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قديم 05-30-2019, 02:16 PM باحث_علمى غير متواجد حالياً   رقم الموضوع : [1]
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افتراضي بحث طبى علمى ممتاز عن سرطان المبيض -لغة انجليزية- Ovarian cancer

What is ovarian cancer?

بحث طبى علمى ممتاز عن سرطان المبيض -لغة انجليزية- Ovarian cancer
Ovarian cancer starts in the cells of the ovary. A cancerous (malignant) tumour is a group of cells that can grow into and destroy nearby tissue. It can also spread (metastasize) to other parts of the body. Cancerous ovarian tumours are grouped by the type of cells that the cancer starts in.
Epithelial ovarian carcinoma starts in epithelial cells. It is the most common type of ovarian cancer. Serous carcinoma is the most common type of epithelial ovarian carcinoma.
Many serous ovarian carcinomas are now thought to come from cells from the nearby fallopian tube that have implanted on the surface of the ovary.
Tumours of borderline malignancy also start in the epithelial cells. They share some, but not all features of carcinomas under the microscope. They do not usually spread into nearby tissues or other parts of the body. Examples of tumours of borderline malignancy are serous tumours and mucinous tumours.
Stromal tumours start from stromal cells. Granulosa cell tumours are the most common type of stromal tumour that can be malignant.
Germ cell tumours start in germ cells. Mature cystic teratoma (dermoid cyst) is the most common type of ovarian tumour overall. It is usually non-cancerous. The most common type of cancerous germ cell tumour is dysgerminoma.
Primary peritoneal serous carcinoma can develop in the peritoneum, which is the membrane that lines the walls of the abdomen and pelvis. It is similar to epithelial ovarian cancer, but there is very little or no cancer in the ovary and it isn’t clear where the cancer started.
Changes to cells in the ovary don’t always lead to cancer. Changes to the cells may lead to non-cancerous conditions such as cysts. They can also lead to non-cancerous tumours such as an adenofibroma.
The ovaries

The ovaries are the organs in a woman’s reproductive system that produce eggs (ova). There are 2 of them, and they are deep in a woman’s pelvis, on both sides of the uterus (womb), close to the ends of the fallopian tubes.
نقرتين لعرض الصورة في صفحة مستقلة
Structure

The ovaries are made up of 3 different types of cells:
Epithelial cells make up the outer layer covering the ovary (called the epithelium).
Germ cells are inside the ovary. They develop into eggs.
Stromal cells form the supportive or connective tissues of the ovary (called the stroma).
A thin layer of tissue called the capsule surrounds each ovary.
نقرتين لعرض الصورة في صفحة مستقلة
Function

The ovaries have 2 main functions. They make the female sex hormones and they produce mature eggs.
The female sex hormones are estrogen and progesterone. The ovaries are the main source of these hormones.

Estrogen is the main female sex hormone. It is responsible for the development of a woman’s breasts, body shape and reproductive organs.
Progesterone prepares the body for conception by causing the buildup of the uterine lining (endometrium) and regulates menstruation and pregnancy.
Each month during ovulation, an ovary releases a mature egg. The egg travels down the fallopian tube to the uterus. If it is fertilized by a sperm, the egg attaches itself (implants) to the lining of the uterus and begins to develop into a fetus. If the egg is not fertilized, it is shed from the body along with the lining of the uterus during menstruation.
During menopause, the ovaries stop releasing eggs and producing sex hormones.


Read more: http://www.cancer.ca/en/cancer-infor...#ixzz5BGG9IIHb


Cancerous tumours of the ovary

A cancerous tumour of the ovary can grow into and destroy nearby tissue. It can also spread (metastasize) to other parts of the body. Cancerous tumours are also called malignant tumours. Cancerous ovarian tumours are grouped by the type of cells that the cancer starts in.
Epithelial tumours

Epithelial tumours start in epithelial cells, which make up the outer layer of the ovary (called the epithelium). Cancerous epithelial tumours are also called epithelial ovarian carcinomas, and the different types have carcinoma as part of their name. Most ovarian cancers are epithelial ovarian carcinomas. It is the type of cancer that is most commonly called “ovarian cancer.” These tumours are found most often in women over the age of 50.
Serous carcinoma is the most common type of cancerous epithelial tumour. It can occur in both ovaries, and tumours can range in size from small to quite large. Serous carcinomas are either high grade (HGSC) or low grade (LGSC). HGSC is more common than LGSC. This cancer is usually diagnosed at a later stage. Many HGSC are now thought to come from cells from the nearby fallopian tube that have implanted on the surface of the ovary.
Other epithelial tumours

These less common tumours also start in the epithelial cells:
Mucinous carcinoma usually occurs in one ovary and can grow to be very large. Most tumours are diagnosed at an early stage. Mucinous carcinoma that has started in the ovary can be hard to tell apart from cancer that has spread (metastasized) from another part of the body to the ovary.
Endometrioid carcinoma is linked to endometriosis in 10% to 40% of cases. Endometriosis is a non-cancerous condition in which endometrial-type tissue (similar to the inner lining of the uterus) can grow into areas of the body other than the uterus, including the ovaries. These tumours can occur in both ovaries and grow to a large size.
Clear cell carcinoma is linked to endometriosis in at least 50% of cases. They are more commonly diagnosed at an early stage as compared to serous carcinoma, but are likewise considered high-grade tumours.
Mixed carcinomas are made up of more than one type of cell. A common combination is clear cell carcinoma mixed with endometrioid carcinoma. Both cell types are linked to endometriosis.
Undifferentiated carcinoma refers to tumours that start in epithelial cells but cannot be grouped into any type of epithelial ovarian carcinoma. This is because the cells no longer resemble those of the other types. They tend to grow and spread more quickly than the other types of epithelial ovarian carcinoma.
Malignant mesodermal mixed tumours (also called carcinosarcoma or MMMT) grow quickly and are usually large. This cancer is usually diagnosed at a later stage.
Tumours of borderline malignancy

Tumours of borderline malignancy tend to develop in women at a younger age than most ovarian cancers. They occur most often in women from age 39 to 45. They may occur in one or both ovaries.
Tumours of borderline malignancy grow differently from typical ovarian cancers. The tumour cells usually don’t grow into nearby tissue as cancer cells normally do. If they spread outside the ovary into the abdominal cavity, they may implant on the lining of the abdomen but not grow into it. They grow slowly and most are stage I at diagnosis.
These tumours are also known as tumours of low malignant potential, borderline tumours, atypical proliferative tumours or borderline epithelial ovarian cancer.
Serous borderline tumours are most often in both ovaries.
Mucinous borderline tumours are either endocervical-type or intestinal-type. The endocervical-type tumours are less common, but more commonly may be in both ovaries. The intestinal-type tumours are large and usually found in one ovary.
Endometrioid borderline tumours, clear cell borderline tumours and Brenner (transitional cell) borderline tumours are almost always found in one ovary.
Stromal tumours

Stromal tumours (also called sex cord stromal tumours) start in the cells of the stromal tissues that support the ovary. These cells produce sex hormones, such as estrogen, progesterone and androgens. Stromal tumours often produce too much of these hormones.
Stromal tumours make up about 7% of all cancerous ovarian tumours. Most are low grade. Most stromal tumours are diagnosed in women older than 50 years of age, but they may occur in adolescents and young women as well.
Granulosa cell tumours are the most common type of malignant stromal tumours. Most of these tumours are stage I at the time of diagnosis. They vary in size and can be solid or contain cysts.

Adult granulosa cell tumours can occur at any age but are most common in perimenopausal women.
Juvenile granulosa cell tumours tend to develop in one ovary and occur most often in girls and women under the age of 30.

Other stromal tumours

These types of stromal tumours are less common:
Sertoli-stromal cell tumours may contain only Sertoli cells (Sertoli cell tumour) or both Sertoli and Leydig cells (Sertoli-Leydig cell tumour). Sertoli-stromal cell tumours are usually diagnosed in young women. The average age at diagnosis of Sertoli and Sertoli-Leydig tumours is 30 and 25 respectively. Sertoli-Leydig tumours may produce androgens, which cause male characteristics such as facial hair and a deepened voice.
Sex cord tumour with annular tubules (SCTAT) represents a separate category of stromal tumour. Experts disagree about whether they are more closely related to granulosa cell tumours or Sertoli-Leydig tumours. There are 2 subtypes of SCTAT tumours:

One type is linked to Peutz-Jeghers syndrome. Tumours often develop in both ovaries. They can be cancerous, but they usually are non-cancerous.
The other type is not associated with Peutz-Jeghers syndrome. Tumours are larger and are more often cancerous.

Gynandroblastomas are large tumours composed of granulosa cells and Sertoli cells. It is not known which type of cell they start from.
Steroid cell tumours are composed of cells resembling steroid-hormone secreting cells. Stromal luteoma and Leydig cell tumours are clinically benign. Steroid cell tumours, not otherwise specified, are clinically malignant in approximately 1/3 of cases.
Fibrosarcomas are high-grade, aggressive tumours. They are usually large and affect one ovary.
Germ cell tumours

Germ cell tumours start in the cells that make the eggs (called germ cells) in the ovary. These tumours account for 2% to 3% of all ovarian cancers. Most germ cell tumours are only in the ovary at the time of diagnosis. They usually develop in young women in their teens and 20s.
Dysgerminomas are the most common cancerous ovarian germ cell tumour. There is spread within the abdomen and pelvis (called extraovarian spread) at the time of diagnosis in a third of cases. In approximately 20% of cases, tumours are in both ovaries.
Yolk sac tumours (endodermal sinus tumours) account for approximately 20% of cancerous ovarian germ cell tumours. Extraovarian spread is found in half of the cases at the time of diagnosis. It is rarely seen in both ovaries in stage I.
Immature teratomas are made up of cancer cells that look like cells from a developing embryo. Immature teratomas are usually found in one ovary but may spread to the other ovary. Immature teratomas are most often found in girls or young women under the age of 20.
Other germ cell tumours

These types of germ cell tumour are very rare:
Mixed germ cell tumours contain 2 or more different types of germ cell tumour cells. The most common combination is dysgerminoma and yolk sac tumour cells.
Embryonal carcinoma is usually seen as part of a mixed germ cell tumour. The tumour can be found in the ovary but more often in the testicle.
Polyembryoma is often found as part of a mixed germ cell tumour.
Choriocarcinomaof the ovary (nongestational) is most often found as part of a mixed germ cell tumour. Choriocarcinoma is composed of trophoblast, the same type of cells that form the placenta during pregnancy.
Small cell carcinoma of the ovary (hypercalcemic type) is a high-grade tumour that is associated with higher than normal amounts of calcium in the blood (hypercalcemia).
Peritoneal carcinomas

Peritoneal carcinomas are closely related to epithelial ovarian cancer but start in the peritoneum. The types of tumour cells are similar to those found in the ovary, but there is very little or no cancer in the ovary, and it isn’t clear where the cancer started. A subset of peritoneal-based carcinomas is frequently associated with endometriosis (e.g. endometrioid carcinoma, clear cell carcinoma).
Primary peritoneal serous carcinomas

High-grade peritoneal serous carcinoma (also referred to as primary peritoneal serous carcinoma) will usually have multiple tumours along the surfaces of many organs in the abdomen and pelvis at the time of diagnosis.
The following criteria are used to diagnose a primary peritoneal serous carcinoma and tell it apart from epithelial ovarian serous carcinoma.

The ovaries are normal in size, are enlarged by a benign growth or were previously removed.
There is more cancer in the abdomen and pelvis than on the surface of either ovary.
Tumours on the ovary are no more than 5 x 5 mm.
The tumours are made up mostly of serous cells (cells that produce fluid).



