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OVARIAN CANCER TREATMENT IN TURKEY

1. What is ovarian cancer?

Ovarian cancer is a disease in which malignant (cancerous) cells form in the tissues of the ovary.

The ovaries are a pair of organs in the female reproductive system. They are located in the pelvis, one on each side of the uterus (the hollow, pear-shaped organ in which the fetus grows). Each ovary resembles an adult woman's almond in size and shape. The ovaries produce eggs and female hormones (chemicals that control the function of certain cells or organs).

2. Risk factors for ovarian cancer  

  • Family history of ovarian cancer in a first-degree relative (mother, daughter, or sister).

  • Inherited changes in the BRCA1 or BRCA2 genes.

  • Other inherited conditions, such as hereditary non-polyposis colorectal cancer (HNPCC; also called Lynch syndrome).

  • Endometriosis

  • Postmenopausal hormone therapy.

  • Obesity.

  • High height.

 

Old age is a major risk factor for most cancers. The likelihood of developing cancer increases with age.

3. Types of ovarian malignant tumors.

To types  malignant  ovarian tumors include the following:

  • Germ cell tumors: tumors that develop in the eggs of women. These are the most common ovarian tumors in girls.  

  • Epithelial tumors: tumors that develop in the tissue that covers the ovary. It is the second most common ovarian tumor in girls. Epithelial ovarian cancer in children is usually found early and is easier to treat than in adult patients.

  • Stromal tumors: Tumors that start in the stromal cells that make up the tissues that surround and support the ovaries. Minor cell granulosa tumors and Sertoli-Leydig tumor are two types of stromal tumors.

  • Small cell ovarian carcinoma: Cancer that begins in the ovary and can spread to the abdomen, pelvis, or other parts of the body. This type of ovarian cancer is growing rapidly and has a poor prognosis.

 

This summary focuses on non-germinal ovarian tumors (epithelial tumors, stromal tumors, and small cell ovarian carcinoma).

4. Risk factors for ovarian cancer

Anything that increases the likelihood of getting sick is called a risk factor. Having a risk factor does not mean that you will get cancer; the absence of risk factors does not mean that you will not get cancer.

The risk of ovarian cancer is increased if you have one of the following conditions:

  • Ollie's disease (a disease that causes abnormal growth of cartilage at the end of long bones).

  • Maffucci syndrome (a condition that causes abnormal growth of cartilage at the ends of the long bones and blood vessels of the skin).

  • Peitz-Jeghers Syndrome (a condition that causes polyps in the intestines and dark spots on the lips and fingers).

  • Familial pleuropulmonary blastoma syndrome (a disorder that can cause cystic nephroma, lung cysts, thyroid problems, and cancers of the lungs, kidneys, ovaries, and soft tissue).

  • DICER1 syndrome (a disease that can cause goiter, polyps in the colon, and tumors of the ovaries, cervix, testis, kidneys, brain, eyes, and lung lining).

 

5. Signs and symptoms of ovarian cancer

Abdominal pain, swelling, or lump, and other signs and symptoms can be caused by ovarian cancer or other medical conditions.

Check with your child's doctor if your child has any of the following:

  • Pain or bloating.

  • Lump in the abdomen.

  • Constipation

  • Painful or missed periods.

  • Unusual vaginal bleeding.

  • Male sex characteristics such as body hair or a deep voice.

  • Early signs of puberty.

 

6. Tests for the diagnosis of ovarian cancer.

The following tests and procedures can be used:

  • Physical examination and health history: Examining the body to check for general signs of health, including checking for signs of illness, such as bumps or anything else that seems out of the ordinary. A history of the patient's health habits, as well as past illnesses and treatments will also be recorded.

  • Computed tomography (computed tomography) : A procedure in which a series of detailed pictures of areas inside the body, such as the pelvis or abdomen, are taken from different angles. The pictures were taken by a computer connected to an X-ray machine. This procedure is also called computed tomography, computed tomography, or computed axial tomography.

  • MRI (Magnetic Resonance Imaging) : A procedure that uses a magnet and radio waves to take a series of detailed pictures of areas inside the body, such as the pelvis or abdomen. The pictures were taken by a computer. This procedure is also called nuclear magnetic resonance imaging (MRI).

  • Ultrasound examination : A procedure in which high-energy sound waves (ultrasound) are reflected from internal tissues or organs in the abdomen or pelvis and create an echo. The echo forms a picture of body tissue called a sonogram. The picture can be printed to view later.

