Ovarian Cancer Diagnosis, Treatments, and Survivorship

Clara Jennings

Ovarian cancer. It's a term many have heard, but for most, it's a foggy concept. What types are there? How is it diagnosed? And what role does our genetic profile play?

Professor Andreas Obermair

That’s an excellent place to start, Clara. Ovarian cancer is not a single disease. The most common type, accounting for around 70 to 80 percent of cases, is high-grade serous carcinoma. It's an aggressive cancer that typically starts in the surface tissue of the ovary or the fallopian tube. However, we also see less common types like low-grade serous carcinoma, which grows more slowly, and clear cell carcinoma, which is more aggressive but rarer.

Clara Jennings

So you’re saying there’s a wide spectrum here. Does that mean each type requires a different approach to diagnosis?

Professor Andreas Obermair

Absolutely. There are more than 30 different types of ovarian cancer. I often remind patients that diagnosing ovarian cancer isn’t straightforward. We begin with imaging techniques like ultrasounds. These help us see abnormalities in the ovaries or surrounding tissues. From there, more detailed scans such as a CT scan can pinpoint the size and spread of the tumor.

Clara Jennings

And when do biopsies come into play?

Professor Andreas Obermair

Ah, biopsies are critical, Clara. We need to obtain a good sized piece of tissue to examine a tissue sample under the microscope to confirm whether it’s cancer and, more importantly, what type it is. For instance, if surgery isn't immediately possible, we might perform a laparoscopy and biopsy to guide initial treatments like chemotherapy. It's the gold standard for also for a genomic diagnosis, which can save lives.

Clara Jennings

I see. And where does something like genetic testing fit into this puzzle?

Professor Andreas Obermair

Genetic testing plays an increasingly crucial role. Mutations in the BRCA1 or BRCA2 genes are particularly important. These mutations not only increase the risk of ovarian and breast cancers but also influence treatment options. For instance, patients with these mutations can benefit from targeted therapies like PARP inhibitors as part of their treatment plan.

Clara Jennings

That’s fascinating. Could you share how genetic testing has changed outcomes for patients?

Professor Andreas Obermair

Sure. Let me give you an example. I had a patient diagnosed with high-grade serous carcinoma. Through genetic testing, we found a BRCA mutation. Not only did this inform her treatment plan—allowing us to tailor her therapy—but it also enabled us to test her family members. Some of them discovered they carried the mutation and took preventative measures, which reduced their cancer risk significantly.

Clara Jennings

Wow. So it’s not just about the individual. It’s a ripple effect for their family, too.

Professor Andreas Obermair

Precisely. Genetic insights are empowering—not just for immediate treatment, but also for long-term survivorship and family planning.

Clara Jennings

This really emphasizes how important it is to understand the type of cancer someone has and leverage all the tools available to diagnose and plan treatment. Up next, we’ll be exploring what happens once that diagnosis is made and why surgery is often a first step.

Clara Jennings

We’ve talked about the challenges of diagnosing ovarian cancer and the tools used to pinpoint its type. Now, Professor, let’s discuss what happens next. Surgery is often the first step, right?

Professor Andreas Obermair

That’s correct. Surgery is typically the cornerstone of treatment for ovarian cancer. For most patients, it involves a hysterectomy, where the uterus is removed, and a bilateral salpingo-oophorectomy, removing both ovaries and fallopian tubes. This procedure is essential for both treating the cancer and accurately staging the disease.

Clara Jennings

Who usually performs this type of surgery? Is it a general surgeon?

Professor Andreas Obermair

Actually, Clara, it’s crucial that a gynecologic oncologist performs the surgery. They specialize in cancers of the female reproductive system and are trained to remove as much of the cancer as possible. This process is called debulking or cytoreductive surgery, and it can significantly improve a patient’s prognosis.

Clara Jennings

That makes sense. And after surgery, chemotherapy is typically the next step, isn’t it?

