Although the five-year survival rate for Stage I ovarian cancer is over 95 percent, very few cases are diagnosed in their early stages. The survival rate for more advanced cases drops to somewhere between twenty and thirty percent. Current surgical and chemotherapeutic options for ovarian cancer treatment are simply not effective enough to combat advanced cases of the disease.
Better ovarian cancer treatment requires a number of medical advances. Several treatment options are under investigation. Screening tools that allow earlier detection of ovarian cancer are also being studied.
Prevention: Oral Contraceptives, Breastfeeding and Tubal Ligation
The best possible treatment, of course, is one that prevents the cancer from developing in the first place. Unfortunately, no one hundred percent effective method exists to prevent the development of ovarian cancer. A number of circumstances that may help prevent the disease have, however, been identified.
Pregnancy: For every pregnancy brought to term, experts estimate that the risk of ovarian cancer drops by ten percent.
Breastfeeding: Breastfeeding, even for a relatively short period of time, appears to lower risk levels.
Oral Contraceptive Use: Women using oral contraceptives may cut their risk of ovarian cancer by as much as fifty percent. This benefit appears to extend for years after contraceptive use is discontinued.
Tubal Ligation: Tubal ligation is a surgical sterilization technique that ties off the fallopian tubes, preventing eggs from leaving the ovaries. Women who have had their “tubes tied” appear to have a lower incidence of ovarian malignancy.
Ovary Removal and Cancer Prevention
Women who carry the genetic mutations BRCA1 and BRCA2 are at greater than normal risk of developing ovarian tumors. If these genes are present, a prophylactic oophorectomy, or ovary removal, may be recommended. Both ovaries are removed as a preventive measure.
Early Stage Surgical Treatment
Surgical removal of the tumor and/or ovary is the standard treatment for Stage I ovarian cancer. Surgery may be complemented with adjuvant chemotherapy or radiation therapy if the tumor has a high histopathology grade.
Advanced Stage Ovarian Cancer Treatment
Surgery is used as a treatment for advanced stage tumors, but the intention is to provide palliative care, not a cure. As much of the tumor mass as possible is removed in the hope of reducing symptoms and prolonging survival. Chemotherapy treatments are also used to reduce symptoms. The platinum-based drug Cisplatin, and Paclitaxel, are the preferred medications.
Clinical Trials: Interferon and Immunotherapy
With the limited effectiveness of current advanced stage ovarian cancer treatments, women with late stage tumors may wish to consider the novel treatments available through clinical trials. A number of different immunotherapy techniques are under investigation. Immunotherapy boosts the body’s immune system, making it more sensitive to the presence of cancer cells.
Interferon alpha and interferon gamma are proteins that trigger immune responses. Clinical trials into interferon alpha have indicated that the protein actively combats a number of possible cancers, including ovarian cancer. Interferon gamma may also make tumor cells more sensitive to the chemotherapy medication Cisplatin. Side effects of interferon include flu-like symptoms, fever and fatigue.
Monoclonal antibodies are “designer” antibodies. The antibodies are designed to bind to carcinoma cells. The immune system has an easier time identifying tumor cells with antibodies attached to them, so the antibodies help direct the immune system to the proper area where it can begin to attack.
The most promising monoclonal antibodies under investigation are anti-CA125 and anti-HER2. CA125 is a protein fragment found in 97 percent of ovarian cancer patients. HER2 is a protein found in breast cancer patients. The anti-HER2 antibodies have proven effective when treating breast cancer, and may also be effective against ovarian cancers.
Monitoring for Signs of Relapse
If the disease goes into remission, careful monitoring to watch for indications of a relapse is required. Regular blood tests to measure CA125 levels are recommended, as are routine pelvic examinations. A “second-look” laparotomy may be performed to check for tumor regrowth.