  • Biopsy : Tissue removed during surgery is examined under a microscope by a pathologist to check for signs of cancer.

  • Serum tumor marker test : A procedure in which a blood sample is examined to measure the amount of certain substances that enter the bloodstream of organs, tissues, or tumor cells in the body. Certain substances are associated with certain types of cancer when found in high concentrations in the blood. These are the so-called tumor markers. Tumor markers alpha-fetoprotein, beta-human chorionic gonadotropin (β-hCG), CEA, CA-125 and others are used to diagnose ovarian cancer.

  • During surgery to remove the tumor, the fluid in the abdomen is checked for signs of cancer.

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Рак яичников

7. Stages of ovarian cancer in childhood

Most ovarian tumors in children are benign (not cancer). They most often occur in women between the ages of 15 and 19.

The process used to determine if cancer has spread from the ovary to nearby sites or to other parts of the body is called staging. There is no standardized system for diagnosing ovarian cancer in children. The results of tests and procedures performed to diagnose ovarian cancer are used to make treatment decisions.

Sometimes ovarian cancer in children recurs (comes back) after treatment.

8. Review of treatment options for children and adolescents. Types of treatment

 

There are different treatments for ovarian cancer in children and adolescents.

  • Children and adolescents with ovarian cancer should plan for treatment with a team of doctors who are experts in treating childhood cancer.

  • There are five standard treatments for ovarian cancer.

    • Operation

    • Radiation therapy

    • Chemotherapy

    • High-dose chemotherapy with autologous stem cell rescue

    • Targeted therapy

  • Treatment for ovarian cancer in children can cause side effects.

  • Patients may want to take part in a clinical trial.

  • Patients can participate in clinical trials before, during, or after starting cancer treatment.

  • Additional tests may be required.

Some treatments are standard (currently used) and some are in clinical trials. A treatment clinical trial is a scientific study designed to help improve existing treatments or provide information about new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment can become the standard treatment.

Because cancer is rare in children, clinical trials should be considered. Some clinical trials are only open to patients who have not yet started treatment.

Children and adolescents with ovarian cancer should plan for treatment with a team of doctors who are experts in treating childhood cancer.

The treatment will be supervised by a pediatric oncologist, a doctor specializing in the treatment of oncological children. The pediatric oncologist works with other pediatricians who are experts in treating children with cancer and specialize in specific areas of medicine. This may include the following professionals and others:

  • Pediatrician.

  • Children's surgeon.

  • Gynecologist.

  • Specialist Pediatric Nurse.

  • Rehabilitation specialist.

  • Social worker .

  • Psychologist .

 

9. Methods of treatment for ovarian cancer.

1. Operation

The surgery is used to remove ovarian cancer. Surgery can also be used to remove ovarian and ovarian cancers or ovarian and fallopian tube cancers.  

Different types of surgery can include:

  • Hysterectomy: Surgery to remove the uterus and sometimes the cervix. When only the uterus is removed, it is called a partial hysterectomy. When both the uterus and cervix are removed, it is called a total hysterectomy. If the uterus and cervix are passed out through the vagina, the operation is called vaginal hysterectomy. If the uterus and cervix are removed through a large incision (incision) in the abdomen, the operation is called total abdominal hysterectomy. If the uterus and cervix are removed through a small incision (incision) in the abdomen using a laparoscope, the operation is called total laparoscopic hysterectomy.

  • Unilateral salpingo-oophorectomy: A surgical procedure to remove one ovary and one fallopian tube.

  • Bilateral salpingo-oophorectomy: A surgical procedure to remove both ovaries and both fallopian tubes.

  • Omentectomy: A surgical procedure to remove an omentum (tissue in the peritoneum that contains blood vessels, nerves, lymphatic vessels, and lymph nodes).

  • Lymph node biopsy: Removal of all or part of a lymph node. A pathologist examines lymph node tissue under a microscope to check for cancer cells  

2. Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy X-rays or other types of radiation to kill cancer cells or prevent them from growing. External beam radiation therapy uses a device outside the body to direct radiation to an area of the body affected by cancer.

3. Chemotherapy

Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells by either killing the cells or stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can infect cancer cells throughout the body (systemic chemotherapy).

When chemotherapy is injected directly into the cerebrospinal fluid, organ or body cavity, such​​ like the abdomen, drugs mainly target cancer cells in these areas (regional chemotherapy).

The type of regional chemotherapy used to treat ovarian cancer is intraperitoneal (IP) chemotherapy. In IP chemotherapy, cancer drugs are transferred directly into the abdomen (the space that contains the abdominal organs) through a thin tube.

