Archive | September 2024

QUOTE FOR TUESDAY:

“Leukemia is the most common cancer in children and teens, accounting for almost 1 out of 3 cancers. Most childhood leukemias are acute lymphocytic leukemia (ALL). Most of the remaining cases are acute myeloid leukemia (AML). Chronic leukemias are rare in children.”

American Cancer Society (https://www.cancer.org/cancer/types/leukemia-in-children.html)

Leukemia

leukemia1leukemia2

Leukemia is the most common cancer in children and teens, accounting for almost 1 out of 3 cancers. Most childhood leukemias are acute lymphocytic leukemia (ALL). Most of the remaining cases are acute myeloid leukemia (AML). Chronic leukemias are rare in children.

A risk factor is anything that affects a person’s chance of getting a disease such as cancer. Different cancers have different risk factors.

Lifestyle-related risk factors such as tobacco use, diet, body weight, and physical activity play a major role in many adult cancers. But these factors usually take many years to influence cancer risk, and they are not thought to play much of a role in childhood cancers, including leukemias.

There are a few known RISK FACTORS for childhood leukemia.

Inherited syndromes

-Some inherited disorders increase a child’s risk of developing leukemia:

  • Down syndrome (trisomy 21): Children with Down syndrome have an extra (third) copy of chromosome 21. They are many times more likely to develop either acute lymphocytic leukemia (ALL) or acute myeloid leukemia (AML) than are other children, with an overall risk of about 2% to 3%. Down syndrome has also been linked with transient leukemia (also known as transient myeloproliferative disorder) – a leukemia-like condition within the first month of life, which often resolves on its own without treatment.
  • Li-Fraumeni syndrome: This is a rare condition caused by a change in the TP53 tumor suppressor gene. People with this change have a higher risk of developing several kinds of cancer, including leukemia, bone or soft tissue sarcomas, breast cancer, adrenal gland cancer, and brain tumors.Other genetic disorders (such as neurofibromatosis and Fanconi anemia) also carry an increased risk of leukemia, as well as some other types of cancers.Having a parent who develops leukemia as an adult does not seem to raise a child’s risk of leukemia.The possible risks from fetal or childhood exposure to lower levels of radiation, such as from x-ray tests or CT scans, are not known for sure. Some studies have found a slight increase in risk, while others have found no increased risk. Any risk increase is likely to be small, but to be safe, most doctors recommend that pregnant women and children not get these tests unless they are absolutely needed.1-Acute lymphocytic leukemia (ALL) is a type of cancer of the blood and bone marrow — the spongy tissue inside bones where blood cells are made.Acute lymphocytic leukemia is the most common type of cancer in children, and treatments result in a good chance for a cure. Acute lymphocytic leukemia can also occur in adults, though the chance of a cure is greatly reduced.
  • The word “acute” in acute lymphocytic leukemia comes from the fact that the disease progresses rapidly and creates immature blood cells, rather than mature ones. The “lymphocytic” in acute lymphocytic leukemia refers to the white blood cells called lymphocytes, which ALL affects. Acute lymphocytic leukemia is also known as acute lymphoblastic leukemia.
  • What is Leukemia?  First their are types of leukemia, which are cancers of the bone marrow and blood and this is the most common childhood cancers unfortunately.  They account for about 30% of all cancers in children.  The most common types that are found in children they are 1.) acute lymphocytic leukemia (ALL) 2.) acute myelogenous leukemia (AML).
  • Exposure to high levels of radiation is a risk factor for childhood leukemia. Japanese atomic bomb survivors had a greatly increased risk of developing AML, usually within 6 to 8 years after exposure. If a fetus is exposed to radiation within the first months of development, there may also be an increased risk of childhood leukemia, but the extent of the risk is not clear.
  • Siblings (brothers or sisters) with leukemia have a slightly increased chance (2 to 4 times normal) of developing leukemia, but the overall risk is still low. The risk is much higher among identical twins. If one twin develops childhood leukemia, the other twin has about a 1 in 5 chance of getting leukemia as well. This risk is much higher if the leukemia develops in the first year of life.

2-Acute myelogenous leukemia (AML) is a cancer of the blood and bone marrow — the spongy tissue inside bones where blood cells are made.

The word “acute” in acute myelogenous leukemia denotes the disease’s rapid progression. It’s called myelogenous (my-uh-LOHJ-uh-nus) leukemia because it affects a group of white blood cells called the myeloid cells, which normally develop into the various types of mature blood cells, such as red blood cells, white blood cells and platelets.

