10 Likely Treatment Complications in Advanced Ovarian Cancer

Ovarian cancer affects millions of women across the globe. Ovarian cancer is a term broadly used to describe any cancerous growth that starts in the ovaries. In later stages, this cancer tends to spread from the ovaries to the pelvis region. Ovarian cancer is one of the biggest causes of cancer-related deaths in women. The early stages of ovarian cancer typically cause no symptoms, allowing cancer to fester unchecked. By the time ovarian cancer gets diagnosed, it has already reached an advanced stage and treatment becomes difficult. The usual treatment of ovarian cancer consists of chemotherapy, surgery, hormone therapy, radiation therapy, or even targeted therapy. Usually, more than one treatment is used.

To understand the various complications resulting from treatment options of ovarian cancer, it is important to get an insight into some of the commonly used ovarian cancer treatments. Let us begin with chemotherapy.

Chemotherapy: This process makes use of anti-cancer or cytotoxic drugs to eliminate or destroy cancer cells growing in the body. The medications are circulated throughout the body through the bloodstream. Carboplatin or paclitaxel are two of the most common chemotherapy drugs used for treating ovarian cancer. Chemotherapy is also used as a treatment option if your ovarian cancer has returned. Either the same chemotherapy drugs will be used or your doctor may use multiple chemo drugs to target the regrowth of cancer aggressively.

Surgery for Ovarian Cancer: In certain cases, wherever feasible, doctors will recommend that you undergo surgery to remove as much of cancer as possible from the pelvis area and your abdomen. Surgery is usually suggested so that chemotherapy can give better results. Once surgery removes the majority of cancer, the chemotherapy will provide better results as there will only be a small number of cancer nodules left in the abdomen. If the surgery proves to be too complicated or cancer has spread to a much more advanced level, then doctors might make you undergo chemotherapy first, followed by surgery. This process is known as neoadjuvant chemotherapy.

Radiotherapy: This procedure is generally used for advanced ovarian cancer. Radiotherapy works by shrinking the tumors and reducing the degree of your symptoms. Surgery and radiotherapy may also be used together to give better and faster results. However, there is a maximum level of radiotherapy dosage that can be applied to a particular area of the body.

Biologics: Biologics or biological therapies are drugs that are used for controlling the growth of cancer cells. Avastin is one of the most common biologics used for stopping the growth of tumors and thus the growth of cancer. In advanced ovarian cancer cases, biologics are used in combination with chemotherapy.

Most advanced stage cancers need aggressive treatment and there are often many complications associated with such aggressive treatments. Therefore, if you are undergoing treatments for advanced stage ovarian cancer, it is necessary to understand what complications these treatments might be having and how you can handle them. Keep in mind, though, that every individual is unique and everybody’s bodies respond to treatment differently. Therefore, the level of complications also varies accordingly. The likely treatment complications in advanced ovarian cancer include:

1. Bruising and Bleeding

   Treatments for advanced ovarian cancer may cause damage to your platelets. Platelets are responsible for stopping you from bleeding out. If your body does not have sufficient amount of platelets, you will experience prolonged bleeding and are also likely to bruise more frequently.

2. Hearing Loss

   Chemotherapy drug cisplatin is also known to cause damage to the nerves leading to your ears. This has an effect on your hearing, often causing ototoxicity.

3. Heart-Related Problems

   While undergoing chemotherapy treatment for advanced ovarian cancer, doctors insert a port in the patient’s chest. A port is a tiny disc-shaped opening that will allow doctors to deliver chemotherapy drugs directly into the bloodstream. It is possible for this port to become infected over a period of time or even damaged. This can cause further complications and problems.

4. Hernias

   Development of hernias is a common complication following surgery to remove ovarian cancer. A hernia develops due to a weak point or a hole that develops in the muscular wall, in this case, the surgery facilitates this development. Organs and tissues are hence able to push through this hole or opening. This causes a hernia or a bulge at the exact point of this opening.