Read more: http://www.cancer.ca/en/cancer-infor...#ixzz5BGGH1alM


Non-cancerous tumours and conditions of the ovary

A non-cancerous (benign) tumour of the ovary is a growth that does not spread (metastasize) to other parts of the body. Non-cancerous tumours are not usually life-threatening. Benign conditions of the ovary, such as cysts and polycystic ovaries, are also non-cancerous.
Benign tumours and cysts usually do not cause symptoms. Symptoms that sometimes occur are:

unusual bleeding from the vagina
pain in the abdomen as the tumour or cyst increases in size

Benign tumours

Benign tumours are usually treated by surgery to remove the part of the ovary that contains the tumour or the entire ovary.
Benign epithelial tumours are the most common type of benign ovarian tumour. They start from the cells that cover the outer surface of the ovary.
Their makeup can be mainly cystic (called cystadenoma), mainly solid (called adenofibroma) or mixed (called cystadenofibroma). Types of benign epithelial tumours are:

serous (e.g. serous cystadenoma, if mainly cystic)
mucinous (e.g. mucinous adenofibroma, if mainly solid)
cystadenofibroma
Brenner tumours

Benign stromal tumours start from the connective tissue cells that hold the ovary together. The tumours may make the female hormones estrogen and progesterone. Types of benign stromal tumours include:

thecoma
fibroma
fibrothecoma – a mixed tumour with both thecoma and fibroma cells
Leydig cell tumour
stromal luteoma

Benign germ cell tumours start from the cells that produce the eggs (ova). They are also called mature cystic teratomas or dermoid cysts. Most benign germ cell tumours develop during a woman’s reproductive years (teens through 40s).
Cysts

Ovarian cysts are a common benign condition. A cyst is a fluid-filled sac that forms on the surface of or inside an ovary. Most ovarian cysts are functional cysts, which means the ovary continues to work as normal with the cyst. Functional cysts form during normal ovulation (release of the egg from the ovary). Follicular cysts and corpus luteum cysts are functional cysts.
Cysts usually go away, without treatment, within a few months. They may also be removed with surgery.
Polycystic ovaries

With polycystic ovaries, changes to the hormone cycle and ovulation process mean that the eggs don’t mature and are not released from the ovaries (called ovulation). Instead, the eggs form very small cysts within the ovaries. The ovaries may get bigger and develop a thick outer layer.
Many women with polycystic ovaries have few periods, or none at all, and usually have difficulty getting pregnant.
Treatment of polycystic ovaries includes:

hormone therapy with progestins
oral contraceptives
infertility treatments for women who want to get pregnant



Read more: http://www.cancer.ca/en/cancer-infor...#ixzz5BGGhmgbg



  رد مع اقتباس
قديم 05-30-2019, 02:19 PM باحث_علمى غير متواجد حالياً   رقم الموضوع : [2]
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افتراضي

Risk factors for ovarian cancer

A risk factor is something that increases the risk of developing cancer. It could be a behaviour, substance or condition. Most cancers are the result of many risk factors. A family history of the disease is the most important risk factor for developing ovarian cancer.
Epithelial ovarian carcinoma is the most common type of ovarian cancer. The number of new cases of this cancer (called the incidence) increases with age. Most epithelial ovarian carcinomas are found in women who have gone through menopause.
Some women can have a higher than average risk for ovarian cancer. Talk to your doctor about your risk. If you are at higher than average risk, you may need a personal plan for testing.
The following are risk factors for epithelial ovarian carcinoma. The risk factors for less common types of ovarian cancer are not well known and may not be the same as for epithelial ovarian carcinoma. But epithelial ovarian carcinoma and fallopian tube cancer share many of the same risk factors. Some experts think that this may be because some epithelial ovarian carcinomas can begin in a fallopian tube.
Risk factors are generally listed in order from most to least important. But in most cases, it is impossible to rank them with absolute certainty.
Known risk factorsPossible risk factors

Family history of ovarian cancer
BRCA gene mutations
Lynch syndrome
Never being pregnant or giving birth
Family history of certain cancers
Personal history of breast cancer
Tall adult height
Ashkenazi Jewish ancestry
Hormone replacement therapy
Smoking
Asbestos
Endometriosis

Being obese
Using talc on the genitals


Research shows that there is no link between alcohol or coffee and a higher risk for epithelial ovarian carcinoma.
Known risk factors

There is convincing evidence that the following factors increase your risk for epithelial ovarian carcinoma.
Family history of ovarian cancer

A family history of ovarian cancer means that 1 or more close blood relatives have or had ovarian cancer. Sometimes ovarian cancer develops in a family more often than would be expected by chance. It may not be clear if the family’s pattern of cancer is due to chance, shared lifestyle factors, a genetic risk passed from parents to children or a combination of these factors.
If several of your relatives have ovarian cancer, you can have a higher risk of developing the disease. These relatives can be on either your mother’s or your father’s side of the family.
You can have a higher risk of developing ovarian cancer if you have 1 first-degree relative (mother, sister or daughter) with the disease. The risk of developing ovarian cancer is greater if your mother had the disease than if your daughter had it. Your risk can be even higher if your relative was diagnosed with ovarian cancer before they were 50 years of age or before they went into menopause.
Having 2 or more first-degree relatives with ovarian cancer can also increase your risk for the disease.
You can have a slightly higher risk for ovarian cancer if you have 1 first-degree relative and 1 second-degree relative (aunt, grandmother or niece) with the disease.
BRCA gene mutations

Breast cancer gene 1 (BRCA1) and breast cancer gene 2 (BRCA2) normally help control the growth of cancer cells. Mutations in these genes (which can be inherited from either parent) increase the risk for breast cancer. These mutations also increase the risk for ovarian cancer. But not all women with mutations in the BRCA1 or BRCA2 gene will develop ovarian cancer.
Overall, the BRCA1 mutation increases the risk for ovarian cancer more than the BRCA2 mutation. Women with the BRCA1 mutation are more likely to develop ovarian cancer before they are 50 years of age. Women with the BRCA2 mutation are more likely to develop the disease after they are 60 years of age. Ovarian cancer is usually diagnosed at a younger age in women who do not have a BRCA gene mutation.
Ovarian cancer is likely linked to an inherited BRCA1 or BRCA2 gene mutation if the woman has:

several family members with breast or ovarian cancer
1 or more female relatives who developed breast cancer before they were 50 years of age
a relative with both breast and ovarian cancer
family members who develop cancer in both breasts (called bilateral breast cancer)
a male relative with breast cancer
Ashkenazi (Eastern European) Jewish ancestry

Serous carcinoma (which is a type of epithelial ovarian carcinoma) is more commonly linked to BRCA gene mutations than other types of ovarian cancer. Having ovarian cancer linked to a BRCA gene mutation also increases the risk of developing papillary serous carcinoma of the peritoneum, which is a cancer in the lining of the abdominal cavity.
Women with ovarian cancer related to a BRCA gene mutation also have a higher than average risk of developing breast and other cancers. Talk to your doctor about your risks. Genetic risk assessment and genetic testing may be an option for some women.
Lynch syndrome

Lynch syndrome is also called hereditary non-polyposis colorectal cancer (HNPCC). It is an uncommon genetic condition that increases the risk for colorectal and other cancers, including ovarian cancer. Women with type B Lynch syndrome, or Lynch II, have a higher risk of developing epithelial ovarian carcinoma in their lifetime.
Never being pregnant or giving birth

Women who have never been pregnant have a higher risk of developing ovarian cancer than women who have been pregnant. Researchers think that the lower risk may be because the hormones that are present during pregnancy have a protective effect. It is possible that the higher risk in women who have never been pregnant is linked to the factors that may make it difficult for her to become pregnant.
The risk for ovarian cancer is also higher in women who have never given birth, even if they have been pregnant. Researchers are not sure if this greater risk is related to the same factors that increase the risk for ovarian cancer in women who have never been pregnant.
Family history of certain cancers

Women who have a family history of breast cancer have a higher risk of developing ovarian cancer. A family history of colorectal, uterine or pancreatic cancer may also increase the risk for ovarian cancer.
Personal history of breast cancer

Women who have been diagnosed with breast cancer have a higher risk of developing ovarian cancer. This could be because of a BRCA gene mutation. Some of the same risk factors for breast cancer that are related to a woman’s menstruation history may also increase her risk of developing ovarian cancer. These risk factors include starting your period early (younger than 11 years of age) or starting menopause later (after age 55).
Tall adult height

Tall women have a slightly higher risk for ovarian cancer. Researchers think this increased risk may be due to developmental factors such as growth and puberty hormones.
Ashkenazi Jewish ancestry

Women of Ashkenazi (Eastern European) Jewish ancestry are more likely than women in the general population to carry a BRCA1 and BRCA2 gene mutation. About 1 in 40 Ashkenazi Jewish women carry a BRCA gene mutation, which is considerably higher than in the general population. Women with these mutations have a higher chance of developing ovarian cancer.
Hormone replacement therapy

Hormonal replacement therapy (HRT) is used to manage the symptoms of menopause (such as hot flashes, vaginal dryness and mood swings).
Research suggests that HRT with estrogen alone, as well as combined HRT with both estrogen and progesterone, increases the risk for ovarian cancer. The longer you take estrogen, the greater your risk for the disease. Women who have taken HRT for more than 5 years have a greater risk than women who have taken it for less than 5 years. One recent large study also found that how recently a woman has taken HRT affects her risk. Current users of HRT have a higher risk compared to women who have stopped taking HRT, no matter how long they took it.
Smoking

Smoking increases a woman’s risk of developing mucinous carcinoma (a type of epithelial ovarian carcinoma).
Asbestos

Women exposed to asbestos, especially in the workplace, have a higher risk of developing ovarian cancer.
Endometriosis

The endometrium is the lining of the uterus. Endometriosis occurs when the endometrium grows outside of the uterus. It can grow on the ovaries, behind the uterus, on the small intestine, on the large intestine or on the bladder. Women with endometriosis may have a higher risk of developing ovarian cancer, especially if the endometriosis involves the ovaries. Other studies show that the risk for certain types of ovarian cancer, including clear cell and endometrioid tumours, may be higher in women with endometriosis.
Possible risk factors

The following factors have been linked with ovarian cancer, but there is not enough evidence to show they are known risk factors. More research is needed to clarify the role of these factors for ovarian cancer.
Being obese

Being obese means having a body mass index (BMI) of 30 or more. Some studies have shown that being obese may increase the risk of developing ovarian cancer.
Using talc on the genitals

Research studies on the use of talc on the genital area and the risk of ovarian cancer have mixed results. Some research suggests that in the past certain sources of talcum powder may have been contaminated with asbestos or may have contained asbestiform fibres, which are fibres that have similar properties as asbestos. Talcum powder available today is tested to ensure that it does not contain asbestos. Talcum powders made with cornstarch do not increase the risk for ovarian cancer.
Unknown risk factors

It isn’t known whether or not the following factors are linked with ovarian cancer. It may be that researchers can’t show a definite link or that studies have had different results. More research is needed to see if the following are risk factors for ovarian cancer:

eating certain amounts or types of foods, such as milk and milk products, fat, vegetables, fruit or meat
using fertility drugs
sedentary behaviour, which means sitting too much

Questions to ask your healthcare team

To make the decisions that are right for you, ask your healthcare team questions about risks.


Read more: http://www.cancer.ca/en/cancer-infor...#ixzz5BGHALULA

Reducing your risk for ovarian cancer

You may lower your risk of developing ovarian cancer by doing the following.
Talk to your doctor about hormone replacement therapy

Hormone replacement therapy (HRT) has both benefits and risks. Studies show that HRT that uses estrogen alone increases the risk of ovarian cancer. Talk to your doctor about the benefits and risks of taking HRT.
Be a non-smoker

Smoking increases the risk of some types of ovarian cancer. If you smoke, get help to quit.
Avoid asbestos exposure

Occupational exposure to asbestos increases the risk of developing ovarian cancer. People who work around asbestos should always take proper safety precautions to limit their exposure.
Maintain a healthy body weight

Some studies show that being obese may increase your risk of developing ovarian cancer. You may lower your risk by having a healthy body weight. Eating well and being physically active can help you have a healthy body weight.
Learn about protective factors

Some drugs and lifestyle choices may help to protect you from developing ovarian cancer.
Oral contraceptives

Research shows that oral contraceptives (birth control pills) lower the risk for all types of ovarian cancer. The risk is lower after using oral contraceptives for only a few months, but using them more than 5 years provides the greatest risk reduction. This protection lasts at least 20 years after you stop taking oral contraceptives.
Research suggests that oral contraceptives may also lower the risk for women who have a higher than average risk of developing ovarian cancer, including women who have never been pregnant or women who have BRCA1 or BRCA2 gene mutations.
Pregnancy

Having been pregnant lowers the risk of developing ovarian cancer. The more times you’ve been pregnant, the greater the protective effect. But pregnancy does not appear to have a protective effect for women who have a strong family history of ovarian cancer or a BRCA gene mutation.
Gynecological surgery

Tubal ligation is surgery that cuts or blocks the fallopian tubes. Having this surgery lowers a woman’s lifetime risk of developing ovarian cancer.
A hysterectomy is surgery to remove the uterus. It may also lower the risk of developing ovarian cancer, but not as well as tubal ligation. Hysterectomy seems to lower the risk when the fallopian tubes and ovaries are also removed (called salpingo-oophorectomy).
Breastfeeding

Some studies suggest that breastfeeding slightly lowers the risk of developing ovarian cancer.
Find out if you’re at high risk for ovarian cancer

Some women can have a higher than average risk for ovarian cancer. Talk to your doctor about your risk. If you are at higher than average risk, you may need a personal plan for testing.
A risk reduction bilateral salpingo-oophorectomy (RRSO) or prophylactic salpingo-oophorectomy may be an option for women who have a very high risk of developing ovarian cancer, including those with a BRCA gene mutation or a family history of ovarian cancer in 2 or more relatives. This surgery removes the ovaries and fallopian tubes. The surgeon may also remove the uterus during this surgery. Women who have a RRSO will experience treatment-induced menopause and can no longer have children. For this reason, this surgery is offered to women between the ages of 35 and 40 or to women who no longer want to have children.
At present, RRSO is the best preventive strategy to lower the risk for ovarian cancer in women with BRCA mutations. It reduces the risk of ovarian cancer by up to 90% in high-risk women. Talk to your doctor about the benefits and risks of RRSO.
More information about preventing cancer

Learn what you can do to prevent cancer.