Acute myelogenous leukemia is also known as acute myeloid leukemia, acute myeloblastic leukemia, acute granulocytic leukemia and acute nonlymphocytic leukemia.

QUOTE FOR MONDAY:

“Leukemia is a broad term for cancers of the blood cells. The type of leukemia depends on the type of blood cell that becomes cancer and whether it grows quickly or slowly. Leukemia occurs most often in adults older than 55, but it is also the most common cancer in children younger than 15.  There is Acute Lymphoblastic Leukemia, Acute Myeloid Leukemia, Chronic Lymphocytic Leukemia , Chronic Myelogenous Leukemia, Hairy Cell Leukemia, Childhood Acute Lymphoblastic Leukemia, and Childhood Acute Myeloid Leukemia.”

National Cancer Institute (https://www.cancer.gov/types/leukemia#: ~:text=Leukemia%20is%20a%20broad%20term,in%20children%20younger%20than%2015.)

Childhood Cancer Awareness Month – Leukemia

 

Leukemia is the most common cancer in children and teens, accounting for almost 1 out of 3 cancers. Most childhood leukemias are acute lymphocytic leukemia (ALL). Most of the remaining cases are acute myeloid leukemia (AML). Chronic leukemias are rare in children.

A risk factor is anything that affects a person’s chance of getting a disease such as cancer. Different cancers have different risk factors.

Lifestyle-related risk factors such as tobacco use, diet, body weight, and physical activity play a major role in many adult cancers. But these factors usually take many years to influence cancer risk, and they are not thought to play much of a role in childhood cancers, including leukemias.

There are a few known RISK FACTORS for childhood leukemia.

Inherited syndromes

-Some inherited disorders increase a child’s risk of developing leukemia:

  • Down syndrome (trisomy 21): Children with Down syndrome have an extra (third) copy of chromosome 21. They are many times more likely to develop either acute lymphocytic leukemia (ALL) or acute myeloid leukemia (AML) than are other children, with an overall risk of about 2% to 3%. Down syndrome has also been linked with transient leukemia (also known as transient myeloproliferative disorder) – a leukemia-like condition within the first month of life, which often resolves on its own without treatment.
  • Li-Fraumeni syndrome: This is a rare condition caused by a change in the TP53 tumor suppressor gene. People with this change have a higher risk of developing several kinds of cancer, including leukemia, bone or soft tissue sarcomas, breast cancer, adrenal gland cancer, and brain tumors.

Other genetic disorders (such as neurofibromatosis and Fanconi anemia) also carry an increased risk of leukemia, as well as some other types of cancers.

Siblings (brothers or sisters) with leukemia have a slightly increased chance (2 to 4 times normal) of developing leukemia, but the overall risk is still low. The risk is much higher among identical twins. If one twin develops childhood leukemia, the other twin has about a 1 in 5 chance of getting leukemia as well. This risk is much higher if the leukemia develops in the first year of life.

Having a parent who develops leukemia as an adult does not seem to raise a child’s risk of leukemia.

Exposure to high levels of radiation is a risk factor for childhood leukemia. Japanese atomic bomb survivors had a greatly increased risk of developing AML, usually within 6 to 8 years after exposure. If a fetus is exposed to radiation within the first months of development, there may also be an increased risk of childhood leukemia, but the extent of the risk is not clear.

The possible risks from fetal or childhood exposure to lower levels of radiation, such as from x-ray tests or CT scans, are not known for sure. Some studies have found a slight increase in risk, while others have found no increased risk. Any risk increase is likely to be small, but to be safe, most doctors recommend that pregnant women and children not get these tests unless they are absolutely needed.

What is Leukemia?  First their are types of leukemia, which are cancers of the bone marrow and blood and this is the most common childhood cancers unfortunately.  They account for about 30% of all cancers in children.  The most common types that are found in children they are 1.) acute lymphocytic leukemia (ALL) 2.) acute myelogenous leukemia (AML).

1.)-Acute lymphocytic leukemia (ALL) is a type of cancer of the blood and bone marrow — the spongy tissue inside bones where blood cells are made.

The word “acute” in acute lymphocytic leukemia comes from the fact that the disease progresses rapidly and creates immature blood cells, rather than mature ones. The “lymphocytic” in acute lymphocytic leukemia refers to the white blood cells called lymphocytes, which ALL affects. Acute lymphocytic leukemia is also known as acute lymphoblastic leukemia.