5. Infection

   As discussed above, chemotherapy destroys the growing cancer cells in the body. However, a common side effect of chemotherapy treatment is that it often destroys healthy cells of the body as well, unable to distinguish between the cancerous cells and these healthy ones. One of the commonly damaged cells is a type of blood cell that creates white blood cells. White blood cells are responsible for protecting our body against infection by fighting the foreign bacteria or germs. Due to the destruction of these blood cells, the count of white blood cells goes down, leaving us at a higher risk for infection.

6. Kidney Damage

   One of the common chemotherapy drugs, cisplatin (brand name Platinol), is known to cause damage to the kidneys. The damage caused is permanent and to prevent the same, doctors tend to administer intravenous (IV) fluids to the patient before and after chemotherapy treatments.

7. Leukemia

   This is one of the more rare complications of advanced ovarian cancer treatment. This happens when chemotherapy causes damage to the bone marrow, leading to myeloid leukemia in many women.

8. Neuropathy

   The same chemotherapy drug cisplatin that causes kidney damage, as well as other chemotherapy drugs such as paclitaxel ((brand name: Taxol) and docetaxel (brand name: Taxotere), are known to cause neuropathy or damage to the nerves. As the treatment progresses, you will start to experience tingling, numbness, and pain in many parts of the body.

9. Onset of Early Menopause and/or Loss of Fertility

   Women suffering from advanced ovarian cancer might need to have large parts of their reproductive system removed during the treatment, affecting their fertility. It could be that you had either one or both of your ovaries and/or uterus removed. In such cases, it becomes impossible for you to conceive. If you have your ovaries removed, the other side effect is that you will enter menopause earlier than expected, if you have not hit menopause yet.

10. Perforations in the Colon

    Some of the targeted therapies for treating advanced ovarian cancer cause a perforation to form in the colon. These perforations can cause severe infections and require further surgeries and medications to fix.

There are complications and side effects associated with each treatment type. Apart from the major complications discussed above, some of the other complications related to advanced cancer treatment may include:

• Vomiting and nausea
• Hair loss
• Loss of appetite
• Thinning of bones
• Mouth sores
• Peeling and blistering of the skin
• Rashes on extremities

In rare cases, the complications are severe enough and may require other surgeries or procedures to be performed. Some of these procedures/surgeries include:

Catheter: Your doctor might have to remove a section of your bladder if cancer spread to the bladder. In this case, a catheter will be inserted into your bladder through the urethral duct to drain the bladder and to allow the bladder time to recover from the surgery. Once the bladder heals, the catheter is removed.

Colostomy: A small part of your colon may also be needed to be removed if a tumor or cancerous cells need to be surgically removed. Sometimes it is possible to simply connect the colon and sew it back together. However, when this is not possible, then having a colostomy is the only option available. During this procedure, the top of the colon is connected to an abdominal opening, allowing waste to be eliminated from the body through this opening. The colon will eventually be reattached, but it takes time.

Ureteric stent: A ureteric stent is put in place if cancer is blocking one or both of the urethras. This ureteric stent helps the body eliminate liquid waste.

The success of advanced ovarian cancer treatment depends on what stage the cancer gets diagnosed. Earlier detection of cancer allows for a more successful rate of treatment. Complications are a part of any medical procedure and these side effects tend to stop after the treatment stops. However, some of these complications are more permanent and will affect the quality of your life in the future.

Therefore, you need to carefully consider all the potential complications any treatment option holds against the benefits of the treatment, before arriving at any conclusion. Furthermore, everyone’s body reacts to treatments in a different manner, so consult your doctor, attend all the recommended screening, and seek the medical help whenever you notice anything amiss.

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• Ascites in Ovarian Cancer Patients
• What is Infarcted Ovarian Cyst: Causes, Symptoms, Treatment, Pathophysiology, Prognosis
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