What is Ovarian Cancer?

Ovarian cancer is a malignant tumor of the ovary, referring to cancer that originates on the ovary itself. Approximately 90-95% are primary ovarian cancers, while the remaining 5-10% are cancers that have spread (metastasized) to the ovary from other primary sites. Ovarian cancer is difficult to diagnose early because it often lacks symptoms in its initial stages, and when symptoms do occur, they are non-specific. Screening methods are also limited. Consequently, 60-70% of patients are diagnosed at an advanced stage, and treatment outcomes for advanced disease are poor. Although the incidence of ovarian cancer is lower than that of cervical cancer and endometrial cancer, ranking it as the third most common gynecologic malignancy, its mortality rate exceeds the combined mortality of cervical and endometrial cancers, making it the leading cause of death among gynecologic cancers and a serious threat to women's health.

What is the Status of Ovarian Cancer in Indonesia?

Ovarian cancer is the sixth most common cancer among Indonesian women, with approximately 5,800 new cases reported in 2022, accounting for 4.7% of all female cancer cases (Source: GLOBOCAN 2022). Due to its insidious early symptoms (such as bloating and indigestion), over 70% of patients are diagnosed at Stage III-IV. The 5-year survival rate is only 30-35%, significantly lower than that of screenable cancers like breast cancer (85%).

What are the Advantages of Fosun Health Hospitals in Treating Ovarian Cancer?

In recent years, with the advancement of technologies like Image-Guided Radiotherapy (IGRT), Intensity-Modulated Radiotherapy (IMRT), and Stereotactic Body Radiotherapy (SBRT), the precision and safety of radiotherapy have significantly improved. It now plays a commendable role in postoperative adjuvant therapy, controlling local recurrences or metastases, palliative care, and in combination with chemotherapy/targeted therapy.

1. CyberKnife:
The CyberKnife M6 Robotic Radiosurgery System is Accuray's latest whole-body stereotactic radiotherapy device. During treatment, the patient lies on the treatment couch, and the CyberKnife's robotic arm, with sub-millimeter accuracy, delivers high doses of radiation from multiple angles using hundreds of beams, maximizing protection of surrounding healthy tissue. It is suitable for solid tumors anywhere in the body. Treatment typically requires only 1-5 sessions of about 30 minutes each. Compared to conventional radiotherapy, it offers high precision, good efficacy, minimal side effects, and a shorter treatment course. The process is painless and comfortable, allowing patients to return home after each session.

o For Ovarian Cancer: It is primarily used to treat postoperative residual disease, isolated metastases (e.g., retroperitoneal lymph nodes), or recurrent lesions, especially in patients who cannot tolerate surgery or have chemotherapy-resistant disease.

Indications & Suitable Candidates for CyberKnife:

o Tumors that are medically inoperable or surgically complex, or patients seeking an alternative to surgery or conventional radiotherapy.

o Recurrent cancers or metastatic tumors that have spread from the primary site to other parts of the body.

o Patients at high risk for postoperative complications.

o Patients who have previously received radiation therapy.

o Individuals actively participating in watchful waiting.

2. Tumor Treating Fields (TTF) Therapy:
Tumor Treating Fields therapy is a novel cancer treatment technology that uses low-intensity, intermediate-frequency (200 kHz) alternating electric fields to target microtubules in dividing cancer cells, disrupting cell division, leading to apoptosis and inhibiting tumor growth. TTF therapy has relatively mild side effects, and its efficacy has been rigorously validated in clinical trials.

o Advantages of TTF Therapy:

§ Can treat deep-seated tumors.

§ Allows for continuous treatment.

§ Precisely targets and inhibits cancer cell division.

§ Safe, non-invasive, with very few side effects.

3. Sino-US Multidisciplinary Team (MDT) Consultation:

o The participating experts are from renowned domestic and international oncology institutions with years of extensive clinical experience in cancer diagnosis and treatment, utilizing advanced medical concepts, cutting-edge techniques, and medications to serve patients.

o Patient-centered approach: A multidisciplinary team including medical oncology, surgical oncology, pathology, and nutrition tailors scientific, standardized treatment plans, prognosis assessments, and follow-up schedules.

o Based on molecular tumor diagnostics (genetic testing) and other pathological diagnostic techniques, adhering to MD Anderson Cancer Center's treatment standards to ensure scientific rigor in treatment plans.

o Designated coordinators assist with implementing MDT recommendations and provide ongoing tracking of the patient's condition, offering oncology health consultation services for each patient and their family.

What are the Traditional Therapies for Ovarian Cancer?

1. Surgery:
Surgery is not only the most effective treatment but also essential for definitive diagnosis and accurate staging. For early-stage cancer, staging surgery is performed, which involves removing the tumor and determining the disease extent. The standard surgical procedure typically includes a total hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and pelvic and para-aortic lymphadenectomy. For advanced cancer, cytoreductive (debulking) surgery is performed to remove as much of the primary tumor and all metastatic deposits as possible, minimizing the residual tumor burden. For young women wishing to preserve fertility, fertility-sparing surgery may be an option if specific criteria are met.

2. Chemotherapy:
Chemotherapy is the primary adjuvant treatment for ovarian cancer. It can not only palliate the disease but may also lead to complete resolution of cancer lesions, significantly prolonging patient survival. Chemotherapy is most often used postoperatively to eradicate cancer cells remaining after surgery.

3. Immunotherapy:
This area is still under active research and exploration. The goal is to enhance the host's immune function to inhibit tumor growth and kill/clear cancer cells. Various types of immunotherapy exist, and agents like interferon, interleukin-2, and thymosin peptides have been used clinically in recent years.