Acute lymphocytic leukemia is the most common type of cancer in children, and treatments result in a good chance for a cure. Acute lymphocytic leukemia can also occur in adults, though the chance of a cure is greatly reduced.

2.)-Acute myelogenous leukemia (AML) is a cancer of the blood and bone marrow — the spongy tissue inside bones where blood cells are made.

The word “acute” in acute myelogenous leukemia denotes the disease’s rapid progression. It’s called myelogenous (my-uh-LOHJ-uh-nus) leukemia because it affects a group of white blood cells called the myeloid cells, which normally develop into the various types of mature blood cells, such as red blood cells, white blood cells and platelets.

Acute myelogenous leukemia is also known as acute myeloid leukemia, acute myeloblastic leukemia, acute granulocytic leukemia and acute nonlymphocytic leukemia.

2.) Acute myelogenous leukemia (AML) is a cancer of the blood and bone marrow — the spongy tissue inside bones where blood cells are made.

The word “acute” in acute myelogenous leukemia denotes the disease’s rapid progression. It’s called myelogenous (my-uh-LOHJ-uh-nus) leukemia because it affects a group of white blood cells called the myeloid cells, which normally develop into the various types of mature blood cells, such as red blood cells, white blood cells and platelets.

Acute myelogenous leukemia is also known as acute myeloid leukemia, acute myeloblastic leukemia, acute granulocytic leukemia and acute nonlymphocytic leukemia.

 

 

 

 

 

 

QUOTE FOR THE WEEKEND:

“Chronic pain is pain that lasts for over three months. You may feel the pain all the time or it may come and go. It can happen anywhere in your body and has countless causes.

Chronic pain is a very common condition and one of the most common reasons why people seek medical care. In 2021, about 20.9% of U.S. adults (51.6 million people) experienced chronic pain, according to a study from the U.S. Centers for Disease Control and Prevention (CDC).

Pain is your body’s way of telling you that something’s wrong, like an alarm. But when that alarm continues to go off for months or years, it can drown out many aspects of life that bring you joy. And it can take quite a toll on your physical, mental and emotional health. Because of this, it’s essential to seek help for chronic pain. Together, you and your healthcare provider can develop a plan to help dampen chronic pain.”.

Cleveland Clinic (https://my.clevelandclinic.org/health/diseases/4798-chronic-pain)

Pain Awareness Month: How to close gates of pain, the role of stress, consequence of chronic stress and the key to prevent it!

 

In most instances, painful sensations arise from tissue injury in the body. Sensitive nerve endings pick up pain signals and carry these messages along nerves to the spinal cord and then onto the brain. All along these complex pathways, there are biological “gates” that can be either opened or closed. When these gates are closed, pain is reduced or eliminated. When open, pain messages continue through the circuit. It is when these gates are jammed open that chronic pain cycles begin.

As you recall, acute pain is short lived and serves as a warning signal. When you fix whatever is wrong, the pain usually goes away. In the case of chronic pain, pain does not necessarily signal that the body is undergoing more damage. Most chronic pain is caused by a malfunction of the nervous system, either in nerves or the brain. The malfunction or opening of the pain gates causes and endless barrage of pain signals to cycle. Chronic pain then becomes a disease itself, taking on a life of its own.

How can we close the gates of pain?

The gates are affected by several factors, most importantly by the pattern of nerve impulses which reach the spinal cord from the rest of the body, and nerve impulses coming from the brain. Sometimes the nerve impulses traveling through the spinal gates can be affected by other forms of physical stimulation. Giving your nervous system a competing source of input can fool the nervous system and alter your perception of pain.

There are many ways to accomplish this. You may have noticed that rubbing or massaging a painful area may have relieved your pain in the past. Applying electrical stimulation (e.g. TENS), applying heat or cold, acupuncture, or nerve blocks may also provide a competing source of input. It is also important to realize that certain mental activities or thoughts taking place in the brain can help to close the spinal gates.

Another way we can work to close the gates of pain is to affect the release of several chemicals that help pain signals travel to the brain. Neurotransmitters are biochemical messengers that carry pain signals from one nerve cell to the next. The three main neurotransmitters that send pain signals to the brain are substance P, NMDA (n-methyl-d-aspartate), and glutamate. Excess amounts of these chemicals, especially substance P, make it easier for pain signals to reach the brain.

