weed out

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Dr. Matt McDonald discusses the progression of ovarian cancer and how it is treated. Matt McDonald, MD: Unfortunately in this day and age, the majority of ovarian cancers present at the late stage. Statistically 80% of all ovarian cancers present at an advanced stage either stage 3 or 4. Treatment options for those patients usually requires a combination of a surgery and chemotherapy. New advances in ovarian cancer at this point in time really rely upon what we call adjuvant treatment for ovary cancer and what I mean by that is surgery for ovarian cancer as for several, several decades, its main goal is to what we call surgically remove the cancer and what that means is remove all of the macroscopic or all of the disease that we can see or touch at the time of surgery. Many times we can't remove every single piece of cancer that we can see or feel, but the goal is to leave as little a nodule of cancer behind following surgery and what we strive to do is leave any cancer behind that will be smaller than 1 cm that's the goal and from a surgical standpoint that may require removal of parts of the intestinal tract or urinary tract, etc. The surgery's goal is to remove the large pieces of cancer and leave the smallest amount of residual tumor behind as we can and that's what chemotherapy is for. Chemotherapy works better on small implants of cancer than it does on large implants of cancer. For many patients, we are employing something called intraperitoneal chemotherapy which is when a patient receiving chemotherapy receives a combination of some intravenous chemotherapy which is a standard traditional approach and some patients will receive a combination where they also receive intraperitoneal chemotherapy or a lot of patients consider this a belly wash chemotherapy where there is a port implanted in the abdomen where we infuse chemotherapy directly into the abdominal cavity and in patient that can tolerate and be administered intraperitoneal chemotherapy, it has been shown that these patients actually do better and have a longer survival rate. And so on this day and age that's what most of us strive to do is to have an excellent surgical result followed by a combination intravenous and intraperitoneal chemotherapy. The challenge to the medical environment is to catch ovarian cancer at an earlier stage and there are some new blood tests that are doing a better job with that than we did ten years ago. There are some new screening algorithms or triage algorithms for an ovarian mass that help patients get to a trained professional such as GYN oncologist for their initial operation which in this time still is the most important aspect of a woman's care with ovarian cancer is that her initial diagnosis and initial management is performed by a GYN oncologist. Most notably there are some blood tests. One's called the OVA 1, which is a blood test that screens for five different analytes in a woman's blood to help us dictate whether or not an ovarian mass is cancer or not and that test does do a better job than some of the other more traditional approaches that we use. Again another challenge to women that have been found to have an ovarian mass is to definitely seek out the right physician. The good news is a vast majority of an ovarian mass that is seen on CT scan or ultrasound is benign. It is not a cancer, the vast majority of a time. The challenge for a medical team is to weed out who are those cancers and who is not and certainly seek second opinions, seek out GYN oncologists, if you have an ovarian mass for a second opinion or a surgical consultation, because it's important that you get the best preoperative evaluation in the event that it is a cancer that you are taking care of by the right medical professional. Learn more about Dr. McDonald: http://presbyteriangyncancer.org/?id=5013&sid=123