Hot Topics in Ovarian Cancer Surgery

#86 with arguably the G.O.A.T. of #OvarianCancer surgery - our Advisory Board Member and Head of Ovarian Cancer Surgery at Memorial Sloan Kettering Cancer Center Dr. Dennis Chi! In this episode, Dr. Chi joins us to Talk About the Hot Topics in Ovarian Cancer Surgery. Let's learn. Let's Connect Ovar Coffee!

[@kellyliu4225]

This is the Best session and the BEST doctor!! Thank you!

[@Ovarcome]

Love this, thank you for watching! Keep Ovarcoming! 💙

[@d.j.recchia5572]

Best opinion I have heard. His approach to surgery makes more common sense to me. I am going to use his opinion to substantiate my request for surgery first.

[@d.j.recchia5572]

My G-d why can’t I get to treatment/first appointment at my center, I have been so sick since May 2023, 8 doctors, 4 hospitals, and last week got my biopsies, and less than 24 hours the outcome is NOT good, my time is important in the lifetime I have left. But to just sit, worry, end of life planning, and still waiting for an appointment, G-d I know whatever the final outcome is, it’s your decision. Just give me one more chance to get a surgeon. I am getting worse again, they can’t expect me to live on pills till the end of my life. What am I to do with my 93 year old mother, who looks like she will outlive me. I don’t want her to see me continue in this pain and suffering. I want one more chance for life. I want to look at another tomorrow 😢 ❤️🐩

[@NurseQuipy]

Does achieving R0 with 3b clear cell improve prognosis statistically?

[@Lemlaybeuh]

Very interesting, feeling how the bloating and pain receded within approximately two months made all the difference, I simply go’ogled the latest by Tilly Strankten and her Ovarian Cyst Guide and although it really took about 10 weeks for it to totally shrink and vanish I’ve never felt so light and relaxed.

[@helenwiegand6183]

Hi, I live in Europe so our healthcare is possibly a bit different to in Australia. I have a history of endometriosis and ovarian cysts which appear functional. At least they usually go away after a few cycles. I was diagnosed with HG Seros Epithelial Ovarian Adenocarcinoma at the age of 40 (in March 2023). I had 2 huge Tumors removed per laparotomy, but nothing else was removed as the surgeon could not see any other suspicious areas in the pelvis/abdomen/lymph node involvement etc. My Tumors were Grade T2b. As no further surgery was done I don’t have a full staging. I could not have chemotherapy so used several natural therapies and good nutrition to keep my immune system working well. 8 months later I’m still NED but the ovarian cysts keep coming and going. I’m considering whether or not to ask the surgeons to remove the other ovary and womb to reduce my risk of OC recurrence. Has anyone faced a similar situation before? I know it’s a bit unique… Thank you!

[@charmaineleopold8689]

My favourite saying is if in doubt get it out!!! If your not going to use it why keep it and increase your potential risk. only my view by the way

[@wanazuzo]

I was transported from a rural area to the city for emergency surgery, and had an exploratory laparotomy 5 weeks ago. The intraoperative preliminary frozen sections from the 15cm tumor were presumed to be stromal or germ cell. The surgeon performed 'complete staging', except he sampled only 3 pelvic nodes and did not take peritoneal biopsies. The final histopathology identified clear cell carcinoma pt1A pN0. One ovary involved, all capsules intact, all other tissue sampled and fluids were negative. They recommend chemo. I'm getting a second opinion, but: shouldn’t surgical staging for OCCC include pelvic and para-aortal lymphadenectomy and also peritoneal sampling? Also, considering the well documented platinum resistance of OCCC, shouldn’t an early stage 1a have the option of observation over chemo? The doctor did not want to discuss the literature or statistics for OCCC...

[@wanazuzo]

one more question (TMI?😂): my surgeon said he recommends chemo because the tumor was grade 3. Does this sound logical? I'm confused because I have been reading that pathologists do not grade OCCC tumors because OCCC is high-grade by definition.

[@rebeccafeder8582]

Yeah. I have endometriosis. No one told me I was at risk. I had a 'prophylactic' hysterectomy and oophrectomy and a small cyst had clear cell carcinoma.

[@Captivated2]

I had stage 1A fallopian tube cancer and was told after hysterectomy and chemo I would never see it again. But 2 years later I had a reoccurrence, 1 small spot found, removed. More chemo. And low dose parp maintenance. 18 months later, CA125 went up from 8 to 12.9 and a CT shows early signs of a reoccurrence in paracolic gutters. My gynecologist does not want to do surgery. Some thing about microscopic disease you can’t remove, but there is a nodule of 1.2 cm that could be removed… I’m wondering if I should get a second opinion.

[@Ovarcome]

Here is the response from Dr. Chi: "Yes you should get a second opinion."

[@d.j.recchia5572]

If you can run, get to another dr. Yesterday, don’t end up like me😢 ❤️🐩

[@user-gk4gq4vi7w]

i got diagnose with stage 3 ovarian cancer low serous carcinoma...the surgery was successful and surgeon did a full hysterectomy everything was taken out and she told me she removed everything she could see ...then couple weeks later i started chemo taxol/carboplatin 6 weeks ...since surgery my blood work has been good ca125 after surgery went from.130 to 30 and during chemo last was 10.7.....i finish 6th chemo 3 weeks ago....my oncologist is talking about on puting me on a maintenance pill not sure which one....my question is do i need a pill and if so which one would you recommend?

[@taylorpresley4604]

I am basically in the same situation as you, my oncologist wants to wait and see before putting me on a maintenance drug as we only have so many bullets to slow this disease down, if that makes sense. Maintenance drugs have side effects too. Wow, your CA 125 was only 130 before surgery and you were Stage 3? Mine was over 740

[@user-gk4gq4vi7w]

@taylorpresley4604 oh wow didnt even know it can go that high in the 700s....but actually my oncologist wants to put me on maintenance pill i go see her this friday to find out which one..how are you doing now? oh yea it is stage 3 c low serous carcinoma...

[@joannethompson1730]

What is GOAT?

[@Ovarcome]

@@joannethompson1730 Greatest of All Times!

[@Ovarcome]

Here is the response from Dr. Chi: "Most likely the pill is what is called a PARP inhibitor although I cannot be sure. These are given in certain situations and I cannot comment solely on the information provided."

[@switdipz9283]

Hello doctor, i have low grade OC stage 3c. Braca negative. ER positive. I had cytoreductive surgery a month ago but my stomach is still swollen or bloated. Post surgery i had fluid coming out of my belly through the drain for 8 days. I was told it was because there was a very considerable amount of disease removed. All visible cancer was removed. The fluid finally reduced so the drain was removed and i went home. No fluid came out of the hole since that day. Is it possible for fluid still building up at this point in my belly please? I had like a yellow vaginal watery discharge after that and was told it must be the same seroma fluid along with some blood because my bladder was scrapped. But the discharge has also had reduced. my belly is still bloated. I can eat and drink a little more though compared to before surgery. what can i do to reduce this swelling or bloating please? I have had ascites before so this is worrying me. Thanking you in advance

[@Ovarcome]

Thank you for watching! Here is the response from Dr. Chi: "Yes abdomen can still be swollen a month after surgery. Yes ascites can still develop after complete cytoreduction"

[@navbharat1443]

Hello, ​@@Ovarcome how can trace ascites from debulking surgery be treated???