Therefore, another way of stopping pain involves manipulating pain provoking neurotransmitters. This can be accomplished by prescription or over the counter medications, acupuncture, injections, hypnosis, or biofeedback.:

The role of the Endorphins:

The endorphins are another class of chemicals which are produced in the brain and serve an important role in the pain experience. These chemical are naturally occurring pain relieving substances, similar to morphine or other opiates, produced in the body. Endorphins work on special receptor sites in the brain. They act as keys which unlock receptors thus generating nerve impulses to shut down pain. Morphine and other opiates have similar chemical structures which turn off pain.
Several situations or conditions raise endorphin levels in the brain thus reducing pain. They include thinking with a positive attitude, happiness, and regular exercise.

The Role of Stress:

It is natural to connect a physical stress to the body, such a broken arm, to the perception of pain. The role of psychological stress may not seem as obvious. The brain structures involved in stress can affect the production of key hormones in the body, suppress the body’s immune system, and activate the autonomic nervous. These are the same biological changes that may occur from physical stresses on the body-the body may not differentiate between physical and psychological stress. The net effects of these changes on the body are to lower our internal resistance to pain, thus further encouraging the chronic pain cycle.

Many sources of stress feed into the chronic pain cycle. First off, as you would expect, pain itself is stressful. Pain sensations are perceived as undesirable and are at very least annoying. Pain creates tension, both physical and emotional. Physical tension may show itself as muscle tension or affect the cardiovascular, gastrointestinal, or immune systems. Emotional tension may reveal itself as anger, frustration, worry, depression, or frustration. Both physical and emotional tension, initially set in motion by pain, worsen pain. Thus the vicious cycle of pain is begins-pain leads to tension and tension leads to more pain.

A second source of stress comes from all the negative consequences that occur as a result of a chronic pain condition. Chronic pain may create difficulties with family relationships, social or recreation activities, self-esteem, and employment.

Yet another source of stress arises from the hardships that can be encountered from the stresses of everyday living. Everything from difficulties putting on your shoes in the morning to difficulties standing long enough to go grocery shopping are added on top of pain-related stressors. In the end, an individual not only suffers from chronic pain, but from chronic stress.

The consequences of chronic stress:

Whatever the type of stress, either physical or psychological, the outcome on pain is to worsen it. Chronic stress also may result in other physical ailments such as tension headaches, muscle spasms, gastrointestinal problems, and elevated blood pressure. It can also lead to fatigue, depression, and a sense of hopelessness.

The key is how to prevent chronic pain:

Chronic pain can’t always be prevented But rememeber if you have pain go to a MD to help you get to your optimal level of function and hopes you get to PAIN FREE.

1-  ONE is staying in good physical and mental health may be the best way to prevent it or help you cope with it.
2-  Treat your health problems early.
3- Get enough sleep every night. Learn to alternate activity with rest throughout each day.
4- Exercise.
5- Eat a balanced diet.

Try to reduce stress in your life.

QUOTE FOR FRIDAY:

“Prostate cancer is cancer that occurs in the prostate. The prostate is a small walnut-shaped gland in males that produces the seminal fluid that nourishes and transports sperm.

Prostate cancer is one of the most common types of cancer. Many prostate cancers grow slowly and are confined to the prostate gland, where they may not cause serious harm. However, while some types of prostate cancer grow slowly and may need minimal or even no treatment, other types are aggressive and can spread quickly.

Prostate cancer that’s detected early — when it’s still confined to the prostate gland — has the best chance for successful treatment.”

MAYO CLINIC (https://www.mayoclinic.org/diseases-conditions/prostate-cancer/symptoms-causes/syc-20353087)

Benign Prostate Hypertrophy (BPH) & Prostate Cancer

Normal Prostate vs. Benign Prostatic Hyperplasia

BPH

Prostate cancer is the second most common cancer among men, first is skin cancer.

African-American men are at the greatest risk to develop prostate cancer. 

The American Cancer Society recommends men with an average risk of prostate cancer should begin the discussion about screening at age 50, while men with higher risk of prostate cancer should begin earlier.

Sexual health is a major overall health marker for men — 1 in 4 men will experience some form of sexual health concern by age 65.

Erectile dysfunction and lower testosterone are linked to larger health risks, including heart disease, high blood pressure-HBP, diabetes and obesity. Remember African Americans are high for blood pressure. Perhaps higher rates of obesity and diabetes place African Americans at greater risk for high blood pressure and heart disease. Researchers have also found that there may be a gene that makes African-Americans much more salt sensitive. This trait increases the risk of developing HBP. In people who have this gene, as little as one extra gram (half a teaspoon) of salt could raise blood pressure as much as five millimeters of mercury (mm Hg). Don’t forget bad diet, overweight to obese and sedentary life style play vital factors for getting HBP so on average it’s not just a gene factor but heredity does key in especially if you have disease (DM, Obese, Cardiac disease with HBP in the nuclear family especially).

