Ovarian Cancer : Side Effects, Prevention

by Food and Drug Administration (FDA)

(Page 4 of 5)

Side Effects

Surgery, the first-line treatment for ovarian cancer, requires several days' hospitalization and a recuperative period of from four to six weeks. Removing the ovaries, which are the main source of the female hormones estrogen and progesterone, causes immediate menopause, and the symptomatic hot flashes are more severe than when menopause occurs more gradually, as it usually does naturally.

Radiation therapy can cause mild skin reactions, such as redness and drying in treated areas, urinary discomfort, diarrhea, and vaginal dryness. (Menopause can also cause vaginal dryness.) A small percent of patients may develop bowel obstruction, sometimes requiring surgical correction.

Other possible side effects of radiation therapy, commonly experienced with chemotherapy as well, include loss of energy and appetite, nausea, and vomiting.

Chemotherapy may also cause mouth sores, hair loss, and reduced platelet and blood cell counts that can lead to infections, anemia or bleeding. The drugs used to treat ovarian cancer may also have neurologic effects, causing hearing loss, ringing in the ears, nerve damage, and numbness or tingling in the face, fingers and toes. There may also be kidney damage.

Most side effects are temporary, and sometimes dietary changes or medicines can ease the symptoms. There are several drugs approved for countering nausea and vomiting often associated with chemotherapy. They include Zofran (ondansetron hydrochloride), Reglan (metocloparamide), and Marinol (dronabinol).

Transfusions can correct red blood cell and platelet deficiencies. Hematopoietic growth factors such as G-CSF, approved in 1991, stimulate production of infection-fighting white blood cells. GM-CSF, which also received FDA approval in 1991 to increase white blood cell counts after bone marrow transplantation, is now being studied for its effectiveness in stimulating white cells after cancer chemotherapy. Among other drugs now under study for their ability to increase white cell counts, and perhaps platelets as well, are stem cell factor and PIXY 321. PIXY 321 is a genetically engineered product consisting of GM-CSF and another hematopoietic growth factor, interleukin-3.

When therapy is completed, the woman continues to have regular checkups that include pelvic examinations and laboratory tests to measure blood levels of tumor markers such as CA 125. The doctor may recommend a laparotomy or laparoscopy after completion of chemotherapy to inspect the abdomen and pelvis and take multiple tissue biopsies. This "second-look surgery" helps evaluate the effectiveness of chemotherapy and determine whether treatment should be continued or stopped. Often a laparotomy or laparoscopy has been done previously to diagnose ovarian cancer.

Attempts at Prevention

The Gilda Radner Familial Ovarian Cancer Registry advises women with two or more first- or second-degree relatives who have had the disease to have their ovaries removed via video laparoscopy as a precautionary measure by age 35, if they have completed their families. The registry also advises that there is a small increased risk (1.8 percent) of developing primary papillary cancer of the peritoneum for women who have had this prophylactic surgery. The registry also recommends that women with a family history of ovarian cancer receive genetic counseling, beginning in their early 20s, and have pelvic and abdominal examination, CA 125 testing, and transvaginal ultrasound every six months beginning in their early 30s.

Jessica Marsh, seven years after her diagnosis, is today free of cancer and feeling fine. "I've become a much more positive person since my cancer," she says. "Life is too short to worry about little things. If life deals me lemons, I'll make lemonade."

The Ovaries — How They Work

The ovaries are located in the pelvis, one on each side of the uterus. About the size and shape of almonds, they are made up of several different cell types. Some carry out the hormonal functions of the organ, while others provide physical support. The ovaries have two main functions:

• ovulation (the release of an egg each month)
• production of estrogen and progesterone, hormones that regulate the menstrual cycle and pregnancy and control the development of female physical traits, such as the breasts, pelvic structure, fat distribution, and body hair.

From birth, the ovaries contain the cells that eventually become ova (eggs). Each month, beginning with puberty and until menopause, hormones produced by the pituitary gland in the brain stimulate ovulation (release of an egg), which alternates each month between the two ovaries. (Not all women ovulate every month.)

The egg travels through the fallopian tube to the uterus. If it is fertilized, it may grow and develop in the womb. If not, hormone changes cause shedding of the uterine lining, and menstruation begins about two weeks later.

About the Author

www.fda.gov
FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.