Ovarian cancer is relatively uncommon and can arise from different types of cells within the ovary. Inherited mutations in the BRCA1 and BRCA2 genes greatly increase a woman's ovarian cancer risk as well as breast cancer risk. Most ovarian cancers are diagnosed in advanced stages, even in more advanced tumors, symptoms and signs are vague and nonspecific. There are no reliable screening tests for ovarian cancer.

 

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Ovarian Cancer Treatment In Malaysia

 

Types of ovarian cancer

Epithelial ovarian cancer (EOC)

Epithelial ovarian cancer (EOC) or ovarian carcinoma accounts for a majority (85%-90%) of all ovarian cancers. The four most common tumor cell types of epithelial ovarian cancer are serous, mucinous, clear cell, and endometrioid. The serous cell type is the most common variety. It is now thought that many of these cancers actually come from the lining in the fallopian tube.

Ovarian low malignant potential tumor

Ovarian tumors of low malignant potential account for about 15% of EOC. They are most often serous or mucinous cell types. They often develop into large masses that may cause symptoms, but they only rarely metastasize. Often, removal of the tumor, even at more advanced stages can be a cure.

Germ cell ovarian cancers

Germ cell tumors arise from the reproductive cells of the ovary. These tumors are uncommon and are seen mostly in teens or young women. This type of tumor includes different categories: dysgerminomas, yolk sac tumors, embryonal carcinomas, polyembryomas, non-gestational choriocarcinomas, immature teratomas, and mixed germ cell tumors.

Stromal ovarian cancers

Another category of ovarian tumor is the sex cord-stromal tumors. These arise from supporting tissues within the ovary itself. Stromal ovarian cancers (hormone-producing tumors) include granulosa-stromal tumors and Sertoli-Leydig cell tumors.

 

IS OVARIAN CANCER PREVENTABLE?

If a patient is positive for a BRCA or Lynch syndrome genetic defect, then the patient should strongly consider removal of her tubes and ovaries to decrease the chance of her getting a cancer. Women with these mutations are at a very high risk of ovarian cancer, and in this situation the risk of heart disease is not as significant as dying of one of these cancers. This can be planned at the end of child bearing, or at age 35.

Talk to our Ovarian Cancer Oncologists and Genetic Counselor at Onco Life Centre about your ovarian cancer risk based on your age and family history of the disease, and how your risk of ovarian cancer can be minimised.

 

OVARIAN CANCER STAGING

 

 
Stage 1 ovarian cancer

Limited to one or both ovaries

 
Stage 2 ovarian cancer

Limited to the pelvis

Stage 3 ovarian cancer

Disease outside of the pelvis, but limited to the abdomen, or lymph node involvement, but not including the inside of the liver

Stage 4 ovarian cancer

Disease spread to the liver or outside of the abdomen

Complete staging of an ovarian cancer includes hysterectomy, removal of the ovaries, tubes, pelvic and aortic lymph node dissection, biopsies of the omentum and peritoneum.

Ovarian cancer staging is determined surgically. If it is stage 4, then diagnosis can be proven with biopsy, and neoadjuvant chemotherapy may be started before surgery.

 

OVARIAN CANCER TREATMENT OPTIONS

Talk to our ovarian cancer oncologists at Onco Life Centre about your treatment options. Treatment recommendations by our ovarian cancer specialists at Onco Life Centre are tailored and personalized and depends on type and stage of ovarian cancer, genetic changes in the blood or tumor, and the patient’s preferences and overall health. There have been advances in ovarian cancer treatment and the landscape of ovarian cancer drug development has evolved immensely over the last 1 to 2 years.

Surgery for ovarian cancer

Surgery is used for both staging and debulking. Staging is the determination of the extent to which as cancer has spread in the body. Debulking is removing as much of the tumor as possible. This surgery usually results in removal of tubes and ovaries (known as salpingo-oophorectomy), the uterus (hysterectomy), removal of the omentum (omentectomy), lymph node biopsies, and any other organ involved in the disease. To accomplish "optimal debulking," at minimum, no individual nodule greater than 1 cm should be left behind. To achieve “optimal debulking”, individual patients might need to go through several rounds of chemotherapy prior to surgery (neoadjuvant chemotherapy).

Chemotherapy for ovarian cancer

Any patient healthy enough to tolerate chemotherapy will often benefit greatly from its use. When initially diagnosed, the usual first-line chemotherapy for ovarian cancer is to give a combination of a platinum drug and a taxane drug. Read More ...

Targeted therapy for ovarian cancer

Targeted therapy is a treatment that targets the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. This type of treatment blocks the growth and spread of cancer cells while limiting damage to healthy cells. To find the most effective treatment, our ovarian cancer oncologist may run tumor profiling tests to identify the genes, proteins, and other factors in your tumor. Read More ...

Hormone therapy for ovarian cancer

Hormone therapy such as the Selective estrogen receptor modulator (SERM) drug and aromatase inhibitors, is more often used to treat stromal tumors, such as recurrent granulosa cell tumors.

Immunotherapy for ovarian cancer

Immunotherapy is an emerging area within gynecologic malignancies, including ovarian cancer. Immunotherapy is a treatment that uses the patient's immune system to fight cancer. Currently, there is approval for immunotherapy drugs for ovarian cancers that are microsatellite instability (MSI)-positive.

Please click here to learn more about Immunotherapy

 

 

Risk Factors

Risk factors are related to two major categories.

Ovulation
Early onset of menarche, late menopause and nulliparity are risk factors.
Family History
15% of ovarian cancers are genetically related. Current guidelines recommend that all women with ovarian cancer should undergo testing for BRCA1 and BRCA2 gene mutations. BRCA1 and BRCA2 are genes that have been identified with hereditary cancer risk.

Less commonly, Lynch syndrome, Li-Fraumeni syndrome, and Cowden's syndrome can be associated with an increased risk of ovarian cancer.

 

Our Best Ovarian Cancer Oncologist

Onco Life Centre combines key elements of ovarian cancer care and ovarian cancer treatment under one roof, with convenience and speed. At Onco Life Centre, we have the necessary medical disciplines to achieve this. Our board certified highly experienced consultant oncologists have earned recognition for excellence in the field of ovarian cancer treatment, providing our patients with the most advanced ovarian cancer treatment options.

DR. CHRISTINA NG VAN TZE

Dr. Christina Ng is a Consultant Medical Oncologist and Founder President of Empowered, The Cancer Advocacy Society of Malaysia.…

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Cost of ovarian cancer treatment

Treatment cost for ovarian cancer depends on several factors, such as the staging and the type of ovarian cancer. Generally, using only chemotherapy is cheaper compared to using targeted therapy or immunotherapy. The more advanced the cancer stage, the more expensive it becomes to treat the cancer. At Onco Life Centre, the cost for treating ovarian cancer using chemotherapy for most of our patients is around MYR4,000 per cycle. Adding in Targeted Therapy can go up from MYR8,000, depending on the specific type of targeted therapy drug used. Immunotherapy treatment cost for ovarian cancer can range from MYR10,000 and above depending on the specific type and dosage of immunotherapy drug used.

 

Patients and their families have opportunities to talk about the way they are feeling with our oncologists, nurses, counselors, or join our psychosocial program and support group at Onco Life Centre.

 

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