Types of ovarian cancer treatment

Ovarian cancer causes tumors to grow in the ovaries, which are glands that are responsible for producing eggs (ovum) and sex hormones in women. Without treatment, cancer cells can spread to the fallopian tubes to reach nearby lymph nodes, invade other healthy tissue, and even cause more severe complications of ovarian cancer. So, what are the drugs and treatments to cure ovarian (ovarian) cancer?

Medicines and treatments for ovarian cancer

Generally, stage 1, 2, and 3 ovarian cancer is curable. However, some patients with stage 3 cancer, which is quite severe and stage 4, cannot be cured.

They are undergoing treatment to reduce the symptoms they feel ovarian cancer. In addition, treatment is still being carried out to slow the spread of cancer cells so that the quality of life is better.

Before being prescribed treatment, you need to get into a series of medical tests to diagnose ovarian cancer. After the results are obtained, then the doctor will determine the appropriate treatment.

The following are ways to treat cancer that are usually recommended for doctors, including:

1. Operation

This cancer has many types, but as many as 75% are types of epithelial tumors. Generally, the treatment of choice for both early and advanced ovarian cancer patients is surgical removal of tumor cells.

Ovarian cancer cure without this drug, is carried out by a gynecological oncologist. The goal is to see how widespread the cancer cells are (staging) and remove as much of the tumor as possible that has spread to other tissues.

Sometimes, surgeons perform biopsy operations on the lymph nodes in the pelvis and abdomen. The goal is to take the tissue as a sample to observe the presence or absence of cancer cells in the area.

Surgical surgery for ovarian cancer, doctors may remove the uterus along with the ovaries and fallopian tubes. This medical procedure is called a bilateral hysterectomy-salpingo-oophorectomy. If the ovaries and / or uterus are removed, it means that the patient is unable to get pregnant and is entering menopause sooner than he should.

In addition, the doctor may remove the omentum, which is the layer of fatty tissue covering the stomach contents and ovarian cancer that has invaded this area. This medical procedure is also known as an omentectomy.

When cancer spreads to the large intestine or small intestine, the doctor will cut off the affected intestine and sew back the rest of the healthy intestine.

After ovarian cancer surgery, the patient must stay in the hospital for 7 days. Recovery of the body to resume daily activities after ovarian cancer surgery takes 4 to 6 weeks.

2. Chemotherapy

Apart from surgery, patients will be recommended chemotherapy. Chemotherapy is the treatment of ovarian cancer using drugs that can be done before or after surgery. With chemotherapy, the spread of cancer (metastasis) can be stopped, the tumor can also be reduced in size, making surgery easier.

Medicines used in chemotherapy for ovarian cancer can be given by injection into a vein or orally. The drug can enter the bloodstream and reach any area of ​​the body affected by cancer.

In epithelial tumors, doctors will use two different types of drugs. The reason is, the use of two drugs works better as the first treatment for ovarian cancer. The type of drug combination used is platinum compound(cisplatin or carboplatin) and taxane drugs, such as docetaxel, which are given by infusion every 3 or 4 weeks.

The number of chemotherapy cycles depends on the stage of the patient's ovarian cancer and the type of drug used, usually reaching 3-6 cycles. A cycle is a schedule of regular drug dosing, followed by rest periods.

Epithelial tumors can shrink and disappear with chemotherapy, but they can also come back. If within 6 to 12 months, the first chemotherapy is effective at killing cancer cells, the patient can use these drugs again when they relapse.

Other chemotherapy drug options

If the drugs above are not effective, the doctor will give other chemotherapy drugs to ovarian cancer patients, such as:

• Altretamine (Hexalen®)
• Capecitabine (Xeloda®)
• Cyclophosphamide (Cytoxan®)
• Gemcitabine (Gemzar®)
• Ifosfamide (Ifex®)

Stage 3 ovarian cancer patients with the spread of cancer almost reaching the cavity will receive intraperitoneal chemotherapy (IP). This means that the drugs cisplatin and paclitaxel are injected into the abdominal cavity through a catheter through a surgical procedure. The drug can travel with the blood to reach the cancer cells that are outside the abdominal cavity.

Women with ovarian cancer and receiving IP chemotherapy drugs usually experience side effects, ranging from nausea, vomiting, to stomach pain. These side effects in women who undergo chemotherapy for ovarian cancer make them need cancer pain relievers so that the side effects are less severe.

In germ cell tumor type ovary cancer, the doctor will give several different drugs at once. This combination of drugs is called BEP, which includes bleomycin, etoposide and cisplatin. Meanwhile, this type of dysgerminoma can be cured with a combination of carboplatin and etoposide drugs which have less side effects.

Reported by the American Cancer Society, if the cancer does not respond to the drug, the doctor will provide other drugs, such as:

• TIP (paclitaxel / Taxol, ifosfamide, and cisplatin / Platinol)
• Veip (vinblastine, ifosfamide, and cisplatin / Platinol)
• VIP (etoposide / VP-16, ifosfamide, and cisplatin / Platinol)
• VAC (vincristine, dactinomycin, and cyclophosphamide)

Chemotherapy is rarely used to treat ovarian cancer, a stromal tumor type. However, when chemotherapy is done, the drugs used are PEB drugs (cisplatin, etoposide, and bleomycin).

