Ovarian cancer: What is maintenance treatment?

Ovarian cancer is a type of cancer that begins in the epithelial cells of the ovaries. The disease is often not detected until it has spread to the pelvis and abdomen. At this late stage, patients are often more difficult to treat. Currently, surgery and chemotherapy are commonly used to treat ovarian cancer. In addition, patients as well as caregivers need to be counseled on maintenance and targeted cancer treatments to improve effectiveness.

The ovaries are an important organ in a woman's reproductive system. Each woman has two ovaries on either side of the uterus, responsible for producing sex hormones and ovulating regularly during menstrual cycles. Egg cells are carried from the ovary to the uterus by a hollow organ called a fallopian tube.
Ovarian cancer is a common malignancy in the United States, with about 23,000 people diagnosed each year. Ovarian cancer is a type of cancer that begins in the epithelial cells of the ovaries. Some ovarian tumors are benign (not cancerous). Malignant (cancerous) ovarian tumors can originate from surface epithelium (cells that cover or line the ovary), germ cells (cells destined to form eggs), or tissue cells. stroma (cells that secrete hormones and connect various structures of the ovary). Most ovarian cancers develop from cells in the lining of the ovaries. These are collectively known as epithelial ovarian cancers. They are the cells that make up the outer layer of tissue around the ovary. Sometimes cancer cells can break away from where they started and spread to other parts of the body, called metastatic ovarian cancer.

Surgery is often the first line of treatment for patients with ovarian cancer. The two main goals of surgery are to remove all or as much of the cancer cells as possible and to see if the cancer has spread. Many women also receive chemotherapy as a treatment before or after surgery. Chemotherapy stops cancer cells from appearing and growing, preventing them from increasing in number.
Other treatments that may be used for ovarian cancer patients include targeted therapy, immunotherapy, hormone therapy, or participation in a clinical trial.

Complete remission means that there are no signs of cancer left after treatment. Partial remission means that the cancer has improved (died in number or size), but has not completely disappeared.
If one treatment doesn't work and the cancer continues to grow or spread, other drugs may work. The second treatment is called the second-line treatment and the third treatment is called the third-line treatment. The treatment your doctor recommends will depend on your overall health, other conditions you may have, previous treatments, any side effects from treatment, as well as the wishes and aspirations of the patient.

Maintenance treatment is designed to continue the good results of a previous treatment plan. After chemotherapy, maintenance treatment is done to try to prevent ovarian cancer from coming back. The goal of maintenance treatment is to keep ovarian cancer under control for as long as possible after the first treatment and to prevent or delay the cancer coming back. Maintenance treatment can even turn temporary remission into permanent remission.

There are 3 drugs that can be used for maintenance treatment:
Certain chemotherapy Angioplasty inhibitors, such as bevacizumab. This is a targeted therapy that stops new blood vessels from forming around the cancer cells. This prevents cancer cells from getting the blood they need to grow and survive a PARP inhibitor, such as niraparib, olaparib, or rucaparib. This is a targeted therapy that inhibits a protein in cells called PARP. PARP is used by cells to repair damage to their DNA. If a cancer cell can't repair damaged DNA, they die.

Many factors help determine the maintenance treatment that may be right for each patient. In addition to previous treatment and general health, test results, preferences and preferences, genetic factors may play a role.
Genes inside cells carry information that determines traits inherited from your parents. Genes with abnormal changes are called mutations. Your doctor will do testing, genetic evaluation, and genetic testing to look for certain mutations before recommending treatment.

One of the gene mutations your doctor will look for is in the BRCA1 or BRCA2 gene. These genes help stop tumor growth by immobilizing damaged cells and helping cells to grow normally. But mutations in these genes can prevent them from repairing damaged cells.
If you have a BRCA1 or BRCA2 gene mutation, your doctor may recommend certain maintenance treatment, such as certain PARP inhibitors. When cancer cells have mutations in the BRCA gene and are unable to repair their DNA, they must rely on PARP to do so. And because PARP inhibitors prevent PARP from doing this job, the DNA is not repaired and those cancer cells die. It is important to know that there are many factors doctors will consider when considering maintenance treatment.

If the cancer continues to grow or spread during maintenance treatment, this is called persistent ovarian cancer. Treatment for persistent ovarian cancer may include starting treatment for recurrence, participating in a clinical trial, or receiving supportive care to reduce cancer symptoms or side effects of treatment aimed at improving patient quality of life. Your doctor will discuss treatment options, including your personal preferences and wishes, if your cancer is persistent.

Questions you can ask your doctor about ovarian cancer and possible treatment include:
Will I get maintenance treatment? What is the goal of treatment? What medications are there, and what are their side effects? What is the best way to manage the symptoms and side effects of treatment? How will I know if the treatment is working? Are there any clinical trials that are right for me? How can I ensure that I have the best quality of life possible? Should I make any lifestyle changes? What should I do if I feel stressed or depressed? Although medicine has now made new developments in the treatment of ovarian cancer, it is quite difficult to be able to cure it and not affect the patient's health. That is why doctors always encourage women to perform periodic screening to detect gynecological cancer early, thereby taking timely intervention.
In the examination and early detection of gynecological diseases, currently Vinmec International Hospital has used tests such as cytology test by Liqui Prep method, HPV genotype PCR test automated system. , transvaginal ultrasound of the uterus and ovaries to give the most accurate results.
Along with modern facilities, the hospital also has a team of doctors and experts who have many years of experience and are well-trained in domestic and foreign environments who will directly participate in the treatment. examination and treatment process to bring the best results for the patient.

Reference source: education