherapy, especially after the patient's abdominal lymph nodes have been removed (see also Chemotherapy and Radiotherapy). Although radiotherapy can decrease the rate of cancer relapse in the pelvis, relapse rates are unchanged in intra-abdominal areas and distant sites, and overall survival is unaffected.
Stage 1 - Germ Cell Tumor
Germ cell tumors, which arise from cells that normally form the eggs, usually are benign and tend to occur in women younger than age 30. If the germ cell tumor is a dysgerminoma (the most widespread germ cell tumor, representing nearly half of all cases), initial treatment begins with surgery to remove the tumorous ovary and the corresponding fallopian tube on the same side - known as unilateral salpingo-oophorectomy.
Adjuvant therapy for such patients may involve follow-up radiotherapy, or chemotherapy, if the woman wants to bear children in the future.
If the germ cell tumor is a nondysgerminoma (e.g., an embryonal carcinoma, immature teratoma, choriocarcinoma, polyembryoma, or mixed germ cell tumor), treatment includes surgery (unilateral salpingo-oophorectomy) to remove the tumorous ovary and the corresponding fallopian tube on the same side, with or without follow-up chemotherapy, or participation in a clinical trial of new chemotherapeutic drug combinations.
The only patients who generally do not require systemic therapy are women with Stage 1A, Grade 1 immature teratoma.
Sex-Cord Stromal Tumor (All Stages)
Because of the extreme rarity of sex-cord stromal tumors and because of their variable biologic behavior, no standard therapy exists for these tumors (see also Types of Ovarian Cancer). For example, granulosa cell tumors often respond well to therapy in younger women, whereas the same tumors may be more aggressive and difficult to manage in women over 40. But the cornerstone of most treatments is surgery to remove as much of the tumor as possible.
Many Sertoli-Leydig cell tumors appear on one side only, so if the patient is young and has early-stage disease (e.g., Stage 1A), the physician may recommend modified surgery to remove only the tumorous ovary and fallopian tube on the same side (unilateral salpingo-oophorectomy).
By contrast, older patients or those with advanced-stage or bilateral disease may benefit from more extensive surgery, including total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, lymphadenectomy, and tumor debulking.
If the stromal cell tumor is malignant, metastatic, and/or if the tumor tends to recur (e.g., granulosa cell tumors recur after 5 or 10 years in many patients), combination chemotherapy also may be beneficial, especially platinum-based combinations, such as cisplatin/vinblastine/bleomycin (PVB).
There are few findings concerning the usefulness of radiotherapy for sex-cord stromal tumors. Ongoing studies suggest that hormonal therapy (with progestins, estrogens, gonadotropin-releasing analogs, etc.) may have a future role in the management of sex-cord stromal tumors; however, to date, the findings are inconclusive.
© 1998-2006
by Healthcommunities.com, Inc. All rights reserved.
Several options exist for limited, Stage 1 epithelial cancer, which occurs in approximately 15% of women (see also Types of Ovarian Cancer)
Surgery should be performed in women who have finished childbearing. This includes total hysterectomy, complete removal of the uterus; bilateral salpingo-oophorectomy, removal of the fallopian tubes and ovaries; omentectomy, removal of the fatty tissue that covers the bowels; and lymphadenectomy, removal of one or more lymph nodes.
Modified ("conservative") surgery - surgery that leaves tumor-free reproductive organs intact - may be conducted in women who still wish to still have children if (1) the tumor is confined (usually not serous or endometriotic in type, which tend to be bilateral tumors), and (2) wedge biopsy of the opposite ovary shows no evidence for disease involvement. Such a procedure carries an increased risk of relapse; therefore, total hysterectomy and salpingo-oophorectomy should be performed immediately after childbearing is complete.
The role of adjuvant, or additional, treatment in patients with early epithelial ovarian cancer remains controversial. Yet results from a patient's histopathology report may suggest additional care, such as:
radiotherapy plus chemotherapy;
combination chemotherapy; or
participation in a clinical trial that evaluates immediate versus delayed chemotherapy.
Some studies suggest that systemic (whole body) chemotherapy may be less hazardous than radiotherapy, especially after the patient's abdominal lymph nodes have been removed (see also Chemotherapy and Radiotherapy). Although radiotherapy can decrease the rate of cancer relapse in the pelvis, relapse rates are unchanged in intra-abdominal areas and distant sites, and overall survival is unaffected.
Stage 1 - Germ Cell Tumor
Germ cell tumors, which arise from cells that normally form the eggs, usually are benign and tend to occur in women younger than age 30. If the germ cell tumor is a dysgerminoma (the most widespread germ cell tumor, representing nearly half of all cases), initial treatment begins with surgery to remove the tumorous ovary and the corresponding fallopian tube on the same side - known as unilateral salpingo-oophorectomy.
Adjuvant therapy for such patients may involve follow-up radiotherapy, or chemotherapy, if the woman wants to bear children in the future.
If the germ cell tumor is a nondysgerminoma (e.g., an embryonal carcinoma, immature teratoma, choriocarcinoma, polyembryoma, or mixed germ cell tumor), treatment includes surgery (unilateral salpingo-oophorectomy) to remove the tumorous ovary and the corresponding fallopian tube on the same side, with or without follow-up chemotherapy, or participation in a clinical trial of new chemotherapeutic drug combinations.
The only patients who generally do not require systemic therapy are women with Stage 1A, Grade 1 immature teratoma.
Sex-Cord Stromal Tumor (All Stages)
Because of the extreme rarity of sex-cord stromal tumors and because of their variable biologic behavior, no standard therapy exists for these tumors (see also Types of Ovarian Cancer). For example, granulosa cell tumors often respond well to therapy in younger women, whereas the same tumors may be more aggressive and difficult to manage in women over 40. But the cornerstone of most treatments is surgery to remove as much of the tumor as possible.
Many Sertoli-Leydig cell tumors appear on one side only, so if the patient is young and has early-stage disease (e.g., Stage 1A), the physician may recommend modified surgery to remove only the tumorous ovary and fallopian tube on the same side (unilateral salpingo-oophorectomy).
By contrast, older patients or those with advanced-stage or bilateral disease may benefit from more extensive surgery, including total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, lymphadenectomy, and tumor debulking.
If the stromal cell tumor is malignant, metastatic, and/or if the tumor tends to recur (e.g., granulosa cell tumors recur after 5 or 10 years in many patients), combination chemotherapy also may be beneficial, especially platinum-based combinations, such as cisplatin/vinblastine/bleomycin (PVB).
There are few findings concerning the usefulness of radiotherapy for sex-cord stromal tumors. Ongoing studies suggest that hormonal therapy (with progestins, estrogens, gonadotropin-releasing analogs, etc.) may have a future role in the management of sex-cord stromal tumors; however, to date, the findings are inconclusive.
© 1998-2006
by Healthcommunities.com, Inc. All rights reserved.
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