BPH is monitored but there is no active treatment. Diet and medicine can control symptoms. You will have a yearly exam. Your health care provider will look for worse or new symptoms before beginning active treatment.

Why go to your health care provider? He will do a yearly exam looking for worse or new symptoms before beginning active treatment. Who should do this? Good candidates which are men with mild signs and symptoms of BPH, There are no side effects in having your doctor check you out. Just remember avoidance to the M.D. may make the situation to be harder to reduce your symptoms later on for not going to the M.D. yearly.

The cause of benign prostatic hyperplasia: (BPH)

The cause of BPH is not well understood; however, it occurs mainly in older men. Benign prostatic hyperplasia does not develop in men whose testicles were removed before puberty. For this reason, some researchers believe factors related to aging and the testicles may cause benign prostatic hyperplasia.

Throughout their lives, men produce testosterone, a male hormone, and small amounts of estrogen, a female hormone. As men age the amount of active testosterone in their blood decreases, which leaves a higher proportion of estrogen. Scientific studies have suggested that benign prostatic hyperplasia may occur because the higher proportion of estrogen within the prostate increases the activity of substances that promote prostate cell growth.

Another theory focuses on dihydrotestosterone (DHT), a male hormone that plays a role in prostate development and growth. Some research has indicated that even with a drop in blood testosterone levels, older men continue to produce and accumulate high levels of DHT in the prostate. This accumulation of DHT may encourage prostate cells to continue to grow. Scientists have noted that men who do not produce DHT do not develop benign prostatic hyperplasia.

Risk factors include aging and a family history of BPH. Other risk factors are obesity, lack of physical activity, and erectile dysfunction (ED).

Can BPH be prevented?

There is no sure way to prevent BPH. Because excess body fat may affect hormone levels and cell growth, diet may play a role. Losing weight and eating a healthy diet, with fruits and vegetables, may help prevent BPH. Staying active also helps weight and hormone levels.

With BPH, the prostate gets larger. When it is enlarged, it can irritate or block the bladder. A common symptom of BPH is the need to urinate often. This can be every one to two hours, especially at night.

Other symptoms include:

  • Feeling that the bladder is full, even right after urinating
  • Feeling that urinating “can’t wait”
  • Weak urine flow
  • Dribbling of urine
  • The need to stop and start urinating several times
  • Trouble starting to urinate
  • The need to push or strain to urinate

In severe cases, you might not be able to urinate at all. This is an emergency. It must be treated right away. It is foolish for someone to not get checked or treated since the condition like any other disease left untreated will only worsen and in time possibly kill you (Ex. CHF OR Diabetes OR even Obesity).

How Can BPH Affect Your Life?

In most men, BPH gets worse as you age. It can lead to bladder damage and infection. It can cause blood in the urine. It can even cause kidney damage. Men with BPH should get treated. Mild cases of BPH may need no treatment at all. In some cases, minimally invasive procedures that do not require anesthesia are good choices. And sometimes a combination of medical treatments works best.

Transurethral resection of the prostate (TURP) is a type of prostate surgery done to relieve moderate to severe urinary symptoms caused by an enlarged prostate, a condition known as benign prostatic hyperplasia (BPH).

During TURP, a combined visual and surgical instrument (resectoscope) is inserted through the tip of your penis and into the tube that carries urine from your bladder (urethra). The urethra is surrounded by the prostate. Using the resectoscope, your doctor trims away excess prostate tissue that’s blocking urine flow and increases the size of the channel that allows you to empty your bladder.

TURP is one of the most effective options for treating urinary symptoms caused by BPH.

Other forms of surgeries (minimally invasive) are:

There are several types of minimally invasive procedures to choose from, they include:

  • Prostatic Stent                                                                
  • High Intensity Focused Ultrasound (HIFU)
  • Holmium Laser Enucleation of Prostate (HoLEP)
  • Interstitial Laser Coagulation (ILC)
  • Transurethral Electroevaporation of The Prostate TUVP
  • Transurethral Microwave Thermotherapy (TUMT)
  • Transurethral Needle Ablation (TUNA)
  • Photoselective Vaporization (PVP)
  • UroLift
  • Catheterization
  • How do you know which is best for you GO to the M.D. (Urologist), whose the expert in making that decision. Guess what guys? Many less invasive procedures can be done right in the doctor’s office. So go find out if you’re having symptoms of BPH! 
  • How do you know which is best for you GO to the M.D. (Urologist), whose the expert in making that decision. Guess what guys? Many less invasive procedures can be done right in the doctor’s office. So go find out if you’re having symptoms of BPH!

