Understanding Ovarian Cancer: From Diagnosis to Treatment
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Are you concerned that you might be at risk for ovarian cancer? When your general practitioner (GP) suspects the possibility of ovarian cancer, a series of diagnostic steps are set in motion to provide clarity and the best treatment for your health. In this comprehensive guide, I’ll walk you through the stages of diagnosis and potential treatments.

CA125 Blood Test

If your GP has suspicions, they may recommend a CA125 blood test. This test measures the specific levels of protein that ovarian cancer cases can sometimes elevate. However, it’s important to note that elevated CA125 levels can also occur due to reasons unrelated to cancer.

Ultrasound Examination

In addition to the blood test, your GP may suggest an ultrasound examination of your abdomen and pelvis. There are two types of ultrasounds to consider:

  • Transvaginal Ultrasound: This procedure involves inserting an ultrasound probe into the vagina to obtain a clearer view of the ovaries and fallopian tubes.
  • Abdominal Ultrasound: If you’re uncomfortable with the transvaginal option, you can request an abdominal ultrasound without a specific reason.

Specialist Consultation

If the initial tests suggest the possibility of ovarian cancer, your GP should promptly refer you to a specialist gynaecological oncologist, a medical professional with expertise in treating cancer patients. Within 31 days of suspicion, you should receive a confirmed diagnosis.

What to Expect From Your First Hospital Appointment?

At your first hospital appointment with the specialist, you will receive a comprehensive explanation of the next steps. Depending on your case, the medical team may perform additional tests, such as MRI or CT scans, and another CA125 blood test if they haven’t done previously.

The Multidisciplinary Approach

Before your second appointment, a multidisciplinary team (MDT) comprising specialist gynaecological cancer surgeons, oncologists, radiologists, and pathologists will review your test results. They will collectively determine the most suitable treatment options for your specific condition.

The Second Appointment: Treatment Recommendations

During your second appointment, if the MDT believes you might have ovarian cancer, they may recommend surgery to remove your cancer and confirm the diagnosis. If scans have revealed the presence of cancer cells or its spread, the MDT may suggest a treatment sequence:

  1. Chemotherapy First: To reduce the tumour size before surgery, you may receive chemotherapy. When surgery occurs in the middle of chemotherapy, it’s referred to as interval surgery.
  2. Surgical Considerations: Your specialist will thoroughly explain the procedures, including their risks, benefits, and potential side effects. You will have ample time to contemplate your options and access support services.

Adapting to Changing Times: Remote Appointments

In light of the challenges posed by COVID-19, the NHS has adapted its healthcare delivery. It may involve remote appointments via telephone or online consultations. For in-person clinic visits, attending alone is recommended, but you can bring a mobile phone for emotional support if needed. You may also have the option to record your appointment for reference.

Treatment Paths

If the initial treatment recommendation is surgery, the hospital will schedule your admission date for the procedure, usually a few days before the surgery. If doctors detect cancer, they may not need to administer chemotherapy following surgery.

Chemotherapy Before Surgery

Sometimes, immediate surgery cannot remove the cancer. In such instances, your clinical team will advise starting with chemotherapy to shrink the tumour. Before administering chemotherapy, the medical team typically conducts a biopsy to confirm the diagnosis, performing the procedure under local anaesthetic.

Tailored Chemotherapy Plans

The oncologist overseeing your chemotherapy will tailor the treatment plan to your unique needs. Depending on your health, you may receive three cycles of chemotherapy every three weeks or a smaller dose weekly for nine weeks before surgery. Each cycle typically takes place as an outpatient procedure.

Post-Operative Considerations

After surgery, your doctor may prescribe three additional cycles of chemotherapy if any traces of the tumour still exist. In some cases, your doctor may recommend bevacizumab (Avastin), a targeted treatment that hinders the cancer’s blood supply, potentially delaying recurrence.

Other therapies like PARP inhibitors, such as Olaparib, may also be considered to prevent or delay cancer reoccurrence.

Life After Treatment

After your chemotherapy or maintenance therapy, you will undergo a final scan to assess any remaining cancer. Subsequently, you will have follow-up outpatient appointments, which may be conducted face-to-face, over the phone, or via online consultations. These appointments are crucial for monitoring your health and addressing any concerns.

Coping and Support

Dealing with a cancer diagnosis can evoke emotions, fear, uncertainty, loneliness, and anger. It’s essential to recognise that these feelings are entirely normal. Some individuals may even experience depression during or after cancer treatments. If you’re struggling, remember that help and support are available.

Talk About It

Opening up about your emotions to a trusted friend or professional can provide tremendous relief and guidance. Don’t hesitate to seek out someone who can listen and offer support.

My Final Verdict

Self-help methods like relaxation techniques, complementary therapies such as reflexology and massage, or dietary adjustments can also aid in coping. However, always consult your medical team before embarking on any new treatment or dietary regimen to ensure it’s appropriate for your situation.

Remember, your mental health is just as important as your physical well-being. Seeking treatment and taking steps to care for yourself can enhance your overall quality of life during and after ovarian cancer treatment.

Mahantesh Karoshi
Mahantesh Karoshi

I'm a Consultant Obstetrician & Gynaecologist and Women's Health Expert. I believe in educating my patients to contribute to achieving the best possible clinical and holistic outcomes. By taking this approach, I enable and empower my patients whilst addressing their issues and concerns. I run a private practice with an extremely high standard of professionalism. My patients are directly involved in their care and management in all stages. My approach to my patient's problems is built on dedication and passion, drawing on analytical thinking and my on-time honored reading, teaching medical professionals nationally and internationally.