Ovarian Cancer

Ovarian Cancer - Dr. Amish Dalal

Types and Stages of Ovarian Cancer

Determination of the types and the stages of ovarian cancer require a thorough check-up and diagnosis to initiate the necessary line of treatment accordingly. Dr. Amish V. Dalal, a renowned Surgical Oncologist, assesses the condition of his patients and recommends treatment.

Staging of Ovarian Cancer

Staging refers to the diagnostic process that assesses the extent to which the cancer has spread from the location of its origin. This aids oncologists to decide on the necessity for a surgery as treatment. Accurate staging is important to arrest malignant tumour from spreading. Once the stage of the cancer has been diagnosed, it remains constant irrespective of the recurrence of cancer. The stage remains unchanged even if the cancer metastasises or spreads to new locations in the body.

As a part of diagnosis and determination of the type and stage of cancer, tissues samples are collected from different parts of the abdomen and the pelvis for examination under a microscope. This procedure also helps oncologists to assess whether the cancer is benign and does not require treatment, or is malignant. In case the cancer is malignant, a surgery is usually considered as treatment. For ovarian cancer, oncologists follow a 1 to 4 staging system. Doctor Amish Dalal analyses the stage of the ovarian cancer basis the tissue collected and recommends the next course of treatment accordingly.

The most recognised staging system is the TNM (Tumour, Nodes and Metastasis). It serves as the basis of the International Federation of Gynecology and Obstetrics or FIGO staging system.

To break it down further, TNM stands for:

  • Post-surgery results for the prognosis of the extent and size of the primary tumour, wherein ‘T’ stands for ‘tumour’
  • Location and number of metastasis to the adjoining lymph nodes, wherein ‘N’ stands for ‘nodes’
  • Presence or absence of distant metastasis, that is, metastasis to other parts of the body, wherein ‘M’ stands for ‘metastasis’

Amish Dalal reviews the medical condition of his patients to decide on the stage of the disease.

Types of Ovarian Cancer

There are different types of ovarian cancer that are classified basis the cell from which the disease has originated. These are:

Common epithelial tumours

This refer to the cells lining the outer surface of ovaries. It usually occurs in postmenopausal women. Most tumours that develop on the surface of ovaries are usually benign and do not require treatment. It needs frequent diagnosis of the tumour for seasoned oncologists like Dr. Amish Dalal to decide on the stage and line of treatment. Some epithelial tumours, referred to as tumours of low malignant potential (LMP tumours) or borderline tumours, may not be clearly identifiable as cancerous. This further emphasises on the importance of frequent evaluation for early diagnosis of the disease.

Germ cell tumours

The origin of germ cell tumours lies in the cells that produce eggs or ova. They can be benign or may need further treatment. The common germ cell tumours are dysgerminomas, teratomas and endodermal sinus tumours. It usually develops among teenagers and women in their twenties.

Stromal tumours

This develops in the connective tissue cells that hold the ovaries together and those that produce female hormones, progesterone and oestrogen. Some of the most common types of stromal tumours are Sertoli-Leydig cell tumours and granulosa-theca tumours. It is a rare form of cancer that manifests itself in the Stage I of the disease, which may not always hold true for other types of cancer.

Small cell ovarian carcinoma (SCCO)

It is a rare cancer type that is usually malignant by nature and affects women in their mid-twenties. Some of the common types are neuro-endocrine, pulmonary and hypercalcemic.

Patients diagnosed with malignant tumours can book an appointment with Amish Dalal at Jaslok Hospital, Breach Candy Hospital, Bhatia General Hospital, Saifee Hospital or Parsee General Hospital.

Book an appointment today.

Ovarian Cancer: Risk Factors & Common Symptoms

“Cancer is not a concentration camp, but it shares the quality of annihilation: it negates the possibility of life outside and beyond itself; it subsumes all living.”

– Siddhartha Mukherjee, The Emperor of All Maladies: A Biography of Cancer


Siddhartha Mukherjee refers to cancer as being the emperor of all maladies. Not without a reason. Ovarian cancer happens to be the most malignant form of gynaecological cancers, and the fifth leading cause of cancer-related deaths amongst women.


Three of the main determinants of ovarian cancer are age, family history and genetics. However, the disease does not restrict itself only within families sharing a past history. Women, especially post-menopause and those with a family history of breast and cervical cancer are advised to undertake screening tests for ovarian cancer. Another factor that plays a major role in ovarian cancer is the BRCA1/2 gene that accounts for 10% of all ovarian cancer cases. Over the past 30 years, Dr. Amish Dalal has successfully diagnosed patients with ovarian cancer.