QUOTE FOR THURSDAY:

“Treatment for ovarian cancer usually involves a combination of surgery and chemotherapy.

  • Surgery: An operation in which doctors cut out the cancer.
  • Chemotherapy: Use of special medicines to shrink or kill the cancer. The drugs can be pills you take or medicines given in your veins, or sometimes both.
  • Targeted therapy: Use of drugs to block the growth and spread of cancer cells. The drugs can be pills you take or medicines given in your veins. You will get tests to see if targeted therapy is right for your cancer type before this treatment is used.

Visit the National Cancer Institute for more information about ovarian cancer treatment.”

Center for Disease Control and Prevention – CDC (https://www.cdc.gov/ovarian-cancer/treatment/?cid=google:paid_search_co:ik_24:q1_24_rsa_refresh:ovarian&gad_source=1&gclid=EAIaIQobChMIj63WtM3HiAMVAU9HAR3BciZCEAAYASAAEgKu-_D_BwE)

Part II Ovarian Cancer in treatments.

 

1-Local Treatments/Therapies:

Some treatments are local, meaning they treat the tumor without affecting the rest of the body.

Types of local therapy used for ovarian cancer include that include:

A-Surgery

That is the main treatment most ovarian cancers. How much surgery you have depends on how far your cancer has spread and on your general health.  For women of childbearing age who have certain kinds of tumors and whose cancer is in the earliest stage, it may be possible to treat the disease without removing both ovaries and the uterus.

B-Radiation

Radiation is another form of therapy that might be used.  Radiation therapy uses high energy x-rays or particles to kill cancer cells. These x-rays may be given in a procedure that is much like having a regular x-ray. Aggressive chemotherapy is usually more effective, so radiation therapy is rarely used in this country as the main treatment for ovarian cancer. However, it can be useful in treating areas where the cancer has spread, either near the main tumor or in a distant organ, like the brain or spinal cord.  External beam radiation – This is the most common type of radiation therapy for women with ovarian cancer. External radiation therapy is much like getting an x-ray, but the radiation is stronger.

2-Systemic Treatment/Therapies:

This includes Chemo therapy, Hormone Therapy and Targeted Therapy.

A. Chemo Therapy:

Chemotherapy (chemo) is the use of drugs to treat cancer. Most often, chemo is a systemic treatment, meaning the drugs enter the bloodstream and reach almost all areas of the body. Chemo can be useful to kill very small amounts of cancer cells that may still be around after surgery, for cancers that have metastasized (spread), or to shrink very large tumors to make surgery easier. Most of the time, chemo uses drugs that are injected into a vein (IV) or given by mouth. In some cases, chemotherapy may also be injected through a catheter (thin tube) directly into the abdominal cavity. This is called intraperitoneal (IP) chemotherapy.

Chemo for ovarian cancer usually involves getting two different types of drugs together. Getting a combination of drugs instead of just one drug alone seems to work better as a first treatment for ovarian cancer. Usually, the combination includes a type of chemo drug called a platinum compound (usually cisplatin or carboplatin), and another type of chemo drug called a taxane, such as paclitaxel (Taxol®) or docetaxel (Taxotere®). These drugs are usually given as an IV (put into a vein) every 3 to 4 weeks.

The typical course of chemo for epithelial ovarian cancer involves 3 to 6 cycles of treatment, depending on the stage and type of ovarian cancer. A cycle is a schedule of regular doses of a drug, followed by a rest period. Different drugs have varying cycles; your doctor will let you know what schedule is planned for your chemo.

Epithelial ovarian cancer often shrinks or even seems to go away with chemo, but the cancer cells may eventually begin to grow again. If the first chemo seemed to work well and the cancer stayed away for at least 6 to 12 months, it can be treated with the same chemotherapy used the first time. In some cases, different drugs may be used.

There are numerous other chemo drugs used that might be helpful in treating ovarian cancer.

B-Hormone Treatment/Therapies

It’s another treatment that may be used with the use of hormones or hormone-blocking drugs to fight cancer. This type of systemic therapy is rarely used to treat epithelial ovarian cancer, but is more often used to treat ovarian stromal tumors. 