Read more: http://www.cancer.ca/en/cancer-infor...#ixzz5BGHPGIH9

Finding ovarian cancer early

When ovarian cancer is found and treated early, the chances of successful treatment are better. Get regular health checkups and see your doctor if you have any symptoms or are worried about your health.
You may need a personal plan for testing if you have a higher than average risk. Talk to your doctor about tests that can help find ovarian cancer early, including the following:

a pelvic exam
transvaginal ultrasound
cancer antigen 125 (CA125) test



Read more: http://www.cancer.ca/en/cancer-infor...#ixzz5BGHXTshV

Symptoms of ovarian cancer

Ovarian cancer may not cause any signs or symptoms in its early stages. Signs and symptoms often appear as the tumour grows and causes changes in the body. Other health conditions can cause the same symptoms as ovarian cancer.
The signs or symptoms of ovarian cancer include:

bleeding from the vagina that isn’t normal (such as heavy or irregular bleeding, bleeding between periods), especially after menopause
frequent discharge from the vagina that is clear, white or coloured with blood
a lump that can be felt in the pelvis or abdomen
bladder problems such as the need to urinate often and the urgent need to urinate
constipation
changes to digestion such as difficulty eating, feeling full after a small meal, heartburn, gas, indigestion or nausea
frequent feeling of pressure in the pelvis or abdomen
fatigue
pain in the legs, lower back, pelvis or abdomen
pain when having sex
swelling of the abdomen
weight loss
buildup of fluid in the abdomen (ascites), around the lungs (pleural effusion) or in the legs (lymphedema)
difficulty breathing



Read more: http://www.cancer.ca/en/cancer-infor...#ixzz5BGHdE8Jo

Diagnosis of ovarian cancer

Diagnosis is the process of finding out the cause of a health problem. Diagnosing ovarian cancer usually begins with a visit to your family doctor. Your doctor will ask you about any symptoms you have and do a physical exam. Based on this information, your doctor may refer you to a specialist or order tests to check for ovarian cancer or other health problems.
The process of diagnosis may seem long and frustrating. It’s normal to worry, but try to remember that other health conditions can cause similar symptoms as ovarian cancer. It’s important for the healthcare team to rule out other reasons for a health problem before making a diagnosis of ovarian cancer.
The following tests are usually used to rule out or diagnose ovarian cancer. Many of the same tests used to diagnose cancer are used to find out the stage (how far the cancer has progressed). Your doctor may also order other tests to check your general health and to help plan your treatment.
Health history and physical exam

Your health history is a record of your symptoms, risk factors and all the medical events and problems you have had in the past. Your doctor will ask questions about your history of:

symptoms that suggest ovarian cancer
breast cancer
Lynch syndrome (also called hereditary non-polyposis colorectal cancer, or HNPCC)
pregnancies
hormone replacement therapy
smoking
exposure to asbestos

Your doctor may also ask about a family history of:

ovarian or breast cancer
Lynch syndrome (also called hereditary non-polyposis colorectal cancer, or HNPCC)
infertility
risk factors for ovarian cancer
other cancers, such as breast, uterine and colorectal cancers

A physical exam allows your doctor to look for signs of ovarian cancer. During a physical exam, your doctor may:

do a pelvic and rectal exam to check the uterus, vagina, ovaries, fallopian tubes, bladder and rectum for any unusual changes
feel the abdomen for lumps, bloating or enlargement of organs such as the liver or spleen

Find out more about physical exams and pelvic exams.
Ultrasound

An ultrasound uses high-frequency sound waves to make images of parts of the body. A pelvic or transvaginal ultrasound may be done to look for ovarian cancer. With the transvaginal ultrasound, the ultrasound wand or probe is placed into the vagina and aimed at the ovaries instead of placing the probe on the surface of the abdomen. Ultrasounds are used to:

find an ovarian tumour and see if it is a solid tumour or a fluid-filled cyst
see the shape and size of the ovary and how it looks inside
evaluate abnormalities in other organs in the pelvis
check for a buildup of fluid in the abdomen

Find out more about ultrasound.
Tumour marker tests

Tumour markers are substances found in the blood, tissues or fluids removed from the body. Tumour marker tests are generally used to check your response to cancer treatment and watch for recurrences. They can also be helpful when diagnosing ovarian cancer.
The following tumour markers may be measured for ovarian cancer.
Cancer antigen 125 (CA125) may be higher in women with ovarian cancer, benign conditions and other cancers.
Carcinoembryonic antigen (CEA) may be higher in women with ovarian cancer and benign conditions.
Human chorionic gonadotropin (HCG or b-HCG) may be higher in young women with ovarian germ cell tumours.
Alpha-fetoprotein (AFP) may be higher in young women with ovarian germ cell tumours.
Find about more about tumour marker tests.
Complete blood count (CBC)

A CBC measures the number and quality of white blood cells, red blood cells and platelets. A CBC is done to provide information about your general health, check for anemia from long-term vaginal bleeding and to provide a baseline to compare with future CBCs during and after treatment.
Find out more about a complete blood count (CBC).
Blood chemistry tests

Blood chemistry tests measure certain chemicals in the blood. They show how well certain organs are functioning and can help find abnormalities.
Lactate dehydrogenase (LDH) may be measured in women with ovarian cancer. Higher levels may indicate an ovarian germ cell tumour.
Hormones, such as estrogen and testosterone and inhibin, may be at higher levels than normal in some women with ovarian stromal tumours.
Find out more about blood chemistry tests.
CT scan

A computed tomography (CT) scan uses special x-ray equipment to make 3-D and cross-sectional images of organs, tissues, bones and blood vessels inside the body. A computer turns the images into detailed pictures.
A CT scan is used to:

assess the pelvis, abdomen and lymph nodes around the ovaries
see if cancer has spread to other organs or tissues
guide the needle when doing a biopsy of an area of suspected metastasis

Find out more about CT scans.
MRI

Magnetic resonance imaging (MRI) uses powerful magnetic forces and radiofrequency waves to make cross-sectional images of organs, tissues, bones and blood vessels. A computer turns the images into 3-D pictures.
An MRI is used to:

assess the pelvis, abdomen and lymph nodes around the ovaries
see if cancer has spread to other organs or tissues
guide the needle when doing a biopsy of an area of suspected metastasis

Find out more about MRIs.
Laparoscopy

During a laparoscopy, the doctor makes a small cut (incision) in the abdomen and places a thin tube (called a laparoscope) into the abdominal cavity. Surgical instruments can be passed through the laparoscope to remove small pieces of tissue. Laparoscopy is done to:

check for abnormal growths and remove samples of tissue from the ovaries and other organs in the abdomen
remove small tumours or cysts
help confirm the stage of a cancer
plan surgery or other treatments

Biopsy

During a biopsy, the doctor removes tissues or cells from the body so they can be tested in a lab. A report from the pathologist will show whether or not cancer cells are found in the sample.
Biopsies for ovarian cancer are often done during surgery called a laparotomy. This surgery is used to diagnose, stage and treat ovarian cancer, often all at the same time. The surgeon makes a large cut (incision) in the abdomen to examine all organs in the abdominal cavity. During this surgery, the surgeon usually removes the entire tumour and also removes tissue samples from different parts of the pelvis and abdomen to detect for any spread to those areas. The samples are sent to the lab to help stage the cancer. This is called surgical staging.
Find out more about biopsies.
Paracentesis

A paracentesis is a procedure in which a hollow needle or tube is inserted through the skin and into the abdominal cavity. This procedure is done to remove symptomatic buildup of fluid in the abdomen (ascites). The fluid is examined for cancer cells.
Chest x-ray

An x-ray uses small doses of radiation to make an image of parts of the body on film. It is used to look for signs of fluid around the lungs (pleural effusion) that could be caused by ovarian cancer that has spread to the lungs.
Find out more about x-rays.
Colonoscopy

A colonoscopy may be done to see if the ovarian cancer has spread to the colon or to rule out colon cancer.
Find out more about colonoscopies.
PET scan

A positron emission tomography (PET) scan uses radioactive materials called radiopharmaceuticals to look for changes in the metabolic activity of body tissues. A computer analyzes the radioactive patterns and makes 3-D colour images of the area being scanned.
A PET scan may be used to find ovarian cancer that has come back or has spread to other organs or tissues.
Find out more about PET scans.
Questions to ask your healthcare team

Find out more about a diagnosis. To make the decisions that are right for you, ask your healthcare team questions about a diagnosis.


Read more: http://www.cancer.ca/en/cancer-infor...#ixzz5BGHjbEUJ



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قديم 05-30-2019, 02:33 PM باحث_علمى غير متواجد حالياً   رقم الموضوع : [3]
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باحث_علمى is on a distinguished road
افتراضي

Grading ovarian cancer

The grade is a description of how the cancer cells look compared to normal cells and their growth rate. To find out the grade of ovarian cancer, the pathologist looks at a tissue sample from the tumour under a microscope.
How different the cancer cells are is described as differentiation.
Low grade usually means that the cancer cells are well differentiated. They look almost like normal cells. Lower grade cancer cells tend to be slow growing and are less likely to spread.
High grade usually means that the cancer cells are poorly differentiated or undifferentiated. They look less normal, or more abnormal. Higher grade cancer cells tend to grow more quickly and are more likely to spread than low-grade cancer cells.
Serous epithelial ovarian cancers are unique, in that the names of the 2 different tumour subtypes include the grade, based on their appearance and behaviour:

LGSC – low-grade serous carcinoma
HGSC – high-grade serous carcinoma

Some ovarian cancers are, by definition, high grade, such as clear cell carcinoma. Other types of ovarian cancer may be graded as 1, 2 or 3, such as endometrioid adenocarcinomas. A lower number means the cancer is a lower grade.
Knowing the grade gives your healthcare team an idea of how quickly the cancer may be growing and how likely it is to spread. This helps them plan your treatment. The grade can also help the healthcare team predict future outcomes (your prognosis) and how the cancer might respond to treatment.




Read more: http://www.cancer.ca/en/cancer-infor...#ixzz5BGI7yeSv


Stages of ovarian cancer

Staging describes or classifies a cancer based on how much cancer there is in the body and where it is when first diagnosed. This is often called the extent of cancer. Information from tests is used to find out the size of the tumour, which parts of the organ have cancer, whether the cancer has spread from where it first started and where the cancer has spread. Your healthcare team uses the stage to plan treatment and estimate the outcome (your prognosis).
The most common staging system for ovarian cancer is the FIGO system. For ovarian cancer there are 4 stages. Often the stages 1 to 4 are written as the Roman numerals I, II, III and IV. Generally, the higher the stage number, the more the cancer has spread. Talk to your doctor if you have questions about staging.
This staging system applies to both epithelial and stromal ovarian tumours, including tumours of borderline malignancy. It is also used to stage cancers that start in the peritoneum (called primary peritoneal carcinoma).
Ovarian cancer is staged during surgery to remove the ovaries and as much cancer that has spread as possible. All tissues removed will be tested for cancer. The stage is based on the results of the tests. Some women who appear to have early stage disease (stage 1) may be assigned a higher stage after complete surgical staging.
Find out more about staging cancer.
Stage 1

The tumour is only in 1 ovary or both ovaries.
For stage 1A, the tumour is only inside 1 ovary and nowhere else. The capsule that surrounds the ovary has not broken (ruptured) (it stays intact).
For stage 1B, tumours are inside both ovaries and nowhere else. The capsule that surrounds each ovary has not broken.
For stage 1C, the tumour is in 1 ovary or tumours are in both ovaries with any of the following:

The capsule surrounding an ovary broke during surgery (called a surgical spill).
The capsule surrounding an ovary broke before surgery. Or cancer cells are seen on the surface of 1 or both ovaries.
Cancer cells are in ascites or peritoneal washings (a saltwater solution used to wash the peritoneal cavity and check for cancer cells at the time of surgery).

Stage 2

The cancer involves 1 ovary or both ovaries and has grown into the surrounding pelvic organs.
For stage 2A, the tumour has grown into the uterus, fallopian tubes or both.
For stage 2B, the tumour has grown into other organs in the lower part of the pelvis, such as the rectum.
Stage 3

The cancer involves 1 or both ovaries or it started in the peritoneum. The cancer has spread to areas outside the pelvis.
For stage 3A, the cancer has spread to the lymph nodes in the back of the abdomen (retroperitoneal lymph nodes). Or a small amount of cancer (seen only through a microscope) has spread to the peritoneum outside the pelvis and to the intestine, and it may have spread to the retroperitoneal lymph nodes.
For stage 3B, a large amount of cancer (seen by the doctor during surgery) has spread to the peritoneum just outside the pelvis and to the intestine, and it may have spread to the retroperitoneal lymph nodes.
For stage 3C, the cancer has spread to the peritoneum outside the pelvis and far from it (more than 2 cm away). It may have grown to the capsule surrounding the liver or spleen, but not inside these organs.
Stage 4

The cancer has spread to other parts of the body (called distant metastasis) outside the abdomen and pelvis.
For stage 4A, there are cancer cells in fluid buildup within the pleural cavity (called pleural effusion).
For stage 4B, the cancer has spread to other organs, such as the liver (inside it), lungs or lymph nodes outside the abdomen.
Recurrent ovarian cancer

Recurrent ovarian cancer means that the cancer has come back after it has been treated. If it comes back in the same place that the cancer first started or close to where it started, it’s called local recurrence. It can also recur in another part of the body. This is called distant metastasis or distant recurrence.


