Kolkata: Women-related cancers although being one of the major causes of mortality in India are less spoken about and cared for.
Cancers such as ovarian cancer especially have a high mortality rate. In India, 59,276 were estimated as new ovarian cancer cases at the end of 2020. The incidence of ovarian carcinoma is expected to increase to 371,000 a year by 2035 (55%) increase, while the death rate increases by 67% to 254,000.
Moreover, women in the perimenopausal age group and in their 50s and 60 years are more likely to develop ovarian cancer, according to Dr Sujata Datta, Consultant, Mother & Child Care, Fortis Hospital Anandapur Kolkata
However, advancements in ovarian cancer treatment and some early screening programs by
NGOs and the government have helped in saving many lives. Also, there have been numerous advances in understanding the genetic basis of cancer which have resulted in more appropriate treatments, Dr Datta said.
The first step is to diagnose the disease using symptom history, physical examination, imaging techniques and tumourmarkers . There are different types of imaging like ultrasound, MRI, CT scan that examine the spread of the disease and the current stage and type of tumour, she said
The next step is deciding whether surgery or adjuvant therapy such as chemotherapy is appropriate as the initial step in treatment, Dr Datta said.
She said the age of patient, type and stage of tumour and to some extent her fertility plans determines the type of surgery done.
Large majority of women then undergo a staging laparotomy that consists of adequate midline incision, meticulous exploration of the abdominal cavity and organs with biopsies as required . Fluid from the abdominal cavity is sent for cytology, and removal of the uterus with both ovaries and tubes are carried out together with pelvic and paraaortic lymph nodes removal and excision of the fatty apron called omentum, Dr Datta said.
In young patients, with certain early stage germ cell tumours that have low malignant potential, and whose families have not been completed , conservative surgery with removal of the affected ovary only sometimes performed, she said.
Dr Datta said for patients with advanced stage ovarian cancer, sometimes a few cycles of chemotherapy are given first to shrink the disease and then surgery is performed to reduce complications and morbidity from the procedure.
For advanced stage cancer surgery is followed up with postoperative chemotherapy.
