“End-stage ovarian cancer life expectancy”

 “End-stage ovarian cancer life expectancy”

End-stage ovarian cancer life expectancy ichhori.com


Ovarian cancer is a condition in which malignant (cancerous) cells are identified inside, around, or on the outer layer of the ovaries, depending on the kind and stage of the illness. When abnormal cells in a body part (in this case, the ovary) begin to expand uncontrollably, cancer develops. Cancer cells can spread to other parts of the body and begin to grow and replace healthy tissue. Ovarian cancer is frequently misdiagnosed and undetected until it has progressed into the pelvis and abdomen. Ovarian cancer is more difficult to treat at this stage. Early-stage ovarian cancer, which is limited to the ovary, is more likely to be effectively treated.

Prevalence of Ovarian Cancer

Ovarian cancer incidence has grown globally owing to a variety of circumstances, including population expansion, higher cancer risk factors, decreasing birth rates, shorter breastfeeding length, and tube ligation. The greatest mortality rate has been found amongst the African population. With regards to high-frequency/incidence population, the great majority occurs in Europe and North America. 

According to several population-based cancer registers in India, the incidence of ovarian carcinoma ranged from 1.7 to 15.2 between 2012 and 2014. In 2020, India reported 59,276 new ovarian cancer cases. By 2035, the annual incidence of ovarian cancer is expected to rise to 371,000 (a 55% increase), with a 67% increase in mortality rates. According to a 2014–2016 study, roughly 229,875 women in the United States were diagnosed with ovarian cancer. In Asia, ovarian cancer is highly prevalent in China (34,575 cases per year) (Human Development Index, Asia, 2012).

In 2021, it was expected to be 21,410 new cancer cases, accounting for 1.1% of all new cancer cases. Deaths from cancer are expected to account for 13,770 of all cancer deaths in 2021, or 2.3% of all cancer deaths.

Incidence of end-stage ovarian cancer

When a person is diagnosed with Stage 4 ovarian cancer, the cancer has spread to other areas of the body, including the lungs and liver tissue. Stage 4 ovarian cancer is also described by cancer cells in the fluid around the lungs. The majority of women who are diagnosed with Stage 4 ovarian cancer have a five-year survival rate of about 17%.About 3 of 4 women with ovarian cancer survive for at least a year after diagnosis, regardless of the type of ovarian cancer they have. About half of ovarian cancer patients (46%) are still living at least 5 years after diagnosis. Women diagnosed under the age of 65 have a higher prognosis than older women.

Life expectancy of Stage 4 Ovarian Cancer

The prognosis for ovarian cancer is determined by the stage and form of cancer. Ovarian cancer can be classified into three types:

  • Epithelial tumors form on the outside of the ovaries in the epithelial layer of tissue.

  • Stromal tumours arise in hormone-producing cells.

  • Germ cell tumors form in the cells that produce eggs.

Epithelial tumors are found in approximately 90% of ovarian cancers, stromal tumors account for around 7% of all ovarian tumors, whereas germ cell tumors are much less common. For these three forms of tumors, the five-year relative survival rate is 44%.

Stage 4 epithelial ovarian cancer has a relative five-year survival rate of 17%, stage 4 ovarian stromal tumors has a relative five-year survival rate of 35%, and stage 4 ovarian germ cell tumors has a relative five-year survival rate of 69%. It is certain that early diagnosis leads to a positive prognosis. The five-year relative survival rate is 92% when diagnosed and treated in stage 1 and just about 15% of ovarian cancers are detected. The five-year survival rate for most women diagnosed with Stage 4 ovarian cancer is about 17%. Other aspects that influence a woman's prognosis include her overall fitness, the cancer's grade, and how well the patient reacts to treatment.

Ovarian cancer survival rate is also determined by the extent to which the cancer has progressed at the time of diagnosis. It is divided into three categories:

  • Localized cancer that is exclusive to the ovaries.

  • Regional: The cancer has spread to neighboring areas or lymph nodes.

  • Distant cancer that has expanded well past its original location.

Localized cancer has a 5-year survival rate of 92.4%, regional cancer is 75.2%, and remote cancer has a 5-year survival rate of 29.2%. 

However, it is important to keep in mind that survival rates are predictions based on the results of vast number of patients who have had a certain cancer in the past, but that they cannot anticipate what will happen in any given situation. These figures only refer to the level of cancer at the time of diagnosis. They do not apply if the cancer expands, progresses, or returns after surgery. These figures do not account for everything. The survival rates are divided into groups depending on the extent to which the cancer has spread. However, other things like age and physical health, as well as how well the cancer responds to care, may have an impact on the prognosis. Treatments change and improve over time, and these figures are founded on those who have been diagnosed and treated for at least five years prior.

