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.

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