Ovarian cancer treatment in Hyderabad: For the majority of ovarian cancer, surgery is the main treatment. The two main goals of surgery are staging and debulking.
Surgical oncologists evaluate the spread of cancer. Next, they decide how much surgery is needed for the patient based on the overall health of the patient.
For a better outcome, cancer is staged and debulked properly. If staging is not done properly, the patient may require more surgeries later. Therefore, a trained and experienced surgical oncologist or a gynecologic surgical oncologist is the best surgeon to perform ovarian cancer surgery.
How is the staging of epithelial ovarian cancer is done?
Staging epithelial ovarian cancer
A surgical oncologist’s first goal is to do staging to know how far cancer has spread. Therefore, the oncology surgeon removes uterus (hysterectomy) along with ovaries and fallopian tubes (bilateral salpingo-oophorectomy). The surgeon removes the omentum ( a fatty tissue layer that covers the abdominal contents) if ovarian cancer spreads to this area. The surgeon removes lymph nodes also and sent those for biopsy to know the spread of cancer.
The surgeon takes out the abdominal fluid or fluid in the pelvis for a biopsy. The fluid is sent for testing. Likewise, surgeons take biopsies from different areas of the abdomen and pelvis. All tissues, fluids and other samples collected during surgery are sent to a lab for testing.
Surgeons do staging to determine the spread of cancer and to treat it accordingly. Correctly staged ovarian cancer is treated effectively. Surgeons may find it difficult to treat cancer which is not staged correctly.
The extent of surgery for ovarian cancer depends on the stage of cancer, its spread and overall health of the patient. Women of childbearing age presented with early-stage ovarian cancer can be treated without removing ovaries and uterus.
Cytoreductive surgery is a standard treatment for ovarian cancer. The goal of the surgery is to remove as much visible cancer as possible. This process is known as debulking. It is important if cancer has spread throughout the abdomen. Treatment prospects are bright for optimally debulked cancer.
Based on the stage and extent of ovarian cancer, the cytoreductive surgery may involve removal of the affected ovary (unilateral oophorectomy); both the ovaries (bilateral oophorectomy); both ovaries and fallopian tubes (bilateral salpingo-oophorectomy); single ovary and its adjoining fallopian tube (unilateral salpingectomy).
Ovarian Cancer Treatment in Hyderabad: HIPEC [Hyperthermic Intraperitoneal Chemotherapy]
The patients who are suffering from advanced-stage ovarian cancer or recurrent ovarian cancer undergo a complete cytoreductive surgery by which the entire visible disease is resected. In other words, optimal cytoreductive surgery is performed. At the end of the surgery, the temperature of the abdomen is raised to 41 to 43 degrees Celsius by insufflation of warm fluid. Next, the abdominal cavity is treated with the infusion of chemotherapy agents like cisplatin for over one and a half hour.
There is a piece of recent evidence in the form of a multicentric trial to support this treatment modality. This type of cytoreductive surgery in combination with HIPEC increases the life span of the patient. It also improves the disease-free interval. A disease-free stage can be achieved without unduly affecting the overall morbidity and mortality associated with the procedure.
As far as HIPEC is concerned, it is a fact that the procedure is a specialized one, as the patients need to be selected carefully to achieve the best result.
HIPEC requires specialized equipment which raises the intra-abdominal chemotherapy temperature from 41 to 43 degrees Celsius, a temperature at which the most optimal effective dose can be achieved without compromising the safety.
For the ovarian cancer treatment, Dr Geetha Nagasree is available at Care Hospitals, Gachibowli, Hyderabad