Read more: http://www.cancer.ca/en/cancer-infor...#ixzz5BGIFamSs


If ovarian cancer spreads

Cancer cells can spread from the ovary to other parts of the body. This spread is called metastasis.
Understanding how a type of cancer usually grows and spreads helps your healthcare team plan your treatment and future care. If ovarian cancer spreads, it can spread to the following:

fallopian tube
other ovary
uterus
cervix
vagina
omentum (a fold in the peritoneum that covers and supports organs and blood vessels in the abdomen)
parietal peritoneum (the membrane that lines the walls of the abdomen and pelvis) or visceral peritoneum (the membrane that covers and supports most of the organs in the abdomen)
diaphragm (the thin muscle below the lungs and heart that separates the chest cavity from the abdomen)
lymph nodes in the pelvis and retroperitoneum
bladder
large intestine
rectum
small intestine
liver
lungs



Read more: http://www.cancer.ca/en/cancer-infor...#ixzz5BGIP5S35

Prognosis and survival in ovarian cancer

If you have ovarian cancer, you may have questions about your prognosis. The prognosis is the doctor’s best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type, grade, stage and other features of your cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis.
A prognostic factor is an aspect of the cancer or a characteristic of the person (such as whether they smoke) that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together. They both play a part in deciding on a treatment plan and a prognosis.
The following are prognostic and predictive factors for ovarian cancer.
Stage

Stage is the most important prognostic factor for most types of ovarian cancer. Women diagnosed with early stage ovarian cancer have a better prognosis than women diagnosed with cancer at a later stage.
Cancer cells in ascites or peritoneal washings

If ovarian cancer cells are found in fluid that has built up in the abdomen (called ascites) or in the washings of the peritoneum taken during surgery, the prognosis is poorer.
Extraovarian spread

Ovarian tumours can spread to and grow onto another organs or another surface near the ovary. If there are a large number of tumours within the pelvis and abdomen, the prognosis is poorer.
Tumour type

Some types of ovarian cancer have a better prognosis. The characteristics of a particular type of tumour often relate to the grade or stage of the tumour. For example, most ovarian stromal tumours are low grade and have a good prognosis.
Grade

The grade of the tumour is an important prognostic factor for ovarian cancer. Low-grade tumours are associated with a better prognosis than high-grade tumours.
Cancer that remains after surgery

The amount of cancer that remains after surgery is called residual disease. No residual disease has a better prognosis than if there is cancer remaining after surgery.
Age

Younger women who have ovarian cancer have a better prognosis than older women.
Performance status

Performance status is a measure of how well a person is able to perform ordinary tasks and carry out daily activities. A woman with a good performance status is more likely to respond to treatment, experience fewer and less severe side effects and have a better prognosis.
Response to chemotherapy

If the treatment is having an effect on the cancer after the first cycle of chemotherapy, it is considered a good prognostic factor.
Cancer antigen 125 (ca125) level

A lowered level of CA125 after chemotherapy is a good prognostic factor.




Read more: http://www.cancer.ca/en/cancer-infor...#ixzz5BGIX1M2Y




Survival statistics for ovarian cancer

Survival statistics for ovarian cancer are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of women, they cannot be used to predict a particular woman’s chances of survival.
There are many different ways to measure and report cancer survival statistics. Your doctor can explain the statistics for ovarian cancer and what they mean to you.
Net survival

Net survival represents the probability of surviving cancer in the absence of other causes of death. It is used to give an estimate of the percentage of people who will survive their cancer.
In Canada, the 5-year net survival for ovarian cancer is 44%. This means that, on average, about 44% of women diagnosed with ovarian cancer will survive for at least 5 years.
Survival by stage and tumour type

Survival varies with each stage and particular tumour type of ovarian cancer. Generally, the earlier ovarian cancer is diagnosed and treated, the better the outcome.
Relative survival

Relative survival looks at how likely people with cancer are to survive after their diagnosis compared to people in the general population who do not have cancer but who share similar characteristics (such as age and sex).
There are no specific Canadian statistics available for the different stages and types of ovarian cancer. The following information comes from a variety of sources. It may include statistics from other countries that are likely to have similar outcomes as in Canada.
Epithelial ovarian cancer survivalStage5-year relative survival1
90%
1A
94%
1B
92%
1C
85%
2
70%
2A
78%
2B
73%
2C
57%
3
39%
3A
59%
3B
52%
3C
39%
4
17%

Ovarian stromal tumour survivalStage5-year relative survival1
95%
2
78%
3
65%
4
35%

Ovarian germ cell tumour survivalStage5-year relative survival1
98%
2
94%
3
87%
4
69%

Ovarian tumour of borderline malignancy survivalStage5-year relative survival10-year relative survival1
99%
97%
2
98%
90%
3
96%
88%
4
77%
69%

Primary peritoneal carcinoma survival

The overall 5-year survival for primary peritoneal carcinoma is about 20%. Long-term survival may be better than 20% if the treatment plan includes chemotherapy.
Questions about survival

Talk to your doctor about your prognosis. A prognosis depends on many factors, including:

your health history
the type of cancer
the grade
the stage
certain characteristics of the cancer
the treatments chosen
how the cancer responds to treatment

Only a doctor familiar with these factors can put all of this information together with survival statistics to arrive at a prognosis.




Read more: http://www.cancer.ca/en/cancer-infor...#ixzz5BGIei8h3



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قديم 05-30-2019, 02:38 PM باحث_علمى غير متواجد حالياً   رقم الموضوع : [4]
باحث_علمى
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باحث_علمى is on a distinguished road
افتراضي

Treatments for ovarian cancer

If you have ovarian cancer, your healthcare team will create a treatment plan just for you. It will be based on your health and specific information about the cancer. When deciding which treatments to offer for ovarian cancer, your healthcare team will consider:

stage
grade
type of tumour
whether you want to get pregnant in the future

You may be offered one or more of the following treatments for ovarian cancer.
Surgery

Surgery is the main treatment for all stages and types of ovarian cancer.
A total hysterectomy and bilateral salpingo-oophorectomy is the most common surgery. This operation removes the uterus, ovaries and fallopian tubes. You may also have nearby lymph nodes, omentum and any other tissues that look abnormal at the time of surgery removed.
A salpingo-oophorectomy may be unilateral (removing the ovary and fallopian tube on one side only) or bilateral (removing both ovaries and fallopian tubes).
Surgical debulking removes as much of the cancer as possible from the abdomen.
A cystectomy removes only the cyst that contains the tumour and leaves the rest of the ovary intact.
Some surgical procedures may be done to relieve symptoms of late-stage ovarian cancer.
Chemotherapy

Chemotherapy is offered before or after surgery to treat some types and stages of ovarian cancer.
Chemotherapy can also be given to relieve pain or to control the symptoms of ovarian cancer (called palliative chemotherapy).
Hormonal therapy

Some women with low-grade ovarian cancer may receive hormonal therapy instead of chemotherapy after surgery.
Targeted therapy

Some women with advanced epithelial ovarian cancer or primary peritoneal carcinoma can be treated with targeted therapy, with or without chemotherapy.
Radiation therapy

Radiation therapy is not commonly used to treat ovarian cancer. Ovarian cancer often involves many organs in the abdomen and radiation therapy needs to be aimed at a small area. It may be used after surgery if chemotherapy can’t be used because of older age or health problems. It may be used to treat small areas of cancer that have come back or spread and to control symptoms of advanced ovarian cancer.
If you can’t have or don’t want cancer treatment

You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.
Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.
Follow-up care

Follow-up after treatment is an important part of cancer care. You will need to have regular follow-up visits, especially in the first 5 years after treatment has finished. These visits allow your healthcare team to monitor your progress and recovery from treatment.
Clinical trials

Some clinical trials in Canada are open to women with ovarian cancer. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.
Questions to ask about treatment

To make the decisions that are right for you, ask your healthcare team questions about treatment.




Read more: http://www.cancer.ca/en/cancer-infor...#ixzz5BGJQBUlY


Treatments for epithelial ovarian cancer

The following are treatment options for the stages of epithelial ovarian cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.
Stage 1

Surgery is the first treatment given for stage 1 epithelial ovarian cancer. It is done to remove the cancer and to see if there is any spread outside of the ovaries. The types of surgery are:

removing the uterus, both ovaries and both fallopian tubes (called a total hysterectomy and bilateral salpingo-oophorectomy)
removing only the ovary with cancer and the fallopian tube on the same side (called a unilateral salpingo-oophorectomy)

During surgery, the surgeon also removes abnormal-looking tissue samples from different parts of the pelvis, abdomen and lymph nodes. These samples are then analyzed in the lab to find out if the cancer has spread. This part of surgery is called surgical staging.
Chemotherapy may be given after surgery for stage 1 epithelial ovarian cancer.
A combination of a platinum drug, such as cisplatin or carboplatin (Paraplatin, Paraplatin AQ), and a taxane drug, such as paclitaxel (Taxol) or docetaxel (Taxotere), is used. Carboplatin and paclitaxel given by IV (intravenously) is the chemotherapy that is most often given for stage 1 epithelial cancer.
Stages 1A and 1B treatment

The grade of the cancer is important when planning treatment for stage 1A and 1B epithelial ovarian cancer.

A grade 1 epithelial ovarian cancer may be treated with a unilateral salpingo-oophorectomy only if you want to be able to get pregnant after treatment.
A grade 2 cancer can be watched closely after surgery without more treatment, or chemotherapy will be given.
A grade 3 cancer is usually treated with chemotherapy after surgery.

Stage 1C treatment

Stage 1C treatment is surgery followed by chemotherapy.
Stage 2

Surgery is the first treatment given for stage 2 epithelial ovarian cancer. The types of surgery are:

total hysterectomy and bilateral salpingo-oophorectomy
removing as much of the cancer as possible (called surgical debulking)

During surgery, the surgeon also removes abnormal-looking tissue samples from different parts of the pelvis, abdomen and lymph nodes. These samples are then analyzed in the lab to find out if the cancer has spread. This part of surgery is called surgical staging.
Chemotherapy is usually given following surgery. Carboplatin and paclitaxel given by IV is the chemotherapy that is most often given. Some women may have intraperitoneal (IP) chemotherapy instead of IV chemotherapy. IP chemotherapy is given directly into the abdomen through an implanted temporary port, instead of IV chemotherapy.
Stage 3

Surgery is the first treatment given for stage 3 epithelial ovarian cancer. The types of surgery are:

total hysterectomy and bilateral salpingo-oophorectomy
removing the fatty tissue that covers the abdominal organs (omentectomy)
surgical debulking

During surgery, the surgeon also removes abnormal-looking tissue samples from different parts of the pelvis, abdomen and lymph nodes. These samples are then analyzed in the lab to find out if the cancer has spread. This part of surgery is called surgical staging.
Chemotherapy is given after surgery with carboplatin or cisplatin along with paclitaxel or docetaxel. Carboplatin and paclitaxel given by IV is the chemotherapy that is most often used.
Intraperitoneal chemotherapy directly into the abdomen may be given instead of intravenous chemotherapy. You may be offered this therapy if you have stage 3 epithelial ovarian cancer with tumours smaller than 1 cm in size after primary surgical debulking.
Sometimes chemotherapy is given before debulking surgery for a few treatments. If the cancer shrinks from the chemotherapy, surgery can be done to remove as much cancer as possible. More chemotherapy is given after the surgery. This is called interval debulking surgery.
Stage 4

Stage 4 epithelial ovarian cancer is often treated with surgery and chemotherapy.
Surgery may be done to remove the tumour and debulk the cancer. Sometimes chemotherapy is given before surgery to shrink the tumour. More chemotherapy may be given after surgery.
During surgery, the surgeon also removes abnormal looking tissue samples from different parts of the pelvis, abdomen and lymph nodes. These samples are then analyzed in the lab to find out if the cancer has spread. This part of surgery is called surgical staging.
Surgical procedures to reduce symptoms and relieve pain for stage 4 cancer include:

paracentesis to remove fluid from the abdomen
thoracentesis to remove fluid from around the lungs
placing a feeding tube into the stomach or intestines
placing a tube (stent) in the large or small intestine or ureter to relieve a blockage caused by a tumour

Chemotherapy for stage 4 epithelial ovarian cancer is often carboplatin or cisplatin with paclitaxel or docetaxel. Carboplatin and paclitaxel is the chemotherapy combination that is most often used.
Recurrent or persistent epithelial ovarian cancer

Recurrent ovarian cancer means that the cancer has come back after it has been treated. Persistent ovarian cancer never went away completely even after treatment.
Surgery may be offered for recurrent or persistent epithelial ovarian cancer. The types of surgery are:

surgical debulking
surgical procedures to reduce symptoms and relieve pain as used in stage 4

Chemotherapy with a combination of drugs is usually used to treat recurrent or persistent epithelial ovarian cancer.
The chemotherapy drugs used depends on the drugs used the first time and how long the cancer stayed away after finishing the last chemotherapy treatment.
If it has been at least 6 months since your last chemotherapy treatment, you may be re-treated with carboplatin and paclitaxel even if these were the drugs you had before.
If the cancer comes back in less than 6 months or it didn’t go away, your healthcare team will consider a different drug combination.
Many drugs can be used in combination to treat recurrent or persistent ovarian cancer if treatment with a platinum drug such as carboplatin or cisplatin isn’t working. Other drugs that may be used include:

docetaxel (Taxotere)
paclitaxel (Taxol)
etoposide (Vepesid)
gemcitabine (Gemzar)
topotecan (Hycamtin)
vinorelbine (Navelbine)
pegylated liposomal doxorubicin (Caelyx)
trabectedin (Yondelis)

Targeted therapy may be used to treat advanced epithelial ovarian cancer. Sometimes a targeted therapy drug is combined with a chemotherapy drug. Targeted therapy drugs approved in Canada include:

bevacizumab (Avastin)
olaparib (Lynparza) for women with a BRCA1 of BRCA2 gene mutation

Olaparib may also be given as maintenance therapy.
Hormonal therapy may be given in addition to chemotherapy to treat advanced epithelial ovarian cancer. Hormonal therapy includes drugs such as:

anastrozole (Arimidex)
letrozole( Femara)
tamoxifen (Nolvadex, Tamofen)

Radiation therapy is sometimes given to treat advanced epithelial ovarian cancer.
If you can’t have or don’t want cancer treatment

You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.
Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.
Clinical trials

Some clinical trials in Canada are open to women with ovarian cancer. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.


