What is Ovarian cancer?
The ovarian, fallopian tube and peritoneal malignancies are collectively “ovarian cancer”. The treatment for these malignancies is similar because they are closely related to one another.
Certain cancers start when healthy cells in these regions transform and proliferate. They grow out of control to produce a mass known as a tumor. A tumor may be benign or malignant. Malignant refers to the ability of a cancerous tumor to develop and metastasize to different body regions. If a tumor is benign, it can enlarge but won’t spread.
An abnormal growth of tissue on the surface of the ovary is an ovarian cyst. It can happen during a typical menstrual cycle and typically goes away on its own. Cancer is not present in simple ovarian cysts.
According to recent studies, high-grade serous cancers account for the majority of ovarian/fallopian tube cancers. And in most cases, the disease really begins at the tip, or outer end, of the fallopian tubes. It then spreads to the ovaries’ surface and has the potential to expand further.
Suggestions based on recent research
Given this new information, several medical professionals advise against tying or banding fallopian tubes for contraception (to prevent future pregnancy). This is usually doing it in order to reduce the risk of ovarian/fallopian tube cancer. When a patient is having surgery for a benign ailment and doesn’t wish to become pregnant, they do this. Some doctors additionally advise fallopian tube removal. This approach might lessen the likelihood that these malignancies would spread in the future.
Under a microscope, the majority of these illnesses resemble one another. This is because the ovaries’ surfaces, the fallopian tubes’ lining, and the peritoneum’s covering cells are similar. Rarely peritoneal cancer can appear after the removal of the ovaries and fallopian tubes. Some peritoneal malignancies, like ovarian cancer, can start in the fallopian tubes. They can then progress from the tube’s end into the peritoneal cavity.
Latest research in ovarian cancer
Researchers are trying to understand ovarian and fallopian tube cancer. They are seeking strategies to stop these malignancies. This is in addition to the most effective treatments and care options for those who have the diagnosis. The researchers are finding new treatment choices through clinical trials for patients in the research areas listed below. Patients with fallopian tube and peritoneal malignancies are now a part of the majority of ovarian cancer trials. Always discuss the best diagnostic and treatment options with your doctor.
In order to detect cancer before a person experiences any symptoms or signs, screening is in use. There are presently no reliable screening procedures for these gynecologic illnesses that are appropriate for members of the general public who are asymptomatic. There is no survival advantage to screening for early-stage ovarian/fallopian tube cancer using serial CA-125 blood tests and pelvic ultrasonography. People with ovarian/fallopian tube cancer and many benign illnesses have elevated levels of CA-125, a chemical known as a tumor marker.
Studies suggest screening for ovarian, fallopian tube, and peritoneal cancers are not useful and may even be harmful for the general population of persons who are asymptomatic. This is owing to the possibility of an increase in unneeded surgical procedures brought on by “false positive” test results.
Some have suggested screening using CA-125 blood tests and transvaginal ultrasound for persons who have a high risk of developing ovarian, fallopian tube, or peritoneal cancer due to their family history, the existence of BRCA1 or BRCA2, or other high-risk gene mutation(s). As previously said, there is no evidence that this strategy increases lifespan or aids in the earlier and more treatable detection of malignancies. Therefore, doctors advise the removal of the ovaries and fallopian tubes if a high-risk gene mutation is present, either after a woman has finished having children or at about age 40. They should also, if at all feasible, remove it ten years before the age at which the person’s nearest relative first had ovarian cancer.
Other targeted therapies
Numerous medicines that target various mutations, including KRAS, BRAF, PI3KCA, and PTEN, are currently undergoing clinical studies. Clinical trials are also in use to examine numerous other brand-new, focused medicines. Through the use of biomarker testing, clinicians are increasingly understanding the biology of each patient’s specific tumor. When matching patients with a clinical study for a particular targeted medicine, this information may be helpful.
Systemic therapy, called immunotherapy, uses drugs to strengthen the body’s defences against cancer. It makes use of substances that the body can produce or in a lab to improve, target, or restore immune system function. Researchers are studying drugs known as checkpoint inhibitors to see if they could improve the immune system’s capacity to eliminate cancer cells. This class of medications targets CTLA4, PD-1, and PD-L1. They reduce tumor size in cases of other malignancies, such as melanoma and some lung cancers, and they have shown some promise in treating ovarian/fallopian tube cancer in particular circumstances. Although the first studies did not demonstrate any effect in reducing the rate of cancer growth, survival data is still under collection.
Another type of immunotherapy being tested by researchers for the treatment of ovarian/fallopian tube cancer is cancer vaccines. Some methods, referred to as “adoptive cell therapy,” use killer T cells from the patient’s immune system. These cells are taken and grown in a lab where they are trained to attack certain targets, including MUC 16 (CA-125), which is present in ovarian/fallopian tube cancer cells. The T cells are subsequently administered to the patient via IV by medical professionals. People with certain blood malignancies have utilized this method, also known as chimeric antigen receptor (CAR) T-cell therapy, with varying degrees of success. Ovarian/fallopian tube cancer clinical studies are underway.
Tamoxifen, aromatase inhibitors, and enzalutamide (Xtandi), a blocker of the androgen receptor, as well as combining aromatase inhibitors with a CDK4/6 inhibitor like palbociclib (Ibrance), are being investigated for the treatment of recurring or later-stage ovarian/fallopian tube cancer.
How damaged genes in ovarian/fallopian tube cancer cells can be fixed or replaced is a novel topic of research. Researchers are investigating the use of specially created viruses that deliver healthy genes directly into the centre of cancer cells, where they can subsequently replace the unhealthy genes with healthy ones.
To enhance patients’ comfort and quality of life, clinical trials are being conducted to discover more effective strategies to lessen the adverse effects and symptoms of conventional cancer treatments.