Meds used in Hormone therapy is:

-Luteinizing Hormone Release Hormone Agonists

LHRH agonists (sometimes called GnRH agonists) can be used in systemic treatment also that will switch off estrogen production by the ovaries. These drugs are used to lower estrogen levels in women who are premenopausal. Examples of LHRH agonists include goserelin (Zoladex®) and leuprolide (Lupron®). These drugs are injected every 1 to 3 months. Side effects can include any of the symptoms of menopause, such as hot flashes and vaginal dryness. If they are taken for a long time (years), these drugs can weaken bones (sometimes leading to osteoporosis).

-Tamoxifen

Tamoxifen is a drug that is often used to treat breast cancer. It can also be used to treat ovarian stromal tumors and is rarely used to treat advanced epithelial ovarian cancer. Tamoxifen acts as an anti-estrogen in many tissues in the body, but as a weak estrogen in others. The goal of tamoxifen therapy is to keep any estrogens circulating in the woman’s body from stimulating cancer cell growth. The anti-estrogen activity of this drug can lead to side effects like hot flashes and vaginal dryness. Because tamoxifen acts like a weak estrogen in some areas of the body, it does not cause bone loss but can increase the risk of serious blood clots in the legs.

-Aromatase inhibitors

Aromatase inhibitors are drugs that block an enzyme (called aromatase) that turns other hormones into estrogen in post-menopausal women. They don’t stop the ovaries from making estrogen, so they are only helpful in lowering estrogen levels in women after menopause. These drugs are mainly used to treat breast cancer, but can also be used to treat some ovarian stromal tumors that have come back after treatment as well as low grade serous carcinomas. They include letrozole (Femara®), anastrozole (Arimidex®), and exemestane (Aromasin®). These drugs are taken as pills once a day.

Common side effects of aromatase inhibitors include hot flashes, joint and muscle pain, and bone thinning. The bone thinning can lead to osteoporosis and bones that break easily.

C-Targeted Drug Therapy:

Targeted therapy is a type of cancer treatment that uses drugs to identify and attack cancer cells while doing little damage to normal cells. These therapies attack the cancer cells’ inner workings − the programming that makes them different from normal, healthy cells. Each type of targeted therapy works differently, but they all change the way a cancer cell grows, divides, repairs itself, or interacts with other cells.

-Bevacizumab

Bevacizumab (Avastin) belongs to a class of drugs called angiogenesis inhibitors. For cancers to grow and spread, they need to make new blood vessels to nourish themselves (called angiogenesis). This drug attaches to a protein called VEGF (that signals new blood vessels to form) and slows or stops cancer growth.

Bevacizumab has been shown to shrink or slow the growth of advanced epithelial ovarian cancers. Bevacizumab appears to work even better when given along with chemotherapy having shown good results in terms of shrinking (or stopping the growth of) tumors. But it doesn’t seem to help women live longer.

Bevacizumab can also be given with olaparib (see below) as maintenance treatment in women whose cancers have the BRCA mutation or genomic instability (see below) and have shrunk quite a bit with chemotherapy containing carboplatin or cisplatin.

This drug is given as an infusion into the vein (IV) every 2 to 3 weeks.

Side effects of bevacizumab

Common side effects include high blood pressure, tiredness, bleeding, low white blood cell counts, headaches, mouth sores, loss of appetite, and diarrhea. Rare but possibly serious side effects include blood clots, severe bleeding, slow wound healing, holes forming in the colon (called perforations), and the formation of abnormal connections between the bowel and the skin or bladder (fistulas). If a perforation or fistula occurs it can lead to severe infection and may require surgery to correct.

PARP inhibitors

Olaparib (Lynparza), rucaparib (Rubraca), and niraparib (Zejula) are drugs known as a PARP (poly(ADP)-ribose polymerase) inhibitors. PARP enzymes are normally involved in one pathway to help repair damaged DNA inside cells. The BRCA genes (BRCA1 and BRCA2) are also normally involved in a different pathway of DNA repair, and mutations in those genes can block that pathway. By blocking the PARP pathway, these drugs make it very hard for tumor cells with an abnormal BRCA gene to repair damaged DNA, which often leads to the death of these cells.

If you are not known to have a BRCA mutation, your doctor might test your blood or saliva and your tumor to be sure you have one before starting treatment with one of these drugs.

