Ovarian cancer diagnosis and management 2 (pie)

Question 1

What is the surgical management of late (stage II to IV) ovarian cancer ?

Answer 1

Cryoreductive surgery (to remove all macroscopic disease)

Question 2

If stage IIIc or IV what is more likely to be done instead of cryreductive surgery first ?

Answer 2

Neo-adjuvant chemo followed by cryoreductive surgery

Question 3

What is the current management of replased ovarian cancer ?

Answer 3

Approx 75% of patients relapse:

Women with platinum-sensitive relapsed ovarian cancer should be treated with a platinum based combination with paclitaxel, PLDH or gemcitabine.

Question 4

What is the first line choice of chemo drugs ?

Answer 4

Carboplatin (this is the best one and can be used on its own in those unfit for combo therapy) + Paclitaxel

Question 5

What are the secondary options for patinets who dont tolerate Paclitaxel as the ajoining therapy to Carbaplatin ?

Answer 5

PLDH or gemcitabine

Question 6

What should be given following cryoreductive (debulking) surgery in advanced ovarian cancer ?

Answer 6

Chemo therapy - with the drugs mentioned

Question 7

When is hormone therapy used in ovarian cancer ?

Answer 7

Hormonal therapy with tamoxifen or an aromatase inhibitor can be used for women with recurrent, platinum-resistant (Carbaplatin is the one we use), ovarian cancer or in those wishing to avoid or delay further chemotherapy, particularly where their original tumour is expressing the oestrogen receptor.