The following pose as common risk factors:

  • A personal history of breast cancer before 45 years of age
  • Personal or family history of cancer in the fallopian tube, ovarian canvcer, or primary peritoneal cancer (a rare form of cancer closely related to epithelial ovarian cancer) among first or second degree relative(s), that is, sister, mother and/or grandmother
  • Family or personal history of the BRCA1/2gene that exists amongst approximately 10% of all ovarian cancer cases, which can be inherited
  • A history of breast cancer in a male relative (cancer occurring in the chest region amongst males is also termed as ‘breast cancer’). Studies show that a history ofbreast cancer in a first or second degree male relative (father, brother or uncle) increases the risk of cancer among the female members of the family as well
  • Personal or family history of hereditary non-polyposis colorectal cancer in a first or second degree relative. Hereditary non-polyposis colorectal cancer is a genetic condition that increases the risk of colon cancer, as well as cancers in other parts of the human body like the stomach, small intestine, ovaries, brain, urinary tract and the skin.

Disregarding, neglecting or not being able to recognize the symptoms of ovarian cancer can have significant consequences. However, patients who have a certain level of awareness and who undergo regular health check-ups have a higher chance of detecting the disease early enough to get cured. If the disease spreads to other organs in the body, it makes its management challenging. Dr. Amish V Dalal, a Surgical Oncologist, is highly acclaimed and sought after for his advice and treatment.


 Common Symptoms of Ovarian Cancer

The common symptoms of ovarian cancer may generally be misleading and can be mistaken as the side-effects of indigestion, associated with:

  • Bloating
  • Abdominal pain
  • Feeling full and/or
  • The urgency to urinate more often

If you or someone you know experiences any of these symptoms make sure to get them diagnosed by an expert like Amish Dalal.

Early Diagnosis and Prevention

Awareness about the symptoms of ovarian cancer and promptly diagnosing them can help in preventing the disease from spreading to other parts of the body. According to the American Cancer Society, approximately 20% of ovarian cancers are diagnosed at an early stage. The Society states that an early detection of the disease at a localised stage enhances the longevity of about 94% of patients by more than 5 years.

Two major diagnostic tests are usually prescribed for the detection of ovarian cancer – transvaginal ultrasound (TVUS) and CA-125 (Cancer Antigen-125) blood test. After understanding the patient’s history and evaluating the present medical condition, Dr. Dalal advises patients on the necessary tests to be conducted.

TVUS involves inserting an ultrasound wand inside the vagina to get a close view at the uterus, ovaries and fallopian tubes. This painless screening test usually aids in detecting the tumour in the ovary and it can estimate whether the growth is cancerous or benign. A high level of CA-125 in the blood stream indicates the existence of ovarian cancer. A reduction in the CA-125 level in the blood shows that the medication is taking effect. When Amish Dalal reviews the symptoms of his patients, he decides on the necessary screening tests accordingly.

Patients diagnosed with cancer can book an appointment with Amish Dalal at Jaslok Hospital, Breach Candy Hospital, Bhatia General Hospital, Saifee Hospital or Parsee General Hospital.

10 Questions To Ask Before Starting Treatment For Ovarian Cancer

Ovarian cancer is more prevalent among women who have reached the age of menopause. Women who have close relatives with the disease are also at a greater risk of being diagnosed with it. Ovarian cancer occurs when normal cells in the ovary turn abnormal and, in advanced stages, spread to other parts of the body.

The initial symptom of ovarian cancer is increase in the size of the abdomen and bloating, though these symptoms do not necessarily always indicate at cancer in the ovary. The required medical tests, under the instructions of an experienced health professional, have to be conducted to diagnose the reason for the abdominal anomalies.  An imaging test like CT scan, ultrasound or both, and a blood test, known as CA-125, are usually recommended to diagnose the cause of the symptoms. If the tests point towards ovarian cancer, the stage of the disease needs to be determined to decide on the next line of treatment. For instance, when patients approach Dr. Amish Vasant Dalal, he closely examines their medical tests and advises surgery, if required.

It helps a patient when she is conscious and well aware about her medical condition. Here is a list of some of the essential questions that a patient needs to ask doctors before starting the treatment for ovarian cancer:

What type of ovarian cancer do I have?

Ovarian cancer be broadly categorised on the basis of their origin of growth – in the cells that produce eggs in the ovary, along the inner wall of the organ (epithelium), or in the cells that produce hormones. Being actively involved in the diagnosis process is a step towards staying updated regarding one’s own medical condition. Doctor Amish Dalal, with his expertise in oncology, can guide patients on the type of ovarian cancer that they have been diagnosed with.

What is the treatment that I need?

Chemotherapy is usually the recommended treatment. However, the healthcare professional may recommend that the patient explore other treatment methods like a surgery as a more effective treatment for the disease. In such cases, the patient needs to approach an oncologist for an opinion on the necessity of a surgery. Dr. Amish V Dalal, an accomplished Surgical Oncologist with 30 years of experience in the field, analyses the medical condition of his patients and recommends a surgery, if needed.

How do you administer chemotherapy?

There are usually two methods for administering chemotherapy – intraperitoneal and intravenous. Intraperitoneal chemo refers to injecting the drug directly into the abdominal cavity through a thin catheter, while for intravenous chemo, the drug is injected into veins. The chemotherapist assesses the suitability of these methods to each patient and administers the treatment accordingly.

