Dr. Gautam Goyal is a lead consultant for the Medical & Hemato-Oncology at Max Super Speciality Hospital, Mohali. Dr. Goyal trained in MD (Internal Medicine) from CSMMU (KGMC), Lucknow before initiating his career in Hemato-Oncology. He completed his DM (Medical Oncology) from Tata Memorial Hospital, Mumbai and is ECMO (ESMO Certified Medical Oncologist).
The female reproductive system contains two ovaries, one on each side of the uterus. The ovaries produce eggs (ova) and the hormones estrogen and progesterone. Ovarian cancer begins in the ovaries and spreads within the pelvis and abdomen later. Early-stage ovarian cancer, in which the disease is confined to the ovary, is more likely to be treated successfully using surgery, radiotherapy, hormone therapy and chemotherapy. Later-stage ovarian cancer is more difficult to treat. Risk factors for developing ovarian cancer include family history, older age, reproductive history, birth control, infertility or fertility treatment, breast cancer, hormone therapy, gynecologic surgery and obesity. Early-stage ovarian cancer causes symptoms like Discomfort in the pelvis area, pain in the lower abdomen, or the lower part of the body, back pain, indigestion or heartburn, feeling full rapidly when eating, frequent and urgent urination, pain during sexual intercourse, changes in bowel habits, such as constipation. Advanced-stage ovarian cancer may cause few and nonspecific symptoms including nausea, weight loss, breathlessness, tiredness, loss of appetite and weight loss. On diagnosing the ovarian cancer, next step is to detect its stage and grade based on its spread. Identifying the stage and grade will help the doctor to decide on the best treatment. The American Cancer Society uses a four-stage system.
Stage 1: Cancer cells affect only the ovary or ovaries and have not spread to another area.
Stage 2: The cancer has affected one or both ovaries and also other organs within the pelvis, such as the uterus, fallopian tubes, bladder, or rectum.
Stage 3: The cancer affects one or both ovaries and either the lining of the abdomen or lymph nodes in the back of the abdomen.
Stage 4: The cancer has spread to other parts of the body, outside the peritoneal cavity. This cavity includes the abdomen and the pelvis. Areas that may now be affected include the liver, spleen, and the fluid around the lungs.
Diagnosis includes tests like blood tests, imaging tests (like MRI, ultrasound and CT scan), laparoscopy (to visualise ovaries through camera), colonoscopy (to visualise any bleeding in colon), abdominal fluid aspiration (to see if the patient’s abdomen is swollen), biopsy (to remove the tumor or part of the tumor to examine for the presence of cancer cells). The kind of treatment depends on many factors, including the type of ovarian cancer, its stage and grade, as well as the general health of the patient.
In most cases, surgery is done to remove the cancer. Chemotherapy is used to target cancer cells that surgery cannot or did not remove. Treatment usually involves 3 to 6 chemotherapy sessions, or cycles. These will be given 3 to 4 weeks apart, to allow the body time to recover. If the cancer returns or begins to grow back again, chemotherapy may be given again to shrink it. Newer medications can directly target specific pathways or functions in cancer cells. These medications include bevacizumab (Avastin) and olaparib (Lynparza). Hormone therapy (HT) may be added to the treatment plan in order to prevent estrogen from reaching the cancer cells. Radiation is less often used in ovarian cancer treatment. It may be used if there are small traces of cancer in the reproductive system, or to treat the symptoms of advanced cancer.
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With vast experience of 12 years & work in the prestigious TMH, Mumbai for over 5 years, he is widely appreciated for his clinical judgement, operative skills and state of art care for patients with all types and stages of cancer. His main area of interest includes breast cancer with breast conservation surgeries and oncoplasty.