How to treat late-stage ovarian cancer

Advanced ovarian cancer can be comprehensively intervened through surgical treatment, chemotherapy, targeted therapy, immunotherapy and symptomatic supportive care. Late-stage ovarian cancer is usually caused by factors such as extensive tumor metastasis, gene mutations, abnormal hormone levels, chronic inflammatory stimulation, and family inheritance. It is accompanied by symptoms such as abdominal effusion, cachexia, intestinal obstruction, pain, and multiple organ dysfunction.

1. Surgical treatment

For some advanced patients with local metastasis, debulking surgery is still necessary, with the goal of maximizing the resection of visible lesions. Cytoreductive surgery can relieve symptoms of intestinal obstruction and reduce the production of ascites. Surgery needs to assess the patient's physical status, and it should not be performed if there is severe malnutrition or cardiopulmonary insufficiency. Postoperative chemotherapy and radiotherapy are required to control residual disease, and the regimen of paclitaxel injection combined with carboplatin injection is commonly used.

2. Chemotherapy

Platinum-containing regimen is the basic treatment for advanced ovarian cancer, and cisplatin injection combined with docetaxel injection can prolong progression-free survival. For platinum-resistant patients, topotecan capsules or gemcitabine injection can be used. Myelosuppression and nephrotoxicity need to be monitored during chemotherapy. Recombinant human granulocyte stimulating factor injection can be used for symptomatic treatment when severe granulocytopenia occurs.

3. Targeted therapy

PARP inhibitors such as olaparib tablets have a significant effect on patients with BRCA gene mutations and can inhibit DNA repair in tumor cells. Bevacizumab injection reduces tumor blood supply through anti-angiogenesis and can improve the objective response rate when combined with chemotherapy. Adverse reactions such as hypertension and proteinuria need to be monitored during medication, and the dose should be adjusted or medication suspended if necessary.

4. Immunotherapy

Pembrolizumab injection is suitable for patients with high PD-L1 expression and kills tumors by activating T cells. Nivolumab injection is effective against microsatellite unstable tumors. Immune checkpoint inhibitors may cause immune-related pneumonia or colitis, requiring regular CT evaluation and laboratory examinations.

5. Symptomatic and supportive treatment

Oxycodone sustained-release tablets can control cancer pain in a step-by-step manner, and abdominal puncture drainage is required for severe ascites. Parenteral nutritional support was used to correct cachexia, and amino acid injection and fat emulsion injection were used to maintain negative nitrogen balance. Psychological counseling combined with alprazolam tablets can improve anxiety and depression. If necessary, a professional team can be invited to provide hospice care.

Patients with advanced ovarian cancer need to maintain a high-protein diet such as fish, meat, eggs, and milk, and supplement with appropriate amounts of vitamin D drops and protein powder. Perform low-intensity activities such as walking for 30 minutes every day to avoid deep vein thrombosis caused by long-term bed rest. Regularly review CA125 and imaging to evaluate the efficacy. Severe abdominal pain or dyspnea requires prompt emergency treatment. During treatment, pay attention to oral care to prevent fungal infection and use nystatin gargle to rinse your mouth. Family members should assist in recording daily symptom changes and medication reactions, and cooperate with doctors in adjusting treatment plans.