Read more: http://www.cancer.ca/en/cancer-infor...#ixzz5BGJWmo8E

Treatments for borderline malignancy ovarian tumours

The following are treatment options for the stages of borderline malignancy ovarian cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.
Early stage borderline malignancy tumours

Surgery is the main treatment for early stage (stages 1 and 2) borderline malignancy ovarian cancer. The types of surgery done will depend on whether you want to get pregnant in the future.
The following may be offered to women who want to have children in the future:

removing only the ovary with cancer and the fallopian tube on the same side (unilateral salpingo-oophorectomy)
removing only the part of ovary with the cyst containing the tumour (cystectomy or partial oophorectomy)

The following surgeries do not allow you to have children in the future:

removing both ovaries and fallopian tubes (bilateral salpingo-oophorectomy)
removing the uterus, both ovaries and both fallopian tubes (total hysterectomy and bilateral salpingo-oophorectomy)

During surgery, the surgeon also removes abnormal-looking tissue samples from different parts of the pelvis, abdomen and lymph nodes. These samples are then analyzed in the lab to find out if the cancer has spread. This part of surgery is called surgical staging.
Advanced stage borderline malignancy ovarian tumours

Surgery is the main treatment for advanced stage (stages 3 and 4) borderline malignancy ovarian cancer. The types of surgery are:

total hysterectomy and bilateral salpingo-oophorectomy
surgical debulking (removing as much of the cancer as possible)

During surgery, the surgeon also removes abnormal-looking tissue samples from different parts of the pelvis, abdomen and lymph nodes. These samples are then analyzed in the lab to find out if the cancer has spread. This part of surgery is called surgical staging.
Further treatment with chemotherapy or radiation therapy is usually not given.
Recurrent borderline malignancy ovarian tumours

Recurrent borderline malignancy ovarian cancer means that the cancer has come back after it has been treated. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.
Surgery is the main treatment for recurrent borderline malignancy ovarian cancer. Debulking surgery is done to remove as much of the tumour as possible.
Chemotherapy with carboplatin (Paraplatin, Paraplatin AQ) or cisplatin combined with other drugs such as paclitaxel (Taxol) may be given after surgery.
If you can’t have or don’t want cancer treatment

You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.
Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.
Clinical trials

Some clinical trials in Canada are open to women with ovarian cancer. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.




Read more: http://www.cancer.ca/en/cancer-infor...#ixzz5BGJfWkeO

Treatments for stromal ovarian cancer

The following are treatment options for the stages of stromal ovarian cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.
Stage 1

Surgery is the main treatment and usually the only treatment for stage 1 stromal ovarian cancer. The types of surgery are:

removing the uterus, both ovaries and both fallopian tubes (total hysterectomy and bilateral salpingo-oophorectomy)
removal of the ovary with cancer and the fallopian tube on the same side (unilateral salpingo-oophorectomy) may be offered to women who want to get pregnant in the future

During surgery, the surgeon also removes abnormal-looking tissue samples from different parts of the pelvis, abdomen and lymph nodes. These samples are then analyzed in the lab to find out if the cancer has spread. This part of surgery is called surgical staging.
Chemotherapy with a combination of drugs that includes carboplatin (Paraplatin, Paraplatin AQ) or cisplatin may be offered after surgery if you have a high risk of the tumour coming back (recurrence). Tumours that have a high risk of recurrence include those that are large, high grade or have broken open (ruptured).
Stages 2, 3 and 4

The following are treatment options for stages 2, 3 and 4 stromal ovarian cancer.
Surgery

Surgery is the main treatment for stages 2, 3, and 4 stromal ovarian cancer. The types of surgery are:

total hysterectomy and bilateral salpingo-oophorectomy
unilateral salpingo-oophorectomy may be offered if you want to get pregnant in the future
surgical debulking (removing as much of the cancer as possible)

During surgery, the surgeon also removes abnormal-looking tissue samples from different parts of the pelvis, abdomen and lymph nodes. These samples are then analyzed in the lab to find out if the cancer has spread. This part of surgery is called surgical staging.
Chemotherapy

Chemotherapy may be offered after surgery for stages 2, 3 and 4 stromal ovarian cancer. The types of combination chemotherapy include:

carboplatin and paclitaxel (Taxol)
PEB (or BEP), which is a combination of cisplatin, etoposide (Vepesid, VP-16) and bleomycin (Blenoxane)
PVB, which is a combination of cisplatin, vinblastine and bleomycin

Hormonal therapy

Hormonal therapymay be offered after surgery for stages 2, 3 and 4 stromal ovarian cancer. Hormonal therapy is often offered to women who cannot tolerate chemotherapy because of the side effects or other health issues. The types of hormonal therapy include:

tamoxifen (Nolvadex, Tamofen)
letrozole (Femara)
anastrozole (Arimidex)
leuprolide (Lupron, Lupron Depot, Eligard)
goserelin (Zoladex)

Recurrent

Recurrent stromal ovarian cancer means that the cancer has come back after it has been treated.
Surgery to debulk the tumour may be offered for recurrent stromal ovarian cancer.
Chemotherapy may be offered for recurrent stromal ovarian cancer. The types of chemotherapy are the same as those used for stages 2, 3 and 4.
Hormonal therapy may be offered for recurrent stromal ovarian cancer. The types of hormonal therapy are the same as those used for stages 2, 3 and 4.
Radiation therapy is also sometimes used for recurrences that are only found in small areas in the pelvis.
If you can’t have or don’t want cancer treatment

You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.
Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.
Clinical trials

Some clinical trials in Canada are open to women with ovarian cancer. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.




Read more: http://www.cancer.ca/en/cancer-infor...#ixzz5BGJniOk1



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قديم 05-30-2019, 02:40 PM باحث_علمى غير متواجد حالياً   رقم الموضوع : [5]
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باحث_علمى is on a distinguished road
افتراضي

Treatments for germ cell ovarian cancer

The following are treatment options for stages of germ cell ovarian cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.
The stages, grades and types of germ cell ovarian cancer are treated the same except for stage 1 dysgerminoma and grade 1 immature teratomas.
Surgery

Surgery is the first treatment for all stages of germ cell ovarian cancer. The types of surgery are:

removing only the ovary with cancer and the fallopian tube on the same side (unilateral salpingo-oophorectomy)
removing as much of the cancer as possible (surgical debulking) may be done for stage 1C and higher

During surgery, the surgeon also removes abnormal-looking tissue samples from different parts of the pelvis, abdomen and lymph nodes. These samples are then analyzed in the lab to find out if the cancer has spread. This part of surgery is called surgical staging.
Chemotherapy

Most women with germ cell ovarian cancer will have chemotherapy after surgery. The types of chemotherapy commonly used are:

PEB (or BEP), which is a combination of cisplatin, etoposide (Vepesid, VP-16) and bleomycin (Blenoxane)
carboplatin (Paraplatin, Paraplatin AQ) and etoposide

Stage 1 dysgerminoma

Stage 1 dysgerminoma is treated with surgery alone to remove the ovary with cancer and the fallopian tube on the same side. You will be watched closely to see if the cancer comes back. If it does, you will be given chemotherapy or radiation. Most women with stage 1 dysgerminoma never need chemotherapy.
Grade 1 immature teratomas

A stage 1 grade 1 immature teratoma is found in one or both ovaries. It is treated by removing the ovary or ovaries with the cancer and the fallopian tube or tubes. Other tissues are removed for testing during the surgery. Grade 1 immature teratomas rarely come back after surgery and chemotherapy is rarely needed.
Recurrent or persistent germ cell ovarian cancer

Recurrent ovarian cancer means that the cancer has come back after it has been treated. Persistent ovarian cancer never went away completely after treatment.
Treatments for recurrent or persistent germ cell ovarian cancer include:
Chemotherapywith a combination of drugs is the main treatment for recurrent or persistent germ cell cancer.
PEB may be used if you haven’t had this combination of drugs before. If these drugs were used before, another combination of chemotherapy drugs will be used such as:

VAC – vincristine (Oncovin), dactinomycin (Cosmegan, actinomycin-D), cyclophosphamide (Procytox)
VeIP – vinblastine, ifosfamide (Ifex), cisplatin

Radiation therapy is often given for dysgerminoma. It is not used very often for other types of germ cell ovarian cancer.
If you can’t have or don’t want cancer treatment

You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.
Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.
Clinical trials

Some clinical trials are open to women with ovarian cancer. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.




Read more: http://www.cancer.ca/en/cancer-infor...#ixzz5BGKDEMn2


Treatments for primary peritoneal carcinoma

The following are treatment options for the stages of primary peritoneal carcinoma. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.
Most cases are stage 3 or 4 at the time of diagnosis. Treatment for primary peritoneal carcinoma is the same as for epithelial ovarian cancer of a similar grade and stage.
Surgery

Surgery is the first treatment for primary peritoneal carcinoma. The types of surgery are:

removing the uterus, both ovaries and both fallopian tubes (total hysterectomy and bilateral salpingo-oophorectomy)
omentectomy
removing as much of the cancer as possible (surgical debulking)

During surgery, the surgeon also removes abnormal-looking tissue samples from different parts of the pelvis, abdomen and lymph nodes. These samples are then analyzed in the lab to find out if the cancer has spread. This part of surgery is called surgical staging.
Surgical procedures to reduce symptoms and relieve pain for stage 4 cancer include:

paracentesis to remove fluid from the abdomen
thoracentesis to remove fluid from around the lungs
placing a feeding tube into the stomach or intestines
placing a tube (stent) in the large or small intestine or ureter to relieve a blockage caused by a tumour

Chemotherapy

Chemotherapy is a treatment for primary peritoneal carcinoma. It is given after surgery with carboplatin (Paraplatin, Paraplatin AQ) or cisplatin along with paclitaxel (Taxol) or docetaxel (Taxotere). Carboplatin and paclitaxel given by IV is the chemotherapy that is most often used.
Other chemotherapy drugs that may be used when the cancer recurs include:

etoposide (Vepesid, VP-16)
gemcitabine (Gemzar)
topotecan (Hycamtin)
vinorelbine (Navelbine)
pegylated liposomal doxorubicin (Caelyx)

Intraperitoneal chemotherapy may be given instead of intravenous chemotherapy. It may be offered to women who still have small residual tumours (less than 1 cm) after surgical debulking.
Sometimes chemotherapy is given before debulking surgery. If the cancer shrinks from the chemotherapy, surgery can be done to remove as much cancer as possible. More chemotherapy is given after the surgery. This is called interval debulking surgery.
Targeted therapy

Targeted therapy may be used to treat some advanced primary peritoneal carcinoma. Sometimes a targeted therapy drug is combined with a chemotherapy drug. Targeted therapy drugs used include:

bevacizumab (Avastin)
olaparib (Lynparza) for women with a BRCA1 or BRCA2 gene mutation

Olaparib may also be given as maintenance therapy.
Hormonal therapy

Hormonal therapy may be given in addition to chemotherapy to treat advanced primary peritoneal carcinoma. Hormonal therapy includes drugs such as:

anastrozole (Arimidex)
letrozole( Femara)
tamoxifen (Nolvadex, Tamofen)

Radiation therapy

Radiation therapy is sometimes used to treat advanced primary peritoneal carcinoma.
If you can’t have or don’t want cancer treatment

You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.
Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.
Clinical trials

Some clinical trials in Canada are open to women with ovarian cancer. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.