What surgery is suitable for me?

A debulking surgery aims for a cytoreductive effort, that is, the aim to remove the cancerous tumour entirely, so there is no remaining residue. In certain instances when the tumour may have spread to the adjoining parts of the body, there may be a big tumour along with the presence of small tumours in the abdominal cavity. However, debulking may not always be a viable option for every patient. Hence, oncologists decide on the necessary course of treatment according to their discretion that is based on the patient’s medical condition. Amish Dalal reviews the condition of his patients and assesses the nature of the surgery to be undertaken.

What are the different procedures of surgery and the one that is suitable for me?

Patients also need to have a detailed discussion with their oncologist regarding the method of surgery best suited for them – open method, laproscopy and robotic surgery. Dr. Amish Dalal is experienced in all these methods of surgery. Patients can approach their oncologists to understand the dynamics of each of these methods of surgery, the suitability of each of these for them and reach a mutual decision.

Patients diagnosed with malignant tumours can book an appointment with Amish Dalal at Jaslok Hospital, Breach Candy Hospital, Bhatia General Hospital, Saifee Hospital or Parsee General Hospital.

Book an appointment today.


Factors That Enhance & Reduce the Risk of Ovarian Cancer

Ovarian cancer is the third most commonly known cancer among Indian women, ahead of breast and cervical cancer. Though genes and genetic history is believed to play a vital role in women developing ovarian cancer, it may spread from the fallopian tubes as well. Genetic tests may help patients in estimating the extent of risk of developing ovarian cancer. For patients who may need surgery, Dr. Amish V Dalal, an acclaimed Surgical Oncologist with 30 years of experience in the field, recommends the necessary line of treatment.

Factors that may increase the risk of ovarian cancer:

Some commonly recognised risk factors that may lead to ovarian cancer:

  • Age: It usually affects women who have been through menopause, that is, above the age of 50, though it may develop among younger women as well.
  • Family history: A woman with more than one relative affected by ovarian cancer from the same side of the family, may be at a higher risk of developing the disease. The increased risk of being affected by cancer in the ovary is commonly believed to be the result of a faulty gene, BRCA1 or BRCA2 mutation. Women with an enhanced risk of cancer in their genes are advised to opt for a genetic testing. Genetic counselling, conducted by healthcare professionals, evaluates the family history and personal medical condition of individuals. They are trained to review the likely presence of the gene mutations that are closely associated with the increased risk of ovarian cancer. For medical tests that indicate that further treatments may be required apart from chemotherapy, Amish Dalal advises the necessary future course of treatment.
  • Hormonal changes: Early puberty, that is, commencement of menstruation before the age of 12, and late menopause, or the onset of the same after the age of 50, may enhance the risk of women developing ovarian cancer.
  • History of child-bearing: Women who have issues in conceiving, have not had children, conceived after the age of 30, or have never used oral contraceptives are believed to be at a marginally greater risk of developing ovarian cancer. This may be due to the ovary being exposed to the frequent process of break and repair of its surface owing to monthly ovulation.
  • Unhealthy lifestyle: Being overweight due to a high fat diet or smoking may increase the risk of ovarian cancer.
  • Endometriosis: When the ‘endometrium’ or the tissue lining the uterus is also present on the outer surface of the organ, it may increase the risk of the development of cancer in the ovary. Doctor Amish Dalal analyses the existing medical condition of patients being administered chemotherapy and recommends a surgery, if necessary.



Factors that may reduce the risk of ovarian cancer

Some commonly recognised factors that may reduce the risk of ovarian cancer:

  • Opting for a surgery for the removal of both the ovaries, Tubal Ligation (a surgery for getting both the tubes tied) or hysterectomy may reduce the risk of ovarian cancer. But these surgeries should be undertaken only on valid medical reasons rather than for reducing the risk of developing cancer in the ovary. Studies conducted till date are inconclusive about the prospect of Tubal Ligation being an effective surgical procedure for reducing the risk of ovarian cancer. If a patient undergoing hysterectomy has a family history of breast or ovarian cancer, the surgical oncologist may consider removing both the ovaries and the fallopian tube. Amish Vasant Dalal assesses the medical condition of his patients and recommends surgery accordingly.
  • Using birth control pills or oral contraceptives for five years or more may reduce the risk of the disease. However, it is mandatory that women consult their doctor before consuming these pills as they may be accompanied by possible risks like increased chances of breast cancer
  • Having conceived and given birth before the age of 30 may also reduce the risk of the disease.
  • Breastfeeding for at least a year may slightly reduce the risk of developing ovarian cancer

Patients diagnosed with malignant tumours can book an appointment with Amish Dalal at Jaslok Hospital, Breach Candy Hospital, Bhatia General Hospital, Saifee Hospital or Parsee General Hospital.

Book an appointment today.