Treatment of Stage 4 Ovarian Cancer

Surgery to remove as much of the tumor as possible, followed by combined chemotherapy, can be used to treat Stage 4 ovarian cancer. The goal of treatment is to keep the cancer under control for as long as possible while still making you feel better and living longer. Surgery to remove the tumor, ovaries, fallopian tubes, and uterus is usually the first step of treatment. The surgeon may need to cut parts of other organs, such as the intestines or kidneys, in order to remove all of the cancer. Chemotherapy will be given to the patient after the surgery. Doctors can use blood tests and scans to monitor the patient's progress.

Before surgery, the doctor may prescribe neoadjuvant chemotherapy if the cancer is very advanced. The term "neoadjuvant chemotherapy" simply refers to chemotherapy provided to patients prior to surgery with the aim of shrinking the tumor. A smaller tumor necessitates less invasive treatment and poses less risks. However, depending on the circumstances, the risks of surgery may outweigh the benefits, and doctors may decide against surgery. Palliative therapies, which help to ease symptoms and offer relief, can be chosen by an individual with stage 4 cancer.

Treatment types:

  1. Chemotherapy before surgery – this is known as interval debulking surgery (IDS)

  2. Chemotherapy after surgery is referred to as debulking surgery.

  3. Chemotherapy without surgery

Chemotherapy before surgery

It is referred to as neoadjuvant or primary chemotherapy. Chemotherapy is used to reduce the size of the cancer and make it easy to extract. Halfway into your chemotherapy treatment, you get a scan. If the scan reveals that the cancer is diminishing, you will have surgery. Following the surgery, you must complete the remainder of the chemotherapy treatment.

Chemotherapy after surgery

If you are well enough, you can have debulking surgery as the first option. The surgeon attempts to extract as much cancer as possible. Chemotherapy is administered after you have recovered from surgery. Adjuvant chemotherapy is the term for this kind of treatment. The aim of adjuvant chemotherapy is to shrink the cancer that has remained since surgery. 

Chemotherapy without surgery

It's likely the surgery won't be possible if a person has terminal cancer or is not in good health. Chemotherapy can be used on its own to shrink the cancer as much as possible to delay its progression. Depending on where the cancer has progressed across the body, a patient will need radiotherapy to alleviate symptoms.

Targeted cancer drugs

Bevacizumab, a form of targeted treatment, can be used in combination with chemotherapy for certain advanced cancers. If the cancer returns following treatment, patients will need a targeted cancer drug named olaparib or niraparib.

Palliative Care for End-Stage Ovarian Cancer

Palliative care can be provided to women with advanced ovarian cancer in addition to traditional therapies including chemotherapy. The primary goal of palliative care, among others, is to make a patient feel as comfortable for as long as possible. Pain, sleep disturbances, fatigues, exhaustion, anxiety, lack of appetite, and other physical and emotional side effects of ovarian cancer treatment can be addressed with palliative care.

Palliative care involves:

  1. Medication to relieve problems like pain or fatigue,

  2. Emotional or dietary treatment

  3. Physical therapy

  4. Alternative medicine, or treatments like acupuncture, aromatherapy, or massage.

According to studies, people with cancer who receive palliative care have a better quality of life and fewer severe symptoms.


Ovarian cancer is one of the most common cancers and causes of death in women around the world. Studies are currently underway to develop novel screening approaches that are both efficient and beneficial in detecting the disease in its early stages. It's crucial to keep in mind that the numbers of surivival are just projections. The prognosis is determined by factors unique to each person.


Sources:

  1. https://www.ovarian.org/about-ovarian-cancer/what-is-ovarian-cancer

  2. https://aujmsr.com/global-scenario-on-ovarian-cancer-its-dynamics-relative-survival-treatment-and-epidemiology-2/#:~:text=In%20India%2C%2059%2C276%20have%20been,increases%20by%2067%25%20to%20254%2C000.

  3. https://seer.cancer.gov/statfacts/html/ovary.html

  4. https://ocrahope.org/patients/about-ovarian-cancer/staging/

  5. https://www.healthline.com/health/cancer/ovarian-cancer-outlook#outlook

  6. https://www.medicalnewstoday.com/articles/326875#treatment-options

  7. https://www.cancerresearchuk.org/about-cancer/ovarian-cancer/stages-grades/stage-4

  8. https://www.cancer.org/cancer/ovarian-cancer/detection-diagnosis-staging/survival-rates.html

  9. https://www.healthline.com/health/ovarian-cancer/palliative-and-hospice-care-for-advanced-ovarian-cancer#takeaway

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