Read more: http://www.cancer.ca/en/cancer-infor...#ixzz5BGKKIKQo


Surgery for ovarian cancer

Most women with ovarian cancer will have surgery. The type of surgery you have depends mainly on the type of the tumour and stage of the cancer. When planning surgery, your healthcare team will also consider other factors, such as your age, overall heath and whether you want to get pregnant in the future.
Surgery may be done for different reasons. You may have surgery to:

accurately diagnose and stage the disease
completely remove the tumour
remove as much of the cancer as possible (called surgical debulking) before other treatments
reduce pain or ease symptoms (called palliative surgery)

The following types of surgery are used to treat ovarian cancer. You may also have other treatments before or after surgery.
Surgical staging

Ovarian cancer is staged during surgery and treated at the same time. All of the tissue and fluid samples that are removed are sent to the lab to be checked for cancer cells. Some women who appear to have early stage disease (stage 1) based on diagnostic tests are assigned a higher stage (stage 2 or 3) after their samples have been analyzed in the lab.
Surgical staging includes:

washing the abdominal cavity to see if there are cancer cells or removing ascites (an abnormal buildup of fluid in the abdomen) for examination to see if there are cancer cells
examining all surfaces in the pelvis and abdomen
scraping the surfaces of the diaphragm to check for cancer cells
biopsy of any areas that look like cancer and from all areas inside the abdomen and pelvis
removing some lymph nodes in the pelvis and abdomen
removing most or all of the omentum (the fatty tissue that covers the abdominal organs)
examining or removing the ovary that doesn’t contain cancer

If the other ovary appears normal, the surgeon will leave it alone if you wish to get pregnant in the future. But if it looks abnormally large, the surgeon will recommend removing it to rule out any cancer spread.
Total hysterectomy and bilateral salpingo-oophorectomy

A total hysterectomy and bilateral salpingo-oophorectomy is the most common surgical procedure used to treat ovarian cancer. This surgery removes the uterus, both ovaries and both fallopian tubes.
Find out more about a hysterectomy.
Salpingo-oophorectomy

A salpingo-oophorectomy removes the ovary and fallopian tube. Salpingo-oophorectomy may be bilateral (the ovaries and fallopian tubes on both sides are removed) or unilateral (only one ovary and one fallopian tube on one side are removed).
Cystectomy

A cystectomy may be done for some types of early stage ovarian cancers if the woman wants to get pregnant in the future. A cystectomy removes only the cyst that contains the tumour and leaves the remaining ovary intact.
Surgical debulking

Surgical debulking removes as much of the cancer as possible. It is also called tumour debulking. Ovarian cancer spreads by seeding cancer cells throughout the abdomen and pelvis. Removing these cancerous areas can happen at different times.
Primary surgical debulking

Primary surgical debulking (also called cytoreductive surgery) removes as much of the ovarian cancer as possible during the first surgery to treat it. The goal is to leave as little of the tumour behind as possible after surgery (ideally less than 1 cm in size). Primary surgical debulking may include removing:

the uterus, ovaries and fallopian tubes (called total hysterectomy and bilateral salpingo-oophorectomy)
the omentum
small tumours from the surface of the diaphragm
part of the diaphragm
part of the stomach, spleen or pancreas
the gallbladder
part of the large intestine or small intestine (called a bowel resection), bladder or liver
lymph nodes in the pelvis and abdomen

During this surgery the surgeon may also place a port in the abdominal wall so that chemotherapy drugs can be given directly into the abdominal cavity (called intraperitoneal or IP chemotherapy).
Interval surgical debulking

Interval debulking surgery may be done after several cycles (usually 3 or 4) of successful chemotherapy. If chemotherapy shrinks the tumours, this can make it safer and easier for the surgeon to remove them. You may be offered interval surgical debulking if primary debulking surgery did not remove all or enough of the cancer.
Palliative surgery

Some surgical procedures may be done to reduce symptoms and relieve pain from ovarian cancer that has spread:

paracentesis to remove fluid from the abdomen
thoracentesis to remove fluid from around the lungs
placing a feeding tube into the stomach or intestines
placing a tube (stent) in the large or small intestine or ureter to relieve a blockage caused by a tumour

Side effects

Side effects can happen with any type of treatment for ovarian cancer, but everyone’s experience is different. Some women have many side effects. Other women have only a few side effects.
If you develop side effects, they can happen any time during, immediately after or a few days or weeks after surgery. Sometimes late side effects develop months or years after surgery. Most side effects will go away on their own or can be treated, but some may last a long time or become permanent.
Side effects of surgery will depend mainly on the type of surgery and your overall health.
Surgery for ovarian cancer may cause these side effects:

bleeding and the need for blood transfusion
bladder problems
lymphedema
fertility problems
treatment-induced menopause
blood clots
wound or blood infection
bowel obstruction

Tell your healthcare team if you have these side effects or others you think might be from surgery. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.
Questions to ask about surgery

Find out more about surgery and side effects of surgery. To make the decisions that are right for you, ask your healthcare team questions about surgery.


Read more: http://www.cancer.ca/en/cancer-infor...#ixzz5BGKU2sE5

Chemotherapy for ovarian cancer

Chemotherapy uses anticancer (cytotoxic) drugs to destroy cancer cells. Most women with ovarian cancer have chemotherapy. Your healthcare team will consider your personal needs to plan the drugs, doses and schedules of chemotherapy. You may also receive other treatments.
Chemotherapy is given for different reasons. You may have chemotherapy to:

destroy cancer cells left behind after surgery and reduce the risk that the cancer will come back (called adjuvant chemotherapy)
shrink a tumour before surgery (called neoadjuvant chemotherapy)
relieve pain or control the symptoms of advanced ovarian cancer (called palliative chemotherapy)

Chemotherapy is usually a systemic therapy. This means that the drugs travel through the bloodstream to reach and destroy cancer cells all over the body, including those that may have broken away from the primary tumour in the ovary.
Chemotherapy for ovarian cancer may be given intravenously (into a vein) or by intraperitoneal (IP) chemotherapy. When drugs are given during IP chemotherapy, they circulate and treat tumours throughout the abdomen as well as being absorbed into the blood stream. So IP chemotherapy is also considered to be a type of systemic treatment.
IP chemotherapy is only given if the cancer has spread inside the abdomen and there is minimal cancer left after surgery. During IP chemotherapy, drugs are injected directly into the abdomen through a port. The port allows the drugs to be safely delivered. The surgeon may place the port at the time of surgery for the ovarian cancer or as a separate surgery.
If you have IP chemotherapy, you will also have intravenous chemotherapy so the side effects may be more severe than with just intravenous chemotherapy alone.
Epithelial ovarian cancer

Chemotherapy for epithelial ovarian cancer is usually a combination of 2 or more drugs given every 3 to 4 weeks intravenously. Usually a platinum drug such as carboplatin (Paraplatin, Paraplatin AQ) or cisplatin is combined with a taxane drug such as paclitaxel (Taxol) or docetaxel (Taxotere).
The most common chemotherapy drug combinations are:

carboplatin and paclitaxel
carboplatin and docetaxel
cisplatin and paclitaxel

You may be offered IP chemotherapy if you have stage 3 epithelial ovarian cancer with tumours smaller than 1 cm in size after primary surgical debulking. Cisplatin and paclitaxel are the drugs most often used in IP therapy.
Different drugs may be given if epithelial ovarian cancer does not respond to a platinum drug combined with a taxane drug. Chemotherapy is also given if epithelial ovarian cancer comes back (recurs). The type of drugs used will depend on if the cancer is sensitive to a platinum drug or never completely goes away with the first chemotherapy.
If the cancer responded to a platinum drug the first time and the cancer comes back more than 6 months after the last chemotherapy treatment, treatment is most likely a platinum drug combination. If the cancer didn’t completely go away with the first chemotherapy or came back in less than 6 months after treatment was finished, other non-platinum drugs will be given. These drugs can include:

docetaxel
paclitaxel
etoposide (Vepesid, VP-16)
gemcitabine (Gemzar)
cyclophosphamide (Procytox)
irinotecan (Camptosar)
premetrexed (Altima)
topotecan (Hycamtin)
vinorelbine (Navelbine)
pegylated liposomal doxorubicin (Caelyx)

Stromal cell ovarian cancer

The most common chemotherapy drug combinations used to treat stromal cell ovarian cancer are:

carboplatin and paclitaxel
PEB (or BEP) – cisplatin, etoposide and bleomycin (Blenoxane)

If an ovarian stromal tumour does not respond to chemotherapy or hormonal therapy drugs used in earlier treatments, or if it recurs, another combination of drugs may be used.
Germ cell ovarian cancer

The most common chemotherapy drug combinations used to treat germ cell ovarian cancer are:

PEB (or BEP) – cisplatin, etoposide and bleomycin
carboplatin and etoposide

If the ovarian germ cell tumour does not respond to drugs used in earlier treatments or if it recurs, other drug combinations that may be used are:

VeIP – vinblastine, ifosphamide (Ifex) and cisplatin
TIP – paclitaxel, ifosphamide and cisplatin
VIP – etoposide, ifosphamide and cisplatin

Tumours of borderline malignancy

The most common chemotherapy drug combinations used to treat tumours of borderline malignancy are carboplatin or cisplatin combined with another drug such as paclitaxel. Chemotherapy may be given after surgery for a tumour that has come back (recurred).
Primary peritoneal carcinoma

The most common chemotherapy drug combinations used to treat primary peritoneal carcinoma are the same as those used to treat epithelial ovarian cancer. Intraperitoneal chemotherapy may be given in addition to intravenous chemotherapy if there are still small tumours remaining after surgical debulking.
Side effects

Side effects can happen with any type of treatment for ovarian cancer, but everyone’s experience is different. Some women have many side effects. Other women have few or none at all.
Chemotherapy may cause side effects because it can damage healthy cells as it kills cancer cells. If you develop side effects, they can happen any time during, immediately after or a few days or weeks after chemotherapy. Sometimes late side effects develop months or years after chemotherapy. Most side effects will go away on their own or can be treated, but some side effects may last a long time or become permanent.
Side effects of chemotherapy will depend mainly on the type of drug, the dose, how it’s given and your overall health. Some common side effects of chemotherapy drugs used for ovarian cancer are:

nausea and vomiting
loss of appetite
sore mouth and throat
low cell blood counts
infection
hair loss
fatigue
treatment-induced menopause
fertility problems
peripheral neuropathy
skin problems

Tell your healthcare team if you have these side effects or others you think might be from chemotherapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.
Information about specific cancer drugs

Details on specific drugs change regularly. Find out more about sources of drug information and where to get details on specific drugs.
Questions to ask about chemotherapy

Find out more about chemotherapy and side effects of chemotherapy. To make the decisions that are right for you, ask your healthcare team questions about chemotherapy.


Read more: http://www.cancer.ca/en/cancer-infor...#ixzz5BGKcgsb4

Radiation therapy for ovarian cancer

Radiation therapy uses high-energy rays or particles to destroy cancer cells. It is rarely used to treat ovarian cancer because this cancer usually involves too many organs and too much tissue in the area for radiation therapy to work well. If you need radiation therapy, your healthcare team will consider your personal needs to plan the type and amount of radiation, and when and how it is given. You may also receive other treatments.
Radiation therapy is given for different reasons. You may have radiation therapy:

if you cannot have chemotherapy because of your older age and health problems
to treat small areas of recurrent or metastatic cancer
to relieve pain or control the symptoms of advanced ovarian cancer (called palliative radiotherapy)

External beam radiation therapy

During external beam radiation therapy, a machine directs radiation through the skin to the tumour and some of the tissue around it.
Side effects

Side effects can happen with any type of treatment for ovarian cancer, but everyone’s experience is different. Some women have many side effects. Other women have few or none at all.
During radiation therapy, the healthcare team protects healthy cells in the treatment area as much as possible. But damage to healthy cells can happen and may cause side effects. If you develop side effects, they can happen any time during, immediately after or a few days or weeks after radiation therapy. Sometimes late side effects develop months or years after radiation therapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.
Side effects of radiation therapy will depend mainly on the size of the area being treated, the specific area or organs being treated, the total dose of radiation and the treatment schedule. Some common side effects of radiation therapy used for ovarian cancer are:

fatigue
skin problems
nausea and vomiting
diarrhea
excessive gas
bladder problems including discomfort, urge to urinate often and bleeding
vaginal irritation and discharge
treatment-induced menopause

Tell your healthcare team if you have these side effects or others you think might be from radiation therapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.
Questions to ask about radiation therapy

Find out more about radiation therapy and side effects of radiation therapy. To make the decisions that are right for you, ask your healthcare team questions about radiation therapy.




