Ovarian Cancer

Ovarian cancer is the seventh most common cancer in France.
Its danger stems from the fact that it is typically discovered at a late stage; the five-year survival rate for all stages combined is 40 percent.

There are several types of ovarian cancer:

• Epithelial tumor (serous, mucinous, endometrioid or clear cell): This is the most frequent type of ovarian cancer, accounting for 90 percent of all cases
• Germ cell tumor: Infrequent, accounting for fewer than 10 percent of cases; develops mainly in young women
• Stromal tumor (granulosa or Sertoli-Leydig): Very rare

The main risk factor is a genetic predisposition caused by a BRCA1 or BRCA2 gene mutation.

Other risk factors include:

• Age
• Family history of breast or ovarian cancer
• Multiple pregnancies

Ovarian cancer is an extremely silent disease, often diagnosed at an advanced stage.
It can be detected by chance during an exam or check-up performed for other purposes.
Sometimes it manifests with mild clinical symptoms such as discomfort or a sensation of heaviness in the pelvic area; pain that is incorrectly diagnosed; or irregular menstrual cycles.
Unlike cervical and breast cancer, there are no screening exams for ovarian cancer.

The American Hospital of Paris has a wide range of specialists skilled at treating this type of cancer.
Our gynecologists perform the necessary gynecological clinical exams that alert other physicians to the need for further diagnostic tests.

Imaging exams available from our world-class diagnostic and testing facilities:

• Pelvic or transvaginal ultrasound
• CT scan
• MRI
• PET scan

Blood tests:

The main test is the CA 125 blood test. An elevated level of CA 125 can signal the presence of ovarian cancer, but other tests are necessary to confirm the diagnosis.

Biopsies: 
The only way to confirm the cancer diagnosis is to remove a small piece of the tumor during a surgical procedure such as laparoscopy or laparotomy.

When ovarian cancer is diagnosed at the American Hospital of Paris, the patient's care is discussed at a multidisciplinary team meeting in order to collaboratively determine the best therapeutic approach and propose a customized treatment plan.

Surgery:

The main treatment for ovarian cancer is the surgical removal of the reproductive system (hysterectomy and adnexectomy) combined with a range of lymphatic biopsies (pelvic and periaortic lymph node dissection) and removal of the omentum.
During this operation, called a laparotomy, the surgeon carefully explores the entire abdominal cavity and removes any cancer detected in the other organs.

If the doctor suspects that the cancer has spread, a laparoscopic procedure might be performed instead to collect samples, establish a diagnosis and begin chemotherapy as the first-line treatment.
With ovarian cancer, the more cancerous cells the surgeon is able to remove, the better the chances are for recovery.

Chemotherapy: 

Chemotherapy for ovarian cancer combines two types of drugs: platinum salts and a taxane.
They are generally administered following surgery, except in the case of advanced ovarian tumors, where chemotherapy is the first-line treatment.
Radiation therapy is not used for ovarian cancer.

As is often the case for cancer, follow-up care is alternately managed by the surgeon and the oncologist.
Patients are closely monitored because of the high risk of relapse in the first five years.

Follow-up care involves:

• Clinical exams
• Blood tests, beginning with CA 125
• Imaging (ultrasound, CT scan, PET scan)

Regular visits are scheduled approximately every four months.
It is also very important for the patient to receive psychological support and be able to talk about her sexuality, which is necessarily affected by the disease and treatments.