Ovarian Cancer (cont.)

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What is the survival rate and prognosis of ovarian cancer?

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Epithelial ovarian cancer is the most deadly of the gynecologic cancers. Approximately 80% of patients will eventually die of the disease. However, survival in the short term is quite good, meaning many years. With the addition of IP chemotherapy, the survival of ovarian cancer has been significantly extended. According to recent studies, if a patient undergoes optimal debulking, followed by IP chemotherapy, then they have a greater than 50% chance to still be alive in six years. This is quite good compared to other advanced stage cancers. Even in the recurrent setting, epithelial ovarian cancer is often very sensitive to chemotherapy. The disease can often go in to complete remission (no detectable disease) many times. However, once it recurs, it is not curable and will continue to come back.

Germ cell and stromal tumors have a much better prognosis. They are often cured because they are more often detected at early stages.

Can ovarian cancer be prevented?

There is no way to truly prevent ovarian cancer. One would think that removal of the fallopian tubes and ovaries would prevent the disease but this is not always the case (primary peritoneal cancer can arise in the pelvis even after the ovaries have been removed). However, there are ways to significantly reduce your risk. If a woman takes birth control pills for more than 10 years, then her risk of ovarian cancer drops significantly. Tubal ligation has long been known to decrease the risk of ovarian cancer. Recently, removal of the entire tube has been shown to further decrease the risk. This procedure, called a salpingectomy, can be considered by any woman considering a tubal ligation. Removal of the ovaries does decrease the risk of cancer, but at the cost of increasing death due to heart disease and other causes. Currently this procedure is often saved for specific situations (genetic risk, family history) in patients under 60 to 65 years of age and is not used in the general population. Until recently, if a woman was close to menopause and was undergoing surgery, then the ovaries and tubes would be removed. The recent studies indicating that many of these cancers actually come from the fallopian tube, and the studies indicating that removal of even postmenopausal ovaries causes other problems has caused a significant shift in this philosophy. Certainly, the tubes should be removed at the time of hysterectomy for any woman. The need for removal of the ovaries is much more uncertain.

Genetic abnormalities are an exception to this recommendation. If a patient is positive for a BRCA or Lynch syndrome genetic defect (mutation), 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. Each patient is recommended to discuss this with her doctor, or a genetic counselor.

How does one cope with ovarian cancer?

A diagnosis of cancer is often accompanied by the emotional side effects of anxiety, fear, and depression. Just as treatments are designed to help fight cancer growth and spread, self-care and support measures to help one handle the emotional aspect of the diagnosis can be extremely valuable.

Many hospitals and cancer treatment centers offer cancer support groups and counseling services to help manage the trying emotional side effects of cancer and its treatment. There are also a number of valuable online resources for both patients and families.

For example, the American Cancer Society offers tips on coping with cancer in everyday life; coping checklists for patients and caregivers; managing anger, fear, and depression; and a series of online "I can cope" classes through their website.

The National Ovarian Cancer Coalition (NOCC) also offers online resources on coping with ovarian cancer.

The National Cancer Institute offers a variety of patient education publications about coping with the effects of cancer and its treatment on everyday life, including materials for caregivers and family.

REFERENCES:

"Ovarian cancer." American Cancer Society. 12 Mar. 2015.

"Ovarian, Fallopian Tube, and Primary Peritoneal Cancer—Health Professional Version." National Cancer Institute.

Green, Andrew, et al. "Ovarian cancer." Medscape. 9 Sept. 2013.


Medically Reviewed by a Doctor on 1/28/2016


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Ovarian Cancer - Symptoms Question: For ovarian cancer, what were the symptoms and signs you experienced?
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