Supportive care for ovarian cancer
Supportive care helps women meet the physical, practical, emotional and spiritual challenges of ovarian cancer. It is an important part of cancer care. There are many programs and services available to help meet the needs and improve the quality of life of women living with cancer and their loved ones, especially after treatment has ended.
Recovering from ovarian cancer and adjusting to life after treatment is different for each woman, depending on the extent of the disease, the type of treatment and many other factors. The end of cancer treatment may bring mixed emotions. Even though treatment has ended, there may be other issues to deal with, such as coping with long-term side effects. A woman who has been treated for ovarian cancer may have the following concerns.
Ascites is a buildup of fluid in the abdomen (peritoneal cavity). It occurs when the body produces fluid faster than it can remove it. Many women with ovarian cancer will develop ascites, especially as the cancer advances.
A bowel obstruction occurs when the large or small intestine (bowel) becomes blocked and the contents cannot pass through the colon. People who have abdominal surgery are at greater risk of developing a bowel obstruction.
Ovarian cancer commonly causes a bowel obstruction because the ovarian tumour or ascites puts pressure on the intestines. Bowel obstruction from ovarian cancer develops slowly over a period of weeks or months.
A pleural effusion is a buildup of fluid in the space between the outside covering of the lung and the inside lining of the chest wall (pleura). It is more common with advanced ovarian cancer.
Lymphedema is the swelling that occurs when lymph fluid collects in part of the body. It occurs when the lymph system cannot work normally and lymph fluid pools in tissues.
Women with ovarian cancer may develop lymphedema in the legs when lymph nodes are removed during surgical staging and primary surgical debulking. (Lymphedema can occur immediately or months or even years after surgery.) Cancer cells can also block the lymph vessels in the groin and pelvis, causing lymph fluid to build up.
Menopause occurs naturally as women age, usually when a woman reaches her early 50s. Menopause is caused when the ovaries produce lower levels of hormones. Women treated for ovarian cancer may experience early menopause as a side effect of cancer treatment. This is known as treatment-induced menopause.
Most ovarian cancers occur in women who are past their child-bearing years, but younger women with ovarian cancer may have concerns about fertility problems. Fertility issues and concerns should be discussed before treatment starts to make sure that the woman is aware of possible side effects that may affect her ability to have children after treatment.
Some treatments for early stage ovarian cancer may be adjusted to preserve fertility in women who still wish to have children:
- During surgery, only one ovary and Fallopian tube may be removed (unilateral salpingo-oophorectomy), sparing the other ovary and the uterus.
- Most chemotherapy treatments do not affect fertility in younger women.
Most young women who receive treatment for ovarian cancer keep or resume normal ovarian function after treatment. They can have normal pregnancies and healthy children.
Sexuality is part of everyday life. Many women continue to have strong, supportive relationships and a satisfying sex life after ovarian cancer. Sexual problems that occur because of ovarian cancer treatment are manageable.
Some women may lose interest in sex. It is common to lose interest in sex around the time of diagnosis and during treatment.
When the woman first starts having sex after treatment, she may be afraid that it will be painful or that she will not have an orgasm. The first attempts at being intimate with a partner may be disappointing. It may take time for the couple to feel comfortable with each other again. Some women and their partners may need counselling to help them cope with these feelings and the effects of cancer treatments on their ability to have sex.
Anxiety and depression in women with ovarian cancer appear to be related to her physical symptoms and how much support she thinks she has from people close to her, including her caregivers. Women with ovarian cancer may have high levels of psychological distress due to the high rate of disease recurrence. High levels of anxiety and depression have been noted during chemotherapy treatment. Anxiety and depression can be long-term problems for some women.
Treatment given to improve the quality of life of people who have a serious illness (such as cancer).
The goal of supportive care is to prevent or treat as early as possible the symptoms of a disease, the side effects caused by treatment and the psychological, social and spiritual problems related to the disease or its treatment.