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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for ovarian cancer

Answered by
Dr.
Dr. Indranil Ghosh

Oncologist

Practicing since :2004

Answered : 1500 Questions

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Posted on Tue, 10 May 2016 in Cancer
Question: What is the best treatment procedure for Ovarian Cancer (Stage 4)? Is immunotherapy a good optional line of treatment along with Chemotherapy/Radiation?
doctor
Answered by Dr. Indranil Ghosh 23 minutes later
Brief Answer:
immunotherapy is not standard

Detailed Answer:
HiThanks for your query.

I would like to know why it is stage 4, is is because of fluid in lungs or liver involvement?

Usually, in stage 4 , we administer chemotherapy for 3 cycles, reassess disease status and if responding, do surgery. After that 3 more chemo. Immunotherapy has not been studied well in ovarian cancer. One additional option is to add anti- blond vessel formation drug called bevacizumab to chemo. This can prolong survival a bit but the drug is quite costly. Usually this is started 5-6 weeks after surgery.

Radiation does not have any role in ovarian cancer.

Hope this helps. I will be available for followup.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indranil Ghosh 4 hours later
Thank you for your reply.

She was admitted with water in the abdomen and lungs. The fluid was drained and on fluid test it was confirmed as cancer. Her CA-125 was above 6500 while the reference range was less than 35.

What is the price of bevacizumab in India? A very rough number would also be helpful. I just need to understand if I can afford it. Does it do anything to improve the quality of life too?
Will this medicine be covered under medical insurance?

She has already had 2 chemo sessions (C1D1 and C1D8). The doctor has suggested a 21 day chemo cycle. Is this interval ideal or it can be shorter for faster recovery.

Is this type of cancer curable?

What could be the expected life span (post diagnosis) in such case?

Thanks.

doctor
Answered by Dr. Indranil Ghosh 52 minutes later
Brief Answer:
ok then surgery should be considered if lung fluid resolves with chemo

Detailed Answer:
bevacizumab costs around 150000-200000 INR per month. can be given upto 12 months. Some doses are given free by the company as well. It does not improve quality of life per se. Only prolongs disease remission. Can be covered by insurance

Usually chemo is given every 21 days but sometimes weekly also.

This is not curable but controllable. Average lifespan around 2.5 years but can vary between 6 months to 5 years or even beyond.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indranil Ghosh 1 hour later
What sort of surgery is advised in such cases? I have read about multiple approaches on the internet.

Any change in diet needed for such patients?

Thanks.
doctor
Answered by Dr. Indranil Ghosh 1 hour later
Brief Answer:
home cooked diet

Detailed Answer:
Surgery includes removal of uterus, ovaries, lymph glands, omentum and any residual visible disease in abdomen only.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indranil Ghosh 27 minutes later
Can you help understand the CT Scan report attached?
Has the cancer spread to the lungs as well? If yes, what is the course of action to treat this?

The fluid removed from the lungs was tested positive.

Thanks.
doctor
Answered by Dr. Indranil Ghosh 15 minutes later
Brief Answer:
fluid in the chest cavity

Detailed Answer:

commonly referred to a s fluid in lungs but it is actually in the chest but outside lungs, in the pleural cavity. This qualifies as stage IV disease. chemo followed by surgery is appropriate.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indranil Ghosh 9 minutes later
Thank you for your time.
doctor
Answered by Dr. Indranil Ghosh 9 hours later
Brief Answer:
you are welcome

Detailed Answer:
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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