Fertility saving surgery for borderline ovarian tumours

Recurrence and Malignant Transformation After Borderline Ovarian Tumours: A Systematic Review and Meta-analysis

https://tinyurl.com/yk7et5rw

Borderline ovarian tumours make up 10 to 20% of ovarian masses. They present at an earlier age and rarely progress to invasive cancer. Because of this, surgery for these tumours is often limited to removal of the ovarian mass with preservation of fertility.

This analysis of all the available information looks at the risks of recurrence and malignant change to determine whether limited fertility-saving surgery is harmful.

More than 5000 women were included who underwent surgery for borderline tumours, which included complete clearance for some, with others having less radical surgery, many for preservation of fertility. Recurrence of the tumour is more likely with limited surgical clearance, with as much as a 30% chance in some instances. Those women who had radical surgery had a low risk of recurrence at about 3%.

Progression to invasive cancer is rare, in about 1% of the whole group. The risk increases after recurrence, with up to 20% malignant change after local recurrence. Usually, the cancer is of low grade, with survival rates at around 60%.

The authors suggest that fertility-saving surgery has serious consequences and that informed consent should include the increased risk of recurrence and malignancy.

Fasting may help chemo

ASCO 2026: Fasting boosts chemotherapy responses for ovarian cancer patients

https://tinyurl.com/5xvffb8k

A pilot clinical study has suggested that fasting before and after chemotherapy may be protective, with better survival.

This group of 36 women with advanced serous ovarian cancer underwent neoadjuvant chemotherapy with three cycles of treatment. For half of the group during the 36 hours before chemo and for 24 hours afterwards, they underwent calorie restriction of less than 350 calories daily. The other half had normal diets.

Those women who fasted had significantly lower insulin levels than the control group. Insulin plays an important role in cancer treatment; cancer cells exhibit increased insulin receptor expression, thereby triggering an essential metabolic survival mechanism. Reducing circulating insulin causes cancer cell death.

Results from the study showed an improved response to neoadjuvant chemo with better clearance. Also, data at 18 months suggested longer cancer-free survival. The authors say further clinical trials are indicated to confirm this benefit.

False diagnosis depresssion

Rethinking depression diagnosis in ovarian cancer: The role of somatic symptoms

https://tinyurl.com/3e2d6jmc

A diagnosis of depression is common for patients with ovarian cancer. The risk is said to be three times that of the general population. This prospective study seeks to assess the role of physical symptoms often seen in these women, which may have led to false diagnoses.

Following treatment, depression diminishes. There is speculation that the depression is an adaptive response to illness rather than a clinical entity.

Psychosociological assessments were undertaken on 428 women with ovarian cancer. They were performed before treatment and a year later and compared to a healthy comparison group of 713 women. Many of the symptoms experienced by ovarian cancer patients, such as fatigue, loss of appetite and brain fog, are criteria that are used to diagnose depression. These symptoms diminish over time, which may account for the reduced severity of depression.

Results from the assessments confirmed the greater risk of clinical depression. However, for many of these women, the high prevalence of somatic symptoms caused a false diagnosis of severe depression. The authors suggest that increased awareness of the possible false diagnosis is required, with education of carers and patients as to the possibility.

MHT may be protective for ovarian cancer patients

Estrogen hormone therapy use in ovarian cancer patients under age 60 at diagnosis

https://tinyurl.com/4uc8sbpa

For many women, the effects of surgical menopause following standard treatment of ovarian cancer is an added insult. Menopause with diminished hormonal circulation can cause a significant decrease in the quality of life.

The impact of the menopause can be reduced by hormone replacement. Previously, there has been some reluctance to prescribe menopausal hormone therapy (MHT) for women with ovarian cancer due to concerns about promoting cancer spread.

This retrospective population study, using data from the BC population database together with information from the pharmacy records, looks at survival for women with ovarian cancer who received MHT compared to those who did not.

Of all the women in British Columbia aged 60 or younger who developed ovarian cancer during the period 1997-2020, about one-sixth of them received MHT. Most of these women had undergone a hysterectomy, meaning that oestrogen therapy only was appropriate.

Results from the study showed improved survival with MHT for women with epithelial and clear cell cancers. Those women who had endometrioid cancer of the ovary had worse survival if exposed to MHT.

The authors suggest that MHT is safe for women with ovarian cancer

and it may improve their quality of life.

Covid-19 and ovarian cancer a lethal combination

COVID-19 mortality risk among women with ovarian cancer: a matched case-control study

https://tinyurl.com/yxr7zb49

Women with ovarian cancer are immunocompromised any additional disease will have a significant impact. This retrospective study from Brazil looks at the risk of death for women with ovarian cancer who are infected with the COVID-19 virus.

During the period 2020-2024, data was collected for 474 patients with ovarian cancer and compared to 1896 controls without ovarian cancer. Both groups had severe COVID-19 infections with Severe Adult Respiratory Syndrome. The ovarian cancer cases were matched for other comorbidities.

Results from the study showed significantly higher mortality, with more than 2.5 times the risk of death for women with ovarian cancer who developed COVID-19. Encouragingly, the death rate was greatly reduced (by 65%) for those women who had been completely vaccinated.

The authors suggest early intervention with antiviral treatment is mandatory for these women and stress the importance of booster vaccination for the latest COVID-19 subtypes.

Is minimal invasive surgery for ovarian cancer hazardous?

Minimally Invasive Surgery, Intraoperative Capsule

Rupture, and Survival in Early Ovarian Cancer

https://tinyurl.com/mp9c87u8

Minimally invasive surgery is increasingly the method of choice for treatment of ovarian cancer either by laparoscopic approach or through use of robotic assistance. Reasons for this include reduced perioperative morbidity and mortality, rapid rehabilitation and reduced scarring or deformity.

In this study using data from the Clinical Cancer National Registry about half of more than 11000 women with ovarian cancer had minimally invasive surgery. Of those women, the intraoperative complication of rupture of the capsule with consequent intraperitoneal spill of cancer cells was 17 % greater for the minimal group compared to open surgery.

Overall survival after 3 years was significantly decreased for women who experienced capsule rupture with 13% increase in death. Although the rate of rupture is low at about 20% for both open and minimal procedures, it is important that this risk be included in informed consent discussions and further improvement of surgical procedure be sought.

Home environment may be cause of ovarian cancer

Residential Radon Levels and Ovarian Cancer Among Postmenopausal Women

https://tinyurl.com/ycxwyvy3

It has long been known that radiation exposure can result in ovarian cancer. Women exposed to the atomic bomb explosions in Japan during World War 2 had an increased incidence of the cancer.

This study looks at exposure to radon gas from naturally occurring sources and correlates the degree of exposure to the risk of developing ovarian cancer.

Radon gas arises from radioactive decay of isotopic material found in rocks most often uranium and thorium. High levels occur in different locations due to the geology, the highest being associated with granite or bluestone. The radiation emitted is of low intensity as alpha radiation which becomes harmful when inhaled.

Using data from the US geological survey areas of high, intermediate, and low levels of radon gas exposure were plotted. A prospective study using information from the women’s Health Initiative measured the risk of ovarian cancer and found that women who lived in high radon gas locations have about a one third greater risk.

Knowing this it may be possible to monitor women who live in these locations to ensure early diagnosis, and possibly reduce the risk by using safer house construction materials to avoid domestic exposure.