Read more: http://www.cancer.ca/en/cancer-infor...#ixzz5BGKkDk7v
Hormonal therapy for ovarian cancer

Hormonal therapy is sometimes used to treat ovarian cancer. It is a treatment that adds, blocks or removes hormones. Hormones are substances that control some body functions, including how cells act and grow. Changing the levels of hormones or blocking certain hormones can slow the growth and spread of ovarian cancer cells. Drugs, surgery or radiation therapy can be used to change hormone levels or block their effects.
You may have hormonal therapy to:

treat some types of ovarian cancer when they are advanced or have recurred
control cancer cells left behind after surgery (if you cannot have chemotherapy for some reason)

Your healthcare team will consider your personal needs to plan your hormonal therapy. You may also receive other treatments.
Hormonal therapies used for ovarian cancer

The following are hormonal therapies used to treat ovarian cancer.
Luteinizing-hormone-releasing hormone (LHRH) agonists

LHRH agonists turn off estrogen production by the ovaries. They are used to lower estrogen levels in women who have not reached menopause (premenopausal). LHRH agonists include goserelin (Zoladex) and leuprolide (Lupron, Lupron Depot, Eligard).
Anti-estrogens

Anti-estrogens block estrogen from getting to the cancer cell. Tamoxifen (Nolvadex, Tamofen) is an anti-estrogen that is used to treat ovarian cancer.
Aromatase inhibitors

Aromatase inhibitors are drugs that block an enzyme called aromatase. Aromatase turns other hormones into estrogen in women who have gone through menopause (post-menopausal). Aromatase inhibitors lower the level of estrogen in post-menopausal women and include:

letrozole (Femara)
anastrozole (Arimidex)
exemestane (Aromasin)

Side effects

Side effects can happen with any type of treatment for ovarian cancer, but everyone’s experience is different. Some women have many side effects. Other women have few or none at all.
If you develop side effects, they can happen any time during, immediately after or a few days or weeks after hormonal therapy. Sometimes late side effects develop months or years after hormonal therapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.
Side effects of hormonal therapy will depend mainly on the type of hormonal therapy, the dose of a drug or combination of drugs, and your overall health. Some common side effects of hormonal therapy for ovarian cancer are:

nausea and vomiting
weight gain
treatment-induced menopause
joint and muscle pain
hot flashes
weakened and thinning bones (osteoporosis)

Tell your healthcare team if you have these side effects or others you think might be from hormonal therapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.
Information about specific cancer drugs

Details on specific drugs change regularly. Find out more about sources of drug information and where to get details on specific drugs.
Questions to ask about hormonal therapy

Find out more about hormonal therapy and side effects of hormonal therapy. To make the decisions that are right for you, ask your healthcare team questions about hormonal therapy.




Read more: http://www.cancer.ca/en/cancer-infor...#ixzz5BGKr0eHQ



  رد مع اقتباس
قديم 05-30-2019, 02:42 PM باحث_علمى غير متواجد حالياً   رقم الموضوع : [6]
باحث_علمى
موقوف
 

باحث_علمى is on a distinguished road
افتراضي

Targeted therapy for ovarian cancer

Some women with ovarian cancer have targeted therapy. It uses drugs to target specific molecules (such as proteins) on cancer cells or inside them. These molecules help send signals that tell cells to grow or divide. By targeting these molecules, the drugs stop the growth and spread of cancer cells and limit harm to normal cells. Targeted therapy may also be called molecular targeted therapy.
You may have targeted therapy to slow the growth of advanced epithelial ovarian cancer or primary peritoneal carcinoma.
Your healthcare team will consider your personal needs to plan the drugs, doses and schedules of targeted therapy. You may also receive other treatments.
Targeted therapy drugs used for ovarian cancer

Olaparib (Lynparza) may be given to women with a BRCA1 or BRCA2 gene mutation. It is usually taken by mouth twice a day. Olaparib may also be given as maintenance therapy.
Bevacizumab (Avastin) may be given in combination with platinum drugs such as carboplatin (Platinol, Platinol AQ) and a taxane drug such as paclitaxel (Taxol) or other chemotherapy drugs at time of diagnosis or recurrence. It is given by IV every 2 to 3 weeks. For recurrent cancer, bevacizumab is usually combined with the chemotherapy drugs paclitaxel and pegylated liposomal doxorubicin (Caelyx) or topotecan (Hycamtin) to help the chemotherapy drugs work better.
Side effects

Side effects can happen with any type of treatment for ovarian cancer, but everyone’s experience is different. Some women have many side effects. Other women have few or none at all.
Targeted therapy attacks cancer cells but doesn’t usually damage healthy cells, so there are usually fewer and less severe side effects than with chemotherapy or radiation therapy. Chemotherapy and radiation therapy can significantly damage healthy cells along with cancer cells.
If you develop side effects, they can happen any time during, immediately after or a few days or weeks after targeted therapy. Sometimes late side effects develop months or even years after targeted therapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.
Side effects of targeted therapy will depend mainly on the type of drug or combination of drugs, the dose, how it’s given and your overall health. Some common side effects of targeted therapy for ovarian cancer are:

fatigue
headaches
muscle and joint pain
sore mouth
loss of appetite
nausea and vomiting
diarrhea
low blood cell counts

Tell your healthcare team if you have these side effects or others you think might be from targeted therapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.
Information about specific cancer drugs

Details on specific drugs change regularly. Find out more about sources of drug information and where to get details on specific drugs.
Questions to ask about targeted therapy

Find out more about targeted therapy. To make the decisions that are right for you, ask your healthcare team questions about targeted therapy.


Read more: http://www.cancer.ca/en/cancer-infor...#ixzz5BGLKFE90

Follow-up after treatment for ovarian cancer

Follow-up after treatment is an important part of cancer care. Follow-up for ovarian cancer is often shared among the cancer specialists (oncologists, surgeon) and your family doctor. Your healthcare team will work with you to decide on follow-up care to meet your needs.
Don’t wait until your next scheduled appointment to report any new symptoms and symptoms that don’t go away. Tell your healthcare team if you have:

pain in the legs, lower back, pelvis or abdomen
swelling of or pain in the abdomen
change in bowel habits
increasing bloating, nausea or vomiting
weight loss

The chance that ovarian cancer will come back (recur) is greatest within 5 years, so you will need close follow-up during this time.
Schedule for follow-up visits

Follow-up visits for ovarian cancer are usually scheduled:

every 3 to 4 months for the first 2to 3 years after finishing initial treatment
every 4 to 6 months for the next 3 years
then once a year

During follow-up visits

During a follow-up visit, your healthcare team will usually ask questions about the side effects of treatment and how you’re coping.
Your doctor may do a physical exam, including:

a pelvic and rectal exam
feeling the neck, abdomen and legs for swelling
feeling the lymph nodes in the groin

Tests are often part of follow-up care. You may have:
Tumour marker tests

Tumour marker tests may be done to monitor how the treatment is working. Rising levels of a tumour marker may mean that the cancer has recurred. The doctor may order tests for different tumour markers for different types of ovarian cancer:

cancer antigen 125 (CA125)
alpha-fetoprotein (AFP)
human chorionic gonadotropin (HCG or b-HCG)
carcinoembryonic antigen (CEA)

Blood tests

Blood chemistry testsmay be done to show how well certain organs are working. They can also be used to find abnormalities that may mean the cancer has spread to certain organs.
Complete blood count (CBC) may be done to check for anemia from long-term bleeding, especially if the ovarian cancer has spread to the small or large intestine (also called the bowel).
Imaging tests

Imaging tests may be ordered to check how the treatment is working or investigate new symptoms:

chest x-ray
CT scan
PET scan

If the cancer has come back, you and your healthcare team will discuss a plan for your treatment and care.
Questions to ask about follow-up

To make the decisions that are right for you, ask your healthcare team questions about follow-up.




Read more: http://www.cancer.ca/en/cancer-infor...#ixzz5BGLRCGwm


Supportive care for ovarian cancer

Supportive care helps women meet the physical, practical, emotional and spiritual challenges of ovarian cancer. It is an important part of cancer care. There are many programs and services available to help meet the needs and improve the quality of life of people living with cancer and their loved ones, especially after treatment has ended.
Recovering from ovarian cancer and adjusting to life after treatment is different for each woman, depending on the stage of the cancer, the organs and tissues removed during surgery, the type of treatment and many other factors. The end of cancer treatment may bring mixed emotions. Even though treatment has ended, there may be other issues to deal with, such as coping with long-term side effects. A woman who has been treated for ovarian cancer may have the following concerns.
Self-esteem and body image

How a person feels about themselves is called self-esteem. Body image is how a person sees their own body. Ovarian cancer and its treatments can affect a woman’s self-esteem and body image. Often this is because cancer or cancer treatments may result in body changes, such as:

scars
hair loss
changes in body weight
sexual problems

Some of these changes can be temporary. Others can last for a long time or be permanent.
For many women, body image and how they think other people see them is closely linked to self-esteem. It may be a real concern for them and can cause considerable distress. They may be afraid to go out, be afraid others will reject them, or feel angry or upset, even if the effects of treatment may not show on the outside of the body.
Find out more about how to cope with problems of self-esteem and body image.
Lymphedema

Lymphedema is a type of swelling that occurs when lymph fluid builds up in tissues. It usually occurs in parts of the body where large numbers of lymph nodes have been removed.
You may have lymphedema in your legs if lymph nodes were removed from your pelvis or groin. Lymphedema is more likely to occur if you were also given radiation therapy to the pelvis.
If you develop lymphedema, your healthcare team can suggest ways to reduce swelling and pain as much as possible and to help prevent more fluid from building up. Ways to manage lymphedema include propping the limb up so that fluid can drain more easily, exercise, compression stockings and regular physiotherapy. You can also ask for a referral to a healthcare professional who specializes in managing lymphedema.
Find out more about lymphedema.
Ascites

Ascites is a buildup of fluid in the abdomen (peritoneal cavity). It occurs when the body produces fluid faster than it can remove it. Many women with ovarian cancer will develop ascites, especially as the cancer progresses.
Find out more about ascites.
Bowel obstruction

A bowel obstruction occurs when the large or small intestine (also called the bowel or the colon) becomes blocked or kinked and the contents cannot pass through the intestine easily. People who have abdominal surgery are at greater risk of developing a bowel obstruction.
Ovarian cancer commonly causes a bowel obstruction because the ovarian tumour or ascites puts pressure on the intestines. Bowel obstruction from ovarian cancer develops slowly over a period of weeks or months.
Find out more about a bowel obstruction.
Pleural effusion

A pleural effusion is a buildup of fluid in the space between the outside covering of the lung and the inside lining of the chest wall (called the pleura). It is more common with cancer that has spread to the lung area.
Find out more about a pleural effusion.
Treatment-induced menopause

Menopause occurs naturally as women age, usually when a woman reaches her early 50s. Menopause is caused when the ovaries produce lower levels of hormones. Women treated for ovarian cancer may experience early menopause as a side effect of cancer treatment.
Find out more about treatment-induced menopause.
Fertility problems

Most ovarian cancers occur in women who are past their child-bearing years, but younger women with ovarian cancer may have concerns about fertility after the diagnosis.
Fertility problems can occur after radiation therapy or chemotherapy for ovarian cancer. Most women who have had surgery for ovarian cancer will not be able to become pregnant because their ovaries have been removed.
Treatments for early stage ovarian cancer may be considered to preserve fertility in women who still wish to have children. Before you start any treatment for ovarian cancer, talk to your healthcare team about side effects that may affect your ability to have children after treatment and what you can do about them.
Find out more about how you can manage fertility problems.
Sexuality

Many women continue to have strong, supportive relationships and a satisfying sex life after ovarian cancer treatment. If sexual problems occur because of ovarian cancer treatment, there are ways to manage them.
Some of the side effects of cancer treatment that can make sex painful or difficult include:

Vaginal dryness caused by cancer treatments, such as radiation therapy or surgery.
Vaginal narrowing caused by scarring after radiation therapy to the pelvic area or some vaginal cancer surgeries.
Treatment-induced menopause caused by cancer treatments such as radiation therapy or surgery.

Some women lose interest in having sex. It is common to have a decreased interest in sex around the time of diagnosis and treatment.
When a woman first starts having sex after treatment, she may be afraid that it will be painful or that she may will not have an orgasm. The first attempts at being intimate with a partner may be disappointing. It may take time for the couple to feel comfortable with each other again. Some women and their partners may need counselling to help them cope with these feelings and the effects of cancer treatments on their ability to have sex.
Find out more about sexuality and cancer and sexual problems for women.
Recurrence

Many women who are treated for ovarian cancer worry that the cancer will come back. It is important to learn how to deal with these fears to maintain a good quality of life.
In addition to the support offered by the treatment team, a mental health professional, such as a social worker or counsellor, can help you learn how to cope and live with a diagnosis of ovarian cancer.
Anxiety and depression

Some women with ovarian cancer are very anxious or depressed during or after treatment. Levels of anxiety and depression appear to be related to physical symptoms and how much support you think you have from people close to you, including your caregivers.
You may need help from your healthcare team. You can also ask to be referred to a mental health professional, such as a social worker or counsellor.
Questions to ask about supportive care

To make decisions that are right for you, ask your healthcare team questions about supportive care.