Professor Andreas Obermair

Yes, exactly. Platinum-based chemotherapy is the standard for most ovarian cancers. We often use a combination of carboplatin and paclitaxel, administered in cycles to allow the body to recover between treatments. This approach targets fast-growing cancer cells but can also affect healthy cells, leading to side effects like fatigue, nausea, and sometimes neuropathy.

Clara Jennings

For listeners who might not know, what is neuropathy?

Professor Andreas Obermair

Neuropathy refers to nerve damage that can cause tingling, pain, or numbness, especially in the hands and feet. While it’s a common side effect of paclitaxel, we monitor patients closely and adjust the treatment if necessary.

Clara Jennings

And beyond chemotherapy, are there emerging options for treatment?

Professor Andreas Obermair

Indeed, there are. For patients with certain genetic markers, like BRCA mutations or homologous recombination deficiency, we now use targeted therapies called PARP inhibitors. These drugs are typically part of maintenance therapy, designed to prevent the cancer from returning. The results so far have been remarkable—offering longer remission periods and improving quality of life.

Clara Jennings

Wow, that sounds promising. So these treatments are highly personalized?

Professor Andreas Obermair

Very much so, Clara. By tailoring treatments to the unique genetic makeup of a patient’s cancer, we’re seeing outcomes that were unimaginable a decade ago. It’s a game changer for ovarian cancer care.

Clara Jennings

With treatments becoming more personalized and effective, Professor, the big question many listeners might have is—what happens next? Life after treatment is a journey in itself. Could you share what survivorship looks like for someone who has faced ovarian cancer?

Professor Andreas Obermair

Survivorship is, indeed, an important phase, Clara. It’s not just about being cancer-free; it’s about managing your physical health, emotional well-being, and even the financial impact of treatment. Regular follow-up is a cornerstone here, with exams scheduled every few months initially, and, over time, less frequently. This ensures we catch any signs of recurrence early.

Clara Jennings

And beyond medical follow-ups, what else should survivors focus on to improve their quality of life?

Professor Andreas Obermair

Several things, really. Maintaining a healthy lifestyle can make a big difference—things like eating a balanced diet, exercising regularly, and avoiding smoking or excessive alcohol, all play into recovery and overall health. Mental health support is equally critical. Survivors often face anxiety about the future or even depression, which is why counseling and support groups can be invaluable.

Clara Jennings

It sounds like there are a lot of resources available. Can you tell us about organizations that might help?

Professor Andreas Obermair

Absolutely. Organizations like the National Ovarian Cancer Coalition provide excellent tools for patients and caregivers. They offer peer-to-peer support, educational programming, and even financial assistance in some cases. Similarly, groups like the Ovarian Cancer Research Alliance create a sense of community while also funding research to advance treatments. These resources are often a lifeline for survivors and their families.

Clara Jennings

That’s great to hear. Now, earlier, you mentioned ongoing research. How do clinical trials fit into survivorship?

Professor Andreas Obermair

Clinical trials are a vital piece of the puzzle. They’re not only a way for patients to access potentially groundbreaking treatments but also a means to contribute to research that helps future patients. Take, for example, PARP inhibitors for maintenance therapy—they were once experimental, but trials confirmed their value. Now, they’re standard care for certain patients.

Clara Jennings

So, participating in a trial could really be a win-win?

Professor Andreas Obermair

Precisely. However, it’s important to discuss this thoroughly with your care team to understand the potential benefits and risks. Trials have eligibility criteria, but they often represent hope and progress for many who participate.

Clara Jennings

I love how you phrased that—hope and progress. As we wrap up today’s episode, it’s clear that survivorship isn’t just about moving on; it’s about holistic care and embracing the post-treatment journey with access to the right tools and resources. Professor, thank you for joining us and sharing your insights.

Professor Andreas Obermair

It’s been a pleasure, Clara. Conversations like these help bridge the gap between complex medical topics and what patients truly need to know.

Clara Jennings

And that’s all for today’s episode of our podcast on ovarian cancer. Thank you to our listeners for joining us on this important journey. Remember, knowledge empowers. Until next time, take care and stay informed.