Hyperthermic intraperitoneal chemotherapy (HIPEC) is a treatment used during surgery and is being studied for ovarian cancer. After the surgeon has removed as much of the tumor tissue as possible, warm chemotherapy is directed directly into the abdominal cavity.

Treatment with more than one anticancer drug is called combination chemotherapy.

How chemotherapy is given depends on the type and stage of cancer treatment.

4. High-dose chemotherapy with salvage of autologous stem cells

High doses of chemotherapy are prescribed to kill cancer cells. Healthy cells, including hematopoietic cells, are also destroyed in cancer treatments. Stem cell rescue is a treatment to replace hematopoietic cells. Stem cells (immature blood cells) are removed from the patient's blood or bone marrow, frozen and stored. After the patient completes chemotherapy, the stored stem cells are thawed and returned to the patient as an infusion. These re-injected stem cells germinate (and regenerate) the body's blood cells.

 

5. Targeted therapy

Targeted therapy is a type of treatment that uses drugs or other substances to identify and destroy cancer cells. Targeted therapy usually does less damage to normal cells than chemotherapy and radiation therapy.

Histone methyltransferase inhibitors: This type of targeted therapy slows the ability of cancer cells to grow and divide. Tasemetostat is used to treat ovarian cancer.

  • Monoclonal antibodies are proteins of the immune system created in the laboratory for the treatment of many diseases, including cancer. As a cancer treatment, these antibodies can attach to a specific target on cancer cells or other cells that can promote cancer cell growth. The antibodies are then able to kill cancer cells, block their growth, or prevent them from spreading. Monoclonal antibodies are given by infusion. They can be used alone or for carrying  drugs, toxins or radioactive materials directly to cancer cells. Monoclonal antibodies can be used in combination with chemotherapy as adjuvant therapy.

  • Bevacizumab is a monoclonal antibody and angiogenesis inhibitor that can be used with chemotherapy to treat ovarian epithelial cancer, fallopian tube cancer, or primary peritoneal cancer that has recurred (come back). It binds to a protein called vascular endothelial growth factor (VEGF) and can prevent the growth of new blood vessels required for tumor growth. Other inhibitors of angiogenesis are being studied in the treatment of advanced or recurrent ovarian cancer.

6. Immunotherapy

Immunotherapy  is the treatment that uses  immune system  patient to fight cancer. Substances produced by the body or produced in the laboratory are used to enhance, direct, or restore the body's natural defenses against cancer. This cancer treatment is a variety  biological therapy  ...

Vaccine therapy  is a cancer treatment that uses a substance or group of substances to stimulate the immune system to find a tumor and kill it. Vaccine therapy is being studied for the treatment of advanced ovarian cancer.

 

10. Side effects of treatment in children.

For information on side effects that occur during cancer treatment.

Side effects from cancer treatments that start after treatment and last for months or years are called late effects. Physical problems such as fertility problems are a late effect of treatment.

Some late effects can be treated or controlled. It is important to talk with your child's doctors about the possible late effects of some treatments.  

Need help?

To organize treatment for ovarian cancer in Turkey, leave a request on the Medikal & Estetik Group website. You will be contacted by a specialized doctor-coordinator who will help you choose the best medical center. Send him your medical records, he will redirect them to the hospital of your choice and request a treatment program.

We will help you organize your trip and stay in touch with you throughout your treatment - from the moment you contact us and even after you return home.

Medikal & Estetik Group is an independent medical service that does not represent the interests of any of the clinics. Patients do not pay for our services - medical centers do it.

Doctors-coordinators will advise you and help you with the choice. Medikal & Estetik Group services are free of charge for you and do not affect the clinic bill.

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COST OF TREATMENT AND DIAGNOSIS OF OVARIAN CANCER IN TURKEY

  • Biopsy for Ovarian Cancer from $ 450

  • CT (computed tomography) for ovarian cancer from $ 50

  • PET-CT for Ovarian cancer from $ 500

  • Hysterectomy with Da Vinci Robot for Ovarian Cancer from $ 21,700

  • Chemotherapy for breast cancer from $ 1200

  • Cyber Knife for Ovarian Cancer from $ 4400

  • Gamma Knife for Ovarian Cancer from $ 6000

  • Hormone therapy for ovarian cancer on request

  • Intraperitoneal chemotherapy HIPEC for ovarian cancer from $ 20,000

  • Radiation therapy for rectal cancer  on request

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