ovarian%20cancer
OVARIAN CANCER
Ovarian cancer is a type of cancer that begins in the ovaries.
It is the 7th most common cancer in women (excluding skin cancer) and the leading cause of death from gynecologic cancer in developed countries.
The 3 histologic types of ovarian cancer are epithelial (primarily seen in women >50 years of age), germ cell (most commonly seen in women <20 years of age) and sex cord stromal (rare and produces steroid hormones).
The median age at the time of diagnosis is 63 years old and >70% present with advanced disease.

    Follow Up

    Epithelial Ovarian Carcinoma

    • Clinical evaluation every 2-4 months x 2 years, then every 3-6 months x 3 years; annually after 5 years
    • Monitoring includes:
      • PE with pelvic exam
      • Genetic risk evaluation if not done yet
      • If elevated initially, CA-125 every visit
      • As indicated: CBC, chemistry profile, CT scan, MRI, PET-CT, PET, chest x-ray
    • Long-term wellness care
    Germ Cell Ovarian Carcinoma
    • Dysgerminoma
      • 1st year: Every 2-3 months with PE, tumor markers1; radiographic imaging2; every 3-4 months with abdominal/pelvic CT
      • 2nd year: Every 3-4 months with PE, tumor markers1; radiographic imaging2; every 6 months with abdominal/pelvic CT
      • 3rd, 4th and 5 years: Every 6 months with PE, tumor markers1; radiographic imaging2; every year with abdominal/pelvic CT
      • Beyond 5 years: Every year with PE, tumor markers1; radiographic imaging2; abdominal/pelvic CT when clinically indicated
    • Non-dysgerminoma
      • 1st year: Every 2 months with PE, tumor markers1; radiographic imaging2; every 3-4 months with chest x-ray and abdominal/pelvic CT
      • 2nd year: Every 2 months with PE, tumor markers1; radiographic imaging2; every 4-6 months with chest x-ray and abdominal/pelvic CT
      • 3rd, 4th and 5 years: Every 4-6 months with PE, tumor markers1; radiographic imaging2; every 6-12 months with abdominal/pelvic CT
      • Beyond 5 years: Every year with PE, tumor markers1; radiographic imaging2; abdominal/pelvic CT when clinically indicated
    Sex Cord-Stromal Ovarian Carcinoma
    • PE when clinically indicated based on stage
      • Early stage/low risk - 6-12 months
      • High risk - 4-6 months
    • Tumor markers1 when clinically indicated or if applicable
    • Radiographic imaging2 only in patients with symptoms, elevated biomarkers or suspicious findings in PE
    1CA-125, beta-human chorionic gonadotropin (β-hCG), alpha-fetoprotein (AFP), inhibin, lactate dehydrogenase (LDH), carcinoembryonicantigen (CEA), CA 19-9
    2Chest X-ray, CT scan, MRI, PET-CT, or PET with contrast unless contraindicated
    Digital Edition
    Asia's trusted medical magazine for healthcare professionals. Get your MIMS JPOG - Malaysia digital copy today!
    Sign In To Download
    Editor's Recommendations
    Most Read Articles
    Pearl Toh, 5 days ago
    Every-two-month injections of the long-acting cabotegravir + rilpivirine were noninferior to once-monthly injections for virologic suppression at 48 weeks in people living with HIV*, according to the ATLAS-2M** study presented at CROI 2020 — thus providing a potential option with more convenient dosing.
    Stephen Padilla, 19 Mar 2020
    The assumption that children are less vulnerable to the coronavirus disease 2019 (COVID-19) compared to adults is not quite true and may even be dangerous, suggests a recent study.
    22 Mar 2020
    Sustained use of lopinavir-combined regimen appears to confer benefits among patients with the novel coronavirus disease (COVID-19), with improvement possibly indicated by increasing eosinophils, suggests a recent study.
    24 Mar 2020
    COVID-19 is a novel disease, with no existing immunity. The virus can be transmitted from person to person, quickly and exponentially. Here’s what we can do to slow down the spread, if not contain the outbreak.