Read more: http://www.cancer.ca/en/cancer-infor...#ixzz5BGLZe04V
Research in ovarian cancer

We are always learning more about cancer. Researchers and healthcare professionals use what they learn from research studies to develop better practices that will help prevent, find and treat ovarian cancer. They are also looking for ways to improve the quality of life of women with ovarian cancer.
The following is a selection of research showing promise for ovarian cancer. We’ve included information from PubMed, which is the research database of the National Library of Medicine. Each research article in PubMed has an identity number (called a PMID) that links to a brief overview (called an abstract). We have also included links to abstracts of the research presented at meetings of the American Society of Clinical Oncology (ASCO), which are held throughout the year.
Reducing the risk of ovarian cancer

Prophylactic salpingectomy is surgery to remove the fallopian tubes before cancer develops. New research suggests that most high-grade serous carcinomas (a type of epithelial tumour) start in the fallopian tubes rather than in the ovaries (American Journal of Surgical Pathology, PMID 25517954). Researchers hope that this different understanding of how ovarian cancer starts will lead to new ways of testing for, reducing the risk of and treating ovarian cancer (American Journal of Obstetrics and Gynecology, PMID 25818671). Studies are trying to find out if women who have a high risk for ovarian cancer should have surgery to remove their fallopian tubes rather than surgery to remove their ovaries.
Find out more about research in reducing the risk of cancer.
Diagnosis and prognosis

A key area of research looks at better ways to diagnose and stage ovarian cancer. Researchers are also trying to find ways to help doctors predict a prognosis (the probability that the cancer can be successfully treated or that it will come back after treatment). The following is noteworthy research into diagnosis and prognosis.
ADAMTS gene mutations

Gene mutations are changes to a normal gene. Researchers think that testing for ADAMTS gene mutationsmay help doctors identify ovarian cancer that will respond better or longer to chemotherapy. The presence of these mutations may also help doctors predict who will have a better long-term prognosis (JAMA Oncology, PMID 26181259).
Tumour markers

Tumour markers are substances, such as proteins, genes or pieces of genetic material like DNA and RNA, that are found naturally in the body. They can be measured in body fluids like blood and urine or tissue that has been removed from the body. A gene mutation or a change in the normal amount of a tumour marker can mean that a person has a certain type of cancer. Tumour marker tests can help doctors predict the prognosis or response to treatment in women with ovarian cancer.
Looking for tumour markers in vaginal washing fluids may help doctors find cancerous ovarian tumours. A study found cancer antigen 125 (CA125), carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) in vaginal washing fluids. It also found that levels of these tumour markers, especially CA125, were higher in vaginal washing fluids from women with cancerous ovarian tumours and lower in fluids from women with non-cancerous conditions. More research is needed to find out the role that vaginal washing fluids may play in looking for tumour markers, but researchers think that they could use these fluids to help diagnose ovarian cancer (European Journal of Gynecological Oncology, PMID 26513883).
Human epididymis protein 4 (HE4) is normally found in ovary cells. Research shows that ovarian cancer cells make more HE4 than healthy ovary cells. One study found that a higher than normal level of HE4 is a better marker of ovarian cancer than the presence of CA125 (European Journal of Gynecological Oncology, PMID 26390703). Another study found that high levels of HE4 in the urine identified women with ovarian cancer. High levels of HE4 in the urine also helped doctors identify tumours of borderline malignancy that had a higher risk of becoming cancerous (Gynecologic Oncology, PMID 25866324). Studies also show that high HE4 levels may help doctors identify ovarian cancer that is more likely to spread quickly (Oncotarget, PMID 26575020). High levels of HE4 may help doctors identify ovarian cancer that will not respond to chemotherapy with platinum drugs. Platinum drugs are platinum-based chemotherapy drugs, such as cisplatin or carboplatin (Paraplatin, Paraplatin AQ). High levels of HE4 may also help doctors predict which cancers are more likely to come back after treatment (Gynecologic Oncology, PMID 25866324).
Lysophosphatidic acid (LPA) levels can help doctors diagnose cancerous ovarian tumours. Studies show that testing for a high level of LPA is a better way to find ovarian cancer before it spreads than testing for the presence of CA125. They also found that LPA levels increase as ovarian cancer spreads (Journal of Cancer Research and Therapeutics, PMID 26148603; Journal of Obstetrical and Gynecological Research, PMID 26472266; Lipids in Health and Disease, PMID 26174150).
Hair loss (alopecia) is a common side effect of chemotherapy for ovarian cancer. Researchers recently reviewed the results of several studies that looked at how much hair loss women had and when it started during their chemotherapy for ovarian cancer. They found that survival was longer when a woman lost almost all of her hair by the 3rd treatment than if it took more chemotherapy treatments for a woman to lose most of her hair (European Journal of Cancer, PMID 25771433). More research is needed to find out whether or not faster hair loss means that cancer is more sensitive to chemotherapy and may have a better prognosis.
Find out more about research in diagnosis and prognosis.
Treatment

Researchers are looking for new ways to improve treatment for ovarian cancer. Advances in cancer treatment and new ways to manage the side effects from treatment have improved the outlook and quality of life for many people with cancer.
Targeted therapy drugs may be used in maintenance therapy for ovarian cancer. The results of a study that reviewed a large number of clinical trials show that maintenance therapy with targeted therapy drugs improved survival rates for women with ovarian cancer (PLoS One, PMID 26402447). Find out more about targeted therapy.
Anti-angiogenesis drugs slow or stop the growth of new blood vessels. Cutting off the blood supply will starve a tumour of oxygen and nutrients, which it needs to grow. Researchers are currently studying several anti-angiogenesis drugs to treat ovarian cancer, including aflibercept (Zaltrap), cediranib (Recentin), fosbretabulin (Zybrestat), imatinib (Gleevec), nintedanib (Ofev), sorafenib (Nexavar) and sunitinib (Sutent). Some results show that these drugs help increase the time before cancer comes back after treatment (Frontiers in Oncology, PMID 26500886). These drugs can cause many side effects, so researchers are looking for ways to identify ovarian cancer that will respond best to each anti-angiogenesis drug (Expert Opinion in Emerging Drugs, PMID 26001052).
Tyrosine kinase inhibitors block a specific enzyme (called tyrosine kinase) that helps send signals within cells. When this enzyme is blocked, the cells stop growing and dividing. Researchers are currently doing clinical trials to study tyrosine kinase inhibitors as a treatment for ovarian cancer (Expert Opinion in Investigative Drugs, PMID 26560712). One of these trials looked at using pazopanib (Votrient) as maintenance therapy. The results show that pazopanib increased the length of time that women with advanced ovarian cancer lived with the disease without it getting any worse (called progression-free survival). More research is needed to find out the role pazopanib may have as a treatment for ovarian cancer (Expert Review in Anticancer Therapy, PMID 26296187).
Cediranib (Recentin) is a drug that blocks vascular endothelial growth factor (VEGF), which is a protein that tells cells to make new blood vessels. Canadian researchers took part in a trial that looked at using cediranib to treat ovarian cancer that came back after chemotherapy with platinum drugs. The results showed that women who received cediranib had a longer time of progression-free survival if the ovarian cancer had responded to platinum drugs than if the cancer hadn’t responded to these drugs (Gynecologic Oncology, PMID 25895616).
Nintedanib (Ofev) is also a drug that blocks VEGF. A study looked at giving nintedanib to women with newly diagnosed advanced ovarian cancer. All the participants received standard first-line chemotherapy of carboplatin and paclitaxel (Taxol). Some women received nintedanib with this chemotherapy. The findings show that nintedanib combined with carboplatin and paclitaxel increased progression-free survival. But women who received nintedanib had more gastrointestinal side effects than the women who did not receive this drug (Lancet Oncology, PMID 26590673).
Olaparib (Lynparza) is a targeted therapy drug that stops the action of the enzyme poly (ADP-ribose) polymerase (a PARP inhibitor). This type of drug kills cancer cells by preventing them from repairing damage and possibly making them more sensitive to anticancer treatments. It is used to treat advanced ovarian cancer with a BRCA1 or BRCA2 mutation. A study looked at olaparib in women with recurrent ovarian cancer whose original cancer responded to platinum-based drugs. All the participants were given chemotherapy with carboplatin and paclitaxel. Some women received olaparib with this chemotherapy and were also given olaparib as maintenance therapy. The findings showed olaparib with carboplatin and paclitaxel followed by maintenance therapy with olaparib improved progression-free survival better than carboplatin and paclitaxel alone. Women with ovarian cancer that had a BRCA mutation benefited most from olaparib (New England Journal of Medicine, PMID 22452356; Lancet Oncology, PMID 25481791).
Niraparib is a targeted therapy drug (a PARP inhibitor). A study looked at this drug as a treatment for platinum-sensitive, recurrent ovarian cancer. The results of the study show the median length of time of progression-free survival for women who received niraparib was longer than for those who received a placebo, whether or not there was a BRCA mutation (New England Journal of Medicine, PMID 27717299).

Veliparib (ABT-888) is a targeted therapy drug (a PARP inhibitor). Researchers studied veliparib as a treatment for persistent or recurrent fallopian tube cancer, epithelial ovarian carcinoma or primary peritoneal carcinoma in women with a BRCA gene mutation. They looked at how well veliparib worked in treating these cancers and the side effects of the drug in women who had up to 3 previous chemotherapy regimens and had not taken a PARP inhibitor in the past. Results show that further study is needed for veliparib to be given alone as a treatment for these cancers (Gynecologic Oncology, PMID 25818403).
Ixabepilone (Ixempra) given weekly with or without bevacizumab (Avastin) may be a treatment option for women with recurrent or persistent fallopian tube cancer, epithelial ovarian carcinoma and primary peritoneal carcinoma. A study looked at ixabepilone with or without bevacizumab in women with one of these cancers that was resistant to a platinum and taxane chemotherapy regimen. Results show that this combination of drugs appears to have an effect on these cancers and the side effects could be managed. Further study is needed in these groups of women (Gynecologic Oncology, PMID 25792179).
Paclical is a special form of the drug paclitaxel (Taxol), which is often used to treat ovarian cancer. A clinical trial found that paclical and carboplatin had the same effectiveness as the standard chemotherapy of paclitaxel and carboplatin and didn’t cause any more side effects. The advantage of paclical is that it doesn’t cause the same allergic reactions as paclitaxel and it can be given over a shorter period of time (ASCO, Abstract 5517).
Hyperthermic intraperitoneal chemotherapy uses heated chemotherapy drugs injected into the abdominal cavity. Researchers looked at several studies that used hyperthermic intraperitoneal chemotherapy after surgery to remove as much cancer as possible. They found that giving hyperthermic intraperitoneal chemotherapy after surgery improved overall survival. It was effective for both newly diagnosed ovarian cancer and ovarian cancer that came back after treatment (European Journal of Surgical Oncology, PMID 26453145).
Find out more about research in chemotherapy and research in targeted therapy.
Supportive care

Living with cancer can be challenging in many different ways. Supportive care can help people cope with cancer, its treatment and possible side effects. The following is noteworthy research into supportive care for ovarian cancer.
Fertility-sparing surgery leaves at least one ovary, one fallopian tube, the uterus and the cervix in place so that the woman may still be able to have children. It may be a treatment option for low-grade epithelial ovarian carcinomas that have not grown outside of the ovary. This type of surgery may be offered to women younger than 40 years of age who wish to have children. Studies are looking at how many women can become pregnant after this treatment, if the type of chemotherapy given after surgery affects fertility and if there is a higher risk that ovarian cancer will come back after this treatment (Gynecologic Oncology, PMID 25969349; Journal of Surgical Oncology, PMID 26193338).
Hormone replacement therapy (HRT) taken for a short period of time can help treat the symptoms of treatment-induced menopause and improve the quality of life for ovarian cancer survivors. Researchers reviewed several studies that looked at HRT in ovarian cancer survivors and found that HRT did not increase the risk of cancer coming back or lower overall survival rates (Gynecologic Oncology, PMID 26232517). Women who are thinking about taking HRT should talk to their doctor because it can increase the risk of blood clots and stroke. It may also increase the risk of breast cancer.
Learn more about cancer research

Researchers continue to try to find out more about ovarian cancer. Clinical trials are research studies that test new ways to prevent, detect, treat or manage ovarian cancer. Clinical trials provide information about the safety and effectiveness of new approaches to see if they should become widely available. Most of the standard treatments for ovarian cancer were first shown to be effective through clinical trials.
Find out more about cancer research and clinical trials.


Read more: http://www.cancer.ca/en/cancer-infor...#ixzz5BGLhKQkW

Ovarian cancer statistics

To provide the most current cancer statistics, statistical methods are used to estimate the number of new cancer cases and deaths until actual data become available.
Incidence and mortality

Incidence is the total number of new cases of cancer. Mortality is the number of deaths due to cancer.
An estimated 2,800 Canadian women will be diagnosed with ovarian cancer in 2017. An estimated 1,800 will die from the disease.
For more information about cancer statistics, go to the Canadian Cancer Statistics publication.




Read more: http://www.cancer.ca/en/cancer-infor...#ixzz5BGLnJ0rk



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