Other side effects that can occur due to chemotherapy for ovarian cancer include bruising and bleeding, extreme fatigue, and susceptibility to infections.

3. Radiation

Apart from using chemotherapy drugs, patients can also undergo radiotherapy as a treatment for ovarian cancer. Ovarian cancer therapy uses high-energy X-rays to kill cancer cells in a procedure similar to when you have a regular X-ray.

Although rarely recommended, radiotherapy is useful for killing ovarian cancer cells that have spread, for example in the brain or spinal cord. External beam radiotherapy is the preferred type and is performed 5 times per week over several weeks.

Meanwhile, the type of radiotherapy that is rarely performed is brachytherapy (placing a radioactive device into the body near the cancer cells). Common side effects of ovarian cancer treatment are burning and peeling skin, diarrhea, nausea, vomiting, and vaginal irritation.

4. Hormone therapy

Ovarian cancer treatment other than cancer with drugs not only with chemotherapy. There are other treatments, such as hormone therapy. In this therapy, doctors use hormone-blocking drugs to fight cancer.

This method of treating ovarian cancer is rarely used in epithelial tumors, but is often used to treat stromal tumors. Several types of drugs used in hormone therapy include:

Luteinizing-hormone-releasing hormone (LHRH) agonists

The drug LHRH or known as GnRH can reduce estrogen levels by inhibiting the production of this hormone in the ovaries.

Examples of this class of drugs are goserelin and leuprolide, which are injected every 1 to 3 months. Side effects of ovarian cancer drugs are vaginal dryness and an increased risk of osteoporosis.

Tamoxifen

Tamoxifen is usually used to treat breast cancer, but it can also treat stoma tumors and advanced epithelial tumors. This drug works as an anti-estrogen so that it can suppress the growth of cancer cells.

The side effects of using these drugs in hormone therapy are hot flashes, vaginal dryness, and an increased risk of serious blood clots in the legs.

Aromatase inhibitors

Aromatase inhibitors are ovarian cancer drugs that work to lower estrogen levels in women after menopause. Usually, drugs are used to treat stromal tumors that come back.

Examples of this class of drugs are letrozole (Femara®), anastrozole (Arimidex®), and exemestane (Aromasin®) which are taken once a day. The side effects of this drug are hot flashes, joint and muscle pain and bone thinning that makes bones brittle.

5. Targeted therapy

The next way to treat ovarian cancer is targeted therapy. The drugs used in this treatment work by attacking cancer cells by damaging the cell's DNA.

Although the cause of ovarian cancer is not known with certainty, the most common cause of cancer is DNA mutations in cells. By damaging the cancer cell's DNA system, these cells will die. Several types of drugs in targeted therapy that are commonly used to treat ovarian cancer are:

Bevacizumab (Avastin)

Bevacizumab has been shown to shrink and slow the growth of ovarian cancer, a type of epithelial tumor. This drug works well when combined with chemotherapy.

Bevacizumab can also be prescribed together with olaparib in women who have a BRCA gene mutation. This gene is a gene inherited by the family that can increase the risk of ovarian cancer, breast cancer and colon cancer. The drug is given intravenously every 2 to 3 weeks.

The side effects of this ovarian cancer drug are increasing blood pressure, lowering the number of white blood cells, causing mouth sores, headaches. and diarrhea.

PARP inhibitors

The PARP inhibitor is a combination of the drugs Olaparib (Lynparza), rucaparib (Rubraca), and niraparib (Zejula). In women with mutations in the BRCA1 and BRCA2 genes, the PARP enzyme pathway is blocked by these genes. The PARP enzyme itself is an enzyme that is involved in repairing damaged DNA in cells.

Therefore, PARP inhibitors work to prevent the BRCA gene from blocking the PARP enzyme pathway to repair damaged cells. In patients with advanced ovarian cancer, whether they have the BRCA gene or not, doctors usually give olaparib and rucaparib. This medicine is taken once a day.

For niraparib drugs, it is usually used when ovarian cancer has shrunk after following chemotherapy with cisplatin or carboplatin drugs.

Healthy lifestyle to support ovarian cancer treatment

Ovarian cancer treatments are very diverse. The doctor will help you determine which treatment is most appropriate according to the condition of the body and the stage of the cancer you have. If ovarian cancer symptoms still appear and you do not feel better about undergoing treatment, consult this with the doctor who treats your condition.

However, it needs to be reminded again that cancer treatment is not a single treatment. Patients are also required to change their lifestyle according to cancer patients. That way, the treatment will be more effective.

These lifestyle changes include adopting an ovarian cancer diet followed by avoiding various food choices that have the potential to increase the risk of cancer, regular exercise, and adequate rest. Patients must also undergo treatment according to the doctor's recommendation and be carried out regularly until the cancer cells are completely removed from the body.