All of these drugs are taken daily by mouth, as pills or capsules.

Olaparib (Lynparza) is used to treat advanced ovarian cancer, typically after chemotherapy has been tried. This drug can be used in patients with or without mutations in one of the BRCA genes.

In women with a BRCA mutation:

  • Olaparib can be used as maintenance treatment for advanced ovarian cancer that has gotten smaller in response to first treatment with chemotherapy containing cisplatin or carboplatin.
  • Olaparib can be used with bevacizumab (see above) as maintenance treatment in women whose cancers have shrunk quite a bit with chemotherapy containing carboplatin or cisplatin.

In women without a BRCA mutation:

  • If the tumor has a high genomic instability score (a test measuring the amount of abnormal genes in cancer cells), olaparib can be used with bevacizumab as maintenance treatment in women whose cancers have shrunk quite a bit with chemotherapy containing carboplatin or cisplatin.

In women with or without a BRCA mutation:

  • Olaparib can be used as maintenance treatment for advanced ovarian cancer that has come back after treatment, and then has shrunk in response to chemotherapy containing cisplatin or carboplatin.

Niraparib (Zejula) may be used in some situations to treat ovarian cancer.

In women with or without a BRCA gene mutation:

  • Niraparib might be used as maintenance treatment for advanced ovarian cancer, where the cancer has shrunk with firsrt-line chemotherapy containing cisplatin or carboplatin.
  • Niraparib might be used as maintenance treatment for advanced ovarian cancer that has come back after treatment, where the cancer has then shrunk with chemotherapy containing cisplatin or carboplatin.

Rucaparib (Rubraca) can be used in women with or without a BRCA mutation, as maintenance treatment for advanced ovarian cancer that has come back after treatment, and then has shrunk in response to chemotherapy containing cisplatin or carboplatin.

These drugs have been shown to help shrink or slow the growth of some advanced ovarian cancers for a time. So far, though, it’s not clear if they can help women live longer.

Side effects of PARP inhibitors

Side effects of these drugs can include nausea, vomiting, diarrhea, fatigue, loss of appetite, taste changes, low red blood cell counts (anemia), belly pain, and muscle and joint pain. Rarely, some patients treated with these drugs have developed a blood cancer, such as myelodysplastic syndrome or acute myeloid leukemia.

Drugs that target cells with NTRK gene changes

A very small number of ovarian cancers have changes in one of the NTRK genes. Cells with these gene changes can lead to abnormal cell growth and cancer. Larotrectinib (Vitrakvi) and entrectinib (Rozlytrek) are targeted drugs that stop the proteins made by the abnormal NTRK genes. These drugs can be used in people with advanced ovarian cancer whose tumor has an NTRK gene change and is still growing despite other treatments.

These drugs are taken as pills, once or twice a day.

Side effects of drugs that target NTRK gene changes

Common side effects include dizziness, fatigue, nausea, vomiting, constipation, weight gain, and diarrhea.

Less common but serious side effects can include abnormal liver tests, heart problems, and confusion.

Typically, any treatment plans for a patient with ovarian cancer are based on the type of ovarian cancer, its stage, and any special situations. Most women with ovarian cancer will have some type of surgery to remove the tumor. Depending on the type of ovarian cancer and how advanced it is, you might need other types of treatment as well, either before or after surgery, or sometimes both.

Those who to expect in treating ovarian cancer?

Based on your treatment options, you might have different types of doctors on your treatment team. These doctors could include:

  • A gynecologic oncologist: a gynecology doctor who is specially trained to use surgery to treat ovarian cancer; many times they are also the ones to give chemotherapy and other medicines to treat ovarian cancer
  • A radiation oncologist: a doctor who uses radiation to treat cancer
  • A medical oncologist: a doctor who uses chemotherapy and other medicines to treat cancer

Many other specialists might be part of your treatment team as well, including physician assistants, nurse practitioners, nurses, psychologists, sex counselors, social workers, nutritionists, genetic counselors, and other health professionals.

Your treatment plan will depend on many factors, including your overall health, personal preferences, and whether you plan to have children. Age alone isn’t a determining factor since several studies have shown that older women tolerate ovarian cancer treatments well.

It’s important to discuss all of your treatment options, including their goals and possible side effects, with your doctors to help make the decision that best fits your needs. It’s also very important to ask questions if there’s anything you’re not sure about.

If time permits, it is often a good idea to seek a second opinion. A second opinion can give you more information and help you feel more confident about the treatment plan you choose.