Ovarian Cancer Care: Hope & Healing

The exact cause of ovarian cancer is not fully understood, but it occurs when cells in the ovary or fallopian tube begin to grow out of control, forming a tumor. Most ovarian cancers are epithelial, starting from cells on the outside of the ovary or in the fallopian tube. Less common types include germ cell tumors, which begin in egg-producing cells, and stromal tumors, which grow in the hormone-producing connective tissue. While the precise trigger for this abnormal cell growth is unknown, certain factors are known to increase a woman's risk of developing the disease. These risk factors are important to understand.

Several factors can increase a woman's risk for ovarian cancer, though many women with risk factors never develop the disease, and some with no known risk factors do:

Yes, a notable percentage of ovarian cancers, about 10% to 15%, are linked to inherited genetic mutations. The most common genetic mutations associated with ovarian cancer are BRCA1 and BRCA2. These genes normally help repair damaged DNA, but when mutated, they can increase the risk of ovarian, breast, and other cancers. Lynch syndrome, another inherited condition, also raises the risk for ovarian cancer, along with colon and uterine cancers. If there is a strong family history of ovarian or related cancers, genetic counseling and testing may be recommended. Identifying these genetic links can help inform personalized screening and prevention strategies.

Receiving an ovarian cancer diagnosis can be challenging. Take a deep breath. Your first step should be to connect with a specialized care team, ideally at a cancer center with expertise in gynecologic oncology. It's perfectly normal to seek a second opinion to ensure you feel confident in your diagnosis and proposed treatment plan. Gather all your medical records, including pathology reports and imaging scans. Write down any questions you have for your doctors. Remember, you don't have to face this alone. Lean on your support system and consider joining a support group or connecting with patient advocates who understand what you are going through.

At TMC Health Cancer Center, we believe in supporting you beyond just medical treatment.

Our comprehensive team includes not only doctors and nurses but als0:

It's helpful to come prepared with questions for your care team.

Consider asking:

Don't hesitate to ask for clarification on anything you don't understand. Your team is there to answer your questions and empower you to make informed decisions.

The treatment of ovarian cancer is a highly personalized and intricate process. At TMC Health Cancer Center our multidisciplinary team of experts works collaboratively to create a unique care plan tailored specifically for you. This approach is essential because every patient’s cancer is different. The optimal treatment plan for ovarian cancer often requires a combination of strategies. This typically includes surgery to remove as much of the cancer as possible followed by systemic therapy like chemotherapy or precision cancer medicines. For some patients radiation therapy may also be a part of the treatment plan.

The specific combination and sequence of these treatments depends on several key factors including the stage and type of the cancer the results of genomic profiling and your overall health. Our team is dedicated to staying at the forefront of cancer research and technology so we can offer you the most advanced treatment options available. We use detailed genomic testing to understand the unique characteristics of your cancer's DNA. This information allows us to target specific mutations that are driving the cancer's growth which can lead to more effective and less toxic therapies. We will guide you through every step of this process ensuring you feel confident in the plan we build together.

Surgery plays a crucial role in both diagnosing and treating ovarian cancer. The initial goal of surgery is twofold: to obtain a biopsy of the cancerous tissue and to remove as much of the tumor as possible. The tissue sample is essential for confirming the diagnosis determining the specific type of ovarian cancer and assessing its stage. Furthermore this tissue is used for comprehensive genomic testing which provides valuable insights into the cancer's genetic makeup and helps us identify potential precision medicine treatments.

Beyond diagnosis surgery is a primary local treatment for the cancer. Our expert surgeons perform a procedure called cytoreduction or debulking which aims to remove all visible cancer from the abdomen and pelvis. Research shows that removing a higher percentage of the tumor during surgery significantly improves the effectiveness of subsequent treatments like chemotherapy. The surgical approach will be determined by the extent of the cancer. In some cases you may undergo primary debulking surgery before any other treatment. In other situations your care team may recommend neoadjuvant chemotherapy first to shrink the tumors before performing what is known as interval debulking surgery. Both approaches are designed to give you the best possible outcome.

Systemic therapy is any treatment that is designed to destroy cancer cells throughout your entire body. This is a critical component of ovarian cancer treatment because even in early-stage cases there may be small undetectable cancer cells that have already spread outside the ovaries. These microscopic cells cannot be removed with surgery alone and require a treatment that circulates throughout the body to eliminate them. For patients with more advanced cancers that cannot be fully removed by surgery systemic therapy is the primary treatment method. There are three main types of systemic therapy used in ovarian cancer care.

