Diagnosis and Management of Ovarian Cancer, Current Status and Future Potential

Abstract

Ovarian carcinoma is the fifth common cause of cancer death among women in Malaysia, with five-year survival rates of 30%. It has been associated with delayed diagnosis, advanced stage of presentation and poor prognosis due to vague symptoms and lack of effective screening. The continued high fatality rate has underpinned efforts to develop effective screening tests and newer therapies that could impact on prognosis. New insights into proteomic analysis and genomic tests with a better understanding of the target lesion have leading to discovery of new treatment modalities in ovarian carcinoma. We present a 58-year-old lady with Stage IV ovarian cancer who had lower abdominal pain and mass, constipation and voiding frequency for six months duration. Ultrasound guided biopsy revealed serous adenocarcinoma likely ovarian in origin. CT scan showed gross ascites and right ovarian mass with infiltration to adjacent small bowel. Tumour markers CA 125 and LDH were high. She has received neoadjuvant chemotherapy followed by cytoreductive surgery and currently in remission.