Ovarian Cancer

Ovarian cancer rarely causes symptoms until after cancerous cells have spread beyond the ovaries. This means it may be more difficult to detect. Its symptoms may also be vague and may not be indicators of ovarian cancer, but could be signs of other medical concerns. Be sure to visit your doctor for an accurate diagnosis. However, here is a list of the most common symptoms associated with ovarian cancer:

• Discomfort of the lower abdominal and back area
• Indigestion
• Heartburn
• Bloating
• Nausea
• Gas
• Loss of appetite
• Unexplained weight loss
• Backache
• Diarrhea
• Constipation
• Frequent or painful urination
• Pelvic pain
• Pain during intercourse
• Unusual cramping
• Irregular bleeding
• Fatigue

If your doctor thinks you might have ovarian cancer, exams and tests will be required to reach an accurate diagnosis. This begins with your physician asking questions about your health history, symptoms, risk factors and family history of disease, and may continue with more in-depth tests:

• Pelvic Exam: This is usually the first exam done. It allows your healthcare provider to feel for any unusual masses (lumps) or other problems. Your doctor puts one or two fingers of a gloved hand inside your vagina. He or she uses the other hand to press on your lower abdomen (belly) to feel for masses. He or she may also put a finger in your rectum to feel for anything unusual that might suggest that the cancer has spread.
• Ultrasound: Your doctor aims sound waves at your ovaries to see check for a cyst or tumor. He or she does this either by putting a small probe into your vagina (transvaginal ultrasound) or aiming them through the skin of your abdomen (abdominal ultrasound). The test isn’t painful, doesn’t use X-rays and doesn’t require sedation.
• CT Scan: This test makes detailed 3-D pictures of organs and tissues in your pelvis or abdomen. You may receive contrast material by mouth and by injection into your arm or hand to helps the organs or tissues show up more clearly.
• CA-125 Blood Test: This blood test shows how much of a protein called CA-125 is in your blood. An elevated CA-125 may be a sign of tumor cells. But it also can be elevated in many non-cancer conditions.  After a diagnosis of ovarian cancer, your healthcare provider may use this blood test to see if you’re responding to treatment, or to check if the cancer has come back.
• Biopsy: Unlike many other types of cancer, a biopsy is rarely used to diagnose ovarian cancer before surgery. If a cancer is present and confined within the ovary, doing a biopsy breaks the covering of the ovary, which may allow the cancer to spread. A diagnosis of ovarian cancer is usually confirmed at the time of surgery.
• Magnetic Resonance Imaging (MRI): a test that uses a large magnet, radio signals, and a computer to make images of organs and tissue in the body.
• Pap Test: Detects cancer of the cervix and uterus.
• Colposcopy: A close examination of your cervix, vagina and vulva for signs of disease using a special instrument called a colposcope. Colposcopy may be recommended if your Pap test result is abnormal.

Each woman's treatment program is specific to her. Upon diagnosis, a plan is mapped out, taking into consideration your age, overall health and health history, the type of ovarian cancer, how much the cancer has advanced, predicted course of the disease, tolerance for available procedures and medications and your personal preferences and opinions. You’ll be assigned a gynecologic oncologist, a specialist in cancer of the female reproductive system. Treatment may include surgery, chemotherapy and/or radiation:

Surgery

• Overview: You may have surgery to diagnose, stage and treat ovarian cancer. The main goal of surgery is to attempt a cure by taking out all of the tumor or tumors. To do this, your surgeon removes tissue and looks at it for signs of cancer, and may remove one or both ovaries and surrounding tissue and lymph nodes. Even if the ovarian cancer has spread beyond the ovaries, surgically removing as much of the cancer as possible can give you a better chance for survival.  These can include:
• Cytoreduction (Debulking) Surgery
• D&C Hysteroscopy
• Hysterectomy
• Laparoscopy
• Laser Surgery
• Lymph-Node Staging
• Oophorectomy
• Radical Surgery
• Reconstructive Surgery
• Risk-Reducing Surgery
• Salpingo-Oophorectomy
• Vaginectomy
• Vulvectomy

Medical Oncology

• Overview: INTEGRIS medical oncology is a dedicated group of medical oncologists specializing in diagnosing and the caring for cancer patients with a variety of medicine options. These treatments are administered orally or intravenously depending upon the treatment plan developed by your multidiscipline cancer care team.
• Chemotherapy: Chemotherapy’s main method of function is to interfere with cancerous cells’ ability to develop and multiply. A patient may be prescribed a combination of a few types of chemotherapy, and it may also be prescribed in tandem with additional treatments, like radiation or surgery.
• Targeted Therapy: Targeted therapy uses medicines that target specific parts of certain types of cancer cells, interfering with their ability to grow and survive. The therapies are specific to each person's cancer.
• Immunotherapy: This is a way to use the body's immune system to help treat or prevent many health problems. It may be used to treat or manage cancer.
• The Multidisciplinary Cancer Clinic: The INTEGRIS Cancer Institute’s Multidisciplinary Gastrointestinal clinic brings together medical oncologists, gastroenterologists, radiation oncologists and radiologists as a team to provide specific services to the patient with the aim of ensuring that the patient receives optimum care and support.

Radiation Therapy

• Overview: Radiation Therapy uses high-energy X-rays to kill cancer cells, but it’s rarely used to treat ovarian cancer. Your doctor is more likely to use it to ease the symptoms of cancer. Women getting radiation for ovarian cancer usually have external radiation. This type of radiation comes from a machine that directs rays of energy at the tumor from outside of the body. Other types of radiation therapy include:
• Image-Guided Radiotherapy (IGRT): Uses frequent two and three-dimensional imaging to direct radiation therapy more accurately.
• Intensity-Modulated Radiation Therapy (IMRT): Advanced, high-precision radiotherapy that uses computer-controlled linear accelerators to deliver precise radiation doses to a malignant tumor or specific areas within the tumor.
• Brachytherapy: Brachytherapy is a type of internal radiation that is given inside the body as close to the cancer as possible. Internal radiation involves giving a higher dose of radiation in a shorter time span than with external radiation.
• Stereotactic Body Radiotherapy (SBRT): Uses very focused beams of high does radiation that more directly target a tumor.
• Multimodality Radio Chemotherapy

At INTEGRIS, we offer a wide variety of support programs and services along with the Troy and Dollie Smith Wellness Center to help patients with breast cancer and their loved ones manage the physical and emotional effects of a cancer diagnosis and treatment.

Support services for ovarian cancer include:

• Mind, body therapies including acupuncture, massage, and yoga
• Research and clinical trials
• Nutrition consultations
• Pastoral care, spiritual support and relaxation techniques
• Resource Room
• Clinical social work services
• Counseling
• Patient navigation and survivor care planning
• Multi-disciplinary clinic coordination
• Cancer screenings
• Patient and family support groups
• Integrative Medicine Clinic