Neoadjuvant therapy is a treatment given before surgery. It is typically a course of chemotherapy administered to shrink the tumor making it smaller and easier for the surgeon to remove. This approach can lead to a more thorough surgical removal of the cancer and may reduce the side effects and risks associated with extensive surgery. Adjuvant therapy is given after surgery to kill any remaining cancer cells that may have been left behind. This is a standard and essential part of the treatment for most patients with ovarian cancer. Finally maintenance therapy is a longer-term treatment administered after the initial therapies are complete. The goal of maintenance therapy is to "maintain" a state of remission and to prevent or delay the cancer from returning. Some doctors prefer the term “continuous therapy” because it more accurately describes the ongoing nature of the treatment.

Chemotherapy involves the use of powerful drugs to kill rapidly dividing cancer cells. These drugs are the cornerstone of systemic therapy for ovarian cancer. While effective chemotherapy can sometimes affect healthy cells as well as cancer cells which can lead to side effects. The initial chemotherapy treatment for ovarian cancer typically involves a combination of platinum-based and taxane-based drugs administered intravenously. These and other chemotherapy drugs are also used to treat recurrent or resistant cancers. Our care team will work closely with you to manage any side effects and ensure you are as comfortable as possible during treatment.

In some cases we may recommend a specialized approach called intraperitoneal (IP) chemotherapy. This is a type of regional chemotherapy where the drugs are infused directly into the peritoneal cavity which is the space that contains your abdominal organs. This method delivers a high concentration of the drugs directly to the cancer cells in the abdomen. Another advanced procedure is Hyperthermic Intraperitoneal Chemotherapy (HIPEC) which combines surgery with a heated chemotherapy wash. During a surgical procedure to remove the cancer a highly concentrated and heated chemotherapy solution is circulated throughout the abdominal cavity for about 90 minutes. The heat can make the chemotherapy more effective at killing cancer cells and the direct application ensures the drugs reach the areas where the most cancer cells are located. After the infusion the solution is washed out and the surgery is completed.

Precision cancer medicine is a modern and highly effective approach that focuses on the unique genetic characteristics of your specific tumor. Through advanced genomic-biomarker testing performed on a biopsy or a blood sample our doctors can identify specific genetic alterations in the cancer's DNA that are fueling its growth. This is a significant shift from traditional treatments that may not be as targeted. Once a specific genetic abnormality is identified a precision medicine can be designed to target it directly. This approach can lead to more effective treatments with fewer side effects than traditional chemotherapy. We highly encourage all patients to discuss the role of genomic testing with their care team.

One of the most promising classes of precision medicines for ovarian cancer is called a PARP inhibitor. The poly ADP-ribose polymerase (PARP) enzyme is a crucial protein that helps repair DNA damage in cells. Cancer cells often rely on this enzyme to repair the damage caused by chemotherapy. PARP inhibitors are drugs that block this enzyme. By preventing the PARP enzyme from working DNA inside the cancerous cells is less likely to be repaired leading to cell death and a slowdown or stoppage of tumor growth. PARP inhibitors can be a powerful tool for certain patients especially as a form of maintenance therapy to keep the cancer from returning.

Staging is the process of determining the extent of the cancer in your body which is a critical step for developing an effective treatment plan. The stage is typically determined after surgical removal of the tumor and a thorough examination of the tissue. The staging system uses Roman numerals from I to IV with letters A through C to describe sub-stages. All new information and research regarding ovarian cancer treatment is categorized and discussed based on these stages.

When a cancer has been treated and then returns after a period of remission it is called recurrent disease. If the cancer does not respond to initial treatment it is considered refractory disease. Both of these situations require careful re-evaluation and a new treatment strategy tailored to the cancer's specific behavior.

Beginning the journey of ovarian cancer treatment can feel overwhelming but at TMC Health Cancer Center you will never be alone. Our team is dedicated to providing compassionate expert care every step of the way. Your care team will include a group of specialists who will work together to support you. This includes your surgeon medical oncologist radiation oncologist and a compassionate team of nurses social workers and support staff. We will work to anticipate your needs and provide you with a holistic approach to care that addresses both your physical and emotional well-being.

Your treatment plan will be unique to you and it may involve a combination of therapies over time. We will always discuss the potential side effects of each treatment and provide you with the resources and support you need to manage them effectively. Open and honest communication is a cornerstone of our philosophy. We encourage you to ask questions express your concerns and participate fully in every decision about your care. Our goal is not only to provide the most advanced medical care but also to empower you to feel confident and supported throughout your treatment and beyond.