Ovarian_Cancer_Flashcards
What is the Risk of Malignancy Index (RMI) and how is it calculated for ovarian cancer?
The Risk of Malignancy Index (RMI) for ovarian cancer is calculated using the formula RMI = U x M x Ca125, where M = menopausal status (1 for pre-menopausal, 2 for post-menopausal), U = ultrasound score (0 for no features, 1 for 1 feature, 2 for ≥2 features), and Ca125 = units/ml. An RMI > 250 warrants referral to gynecology.
What is the management for stage 1 ovarian cancer?
Management for stage 1 ovarian cancer includes total hysterectomy with bilateral salpingo-oophorectomy, with adjuvant systemic chemotherapy if needed. If fertility needs to be preserved, only the affected ovary can be removed (only for stage 1a).
What is the management for stage 2 ovarian cancer?
Management for stage 2 ovarian cancer includes debulking surgery to remove as much of the cancer as possible, with chemotherapy given as neo-adjuvant or adjuvant.
What is the management for stage 3 ovarian cancer?
Management for stage 3 ovarian cancer includes similar steps as stage 2, with the addition of targeted treatment with bevacizumab (targets VEGF-A). If surgery is not possible, chemotherapy (platinum-based) and symptomatic treatment (e.g., ascitic drain, constipation treatment) are given.
What is the management for stage 4 ovarian cancer?
Management for stage 4 ovarian cancer is similar to stage 3, but palliative care is more likely.
What are the options for chemotherapy in ovarian cancer?
Options for chemotherapy in ovarian cancer include primary treatment, adjunct treatment following surgery, or for relapse of disease. The first-line combination is a platinum compound with paclitaxel, usually given as an outpatient treatment every 3 weeks for 6 cycles.
What is the first-line chemotherapy combination for ovarian cancer?
The first-line chemotherapy combination for ovarian cancer is a platinum compound with paclitaxel.
Why is carboplatin preferred over cisplatin in ovarian cancer treatment?
Carboplatin is preferred over cisplatin in ovarian cancer treatment because it is less nephrotoxic and causes less nausea.
What is the mechanism of action of paclitaxel in chemotherapy?
The mechanism of action of paclitaxel in chemotherapy is to cause microtubular damage, preventing replication and cell division.
What is the role of bevacizumab in ovarian cancer treatment?
Bevacizumab is a monoclonal antibody against VEGF that inhibits angiogenesis. It is not routinely prescribed in ovarian cancer due to cost but is available for the treatment of recurrent disease.
What follow-up is required after chemotherapy for ovarian cancer?
Follow-up after chemotherapy for ovarian cancer includes clinical examination and CA125 measurement. CA125 tends to rise prior to the onset of clinical evidence of disease recurrence. A CT scan is also performed following the completion of chemotherapy to assess the response to treatment.
What are the risk factors for ovarian cancer?
Risk factors for ovarian cancer include age, family history, obesity, hormone replacement therapy, endometriosis, smoking, and diabetes.
What are the protective factors for ovarian cancer?
Protective factors for ovarian cancer include the use of the COCP, pregnancy and breastfeeding, and hysterectomy.
What should be explained to patients about the diagnosis of ovarian cancer?
Patients should be explained that ovarian cancer is a serious diagnosis requiring further investigations and treatment. They should also be informed about the risk factors and protective factors associated with ovarian cancer.
What should be explained to patients about the management of ovarian cancer?
Patients should be explained that the definitive management for ovarian cancer will be surgical with or without chemotherapy. They should also be informed about the potential need for follow-up and monitoring after treatment.
