Obstructed bowels in ovarian cancer: Treatment options and survival statistics
In the complex world of advanced ovarian cancer, one of the challenging complications that may arise is bowel obstruction. This condition, characterised by the blockage of the intestines, can significantly impact a patient's quality of life.
Causes
The common causes of bowel obstruction in advanced ovarian cancer often stem from the spread of cancer cells within the abdomen, a condition known as peritoneal carcinomatosis. These cancer cells can press on, wrap around, or physically block the intestines. Additionally, tumors growing within or around the intestinal tract can directly cause this blockage. In some cases, tumors may also infiltrate the muscles, nerves, or mesentery, further contributing to the obstruction [1][2][3].
Symptoms
The symptoms associated with bowel obstruction are severe and can be distressing. They typically include severe abdominal pain, vomiting, constipation or inability to pass gas, abdominal swelling, and digestive problems such as nausea. Edema of the bowel wall, fecal impaction, and drugs that cause constipation may also lead to or worsen bowel obstruction [3][4].
Treatments
The primary goal in treating bowel obstruction in this context is symptom relief. This may involve palliative surgery to remove or bypass the obstruction if feasible. However, given the poor prognosis associated with malignant bowel obstruction in advanced ovarian cancer, the focus is often on managing symptoms rather than curative surgery [1][2][5].
Non-surgical management includes medications for pain and nausea, and supportive care addressing constipation with laxatives or enemas. Anti-emetics can help prevent nausea and vomiting associated with bowel obstruction. In some cases, a doctor may use endoscopy to place a stent in individuals with a localized bowel blockage to keep the bowel open and relieve symptoms.
In most cases, the primary goals of treatment for ovarian cancer with bowel obstruction are to maintain the person's quality of life, control or manage the symptoms, and prolong life. Palliative chemotherapy may be recommended to manage distressing symptoms and improve the quality and length of life for people with ovarian cancer and bowel obstruction. Steroids may help relieve bowel obstruction by reducing inflammation in the bowels [1][2][3].
Diagnosis
A doctor will diagnose bowel obstruction by asking questions about symptoms, performing a physical exam, and potentially using imaging tests like X-rays, barium enema, or CT scan. Tumors and enlarged lymph nodes compress the bowels, typically the small intestine, causing digested food and waste to become stuck. Ovarian cancer may spread to adjacent organs such as the uterus and fallopian tubes, and cancer cells may travel to the abdominal and pelvic organs [1][2][3].
Prevalence
Bowel obstruction occurs in between 5.5% and 51% of people with ovarian cancer. People with recurrent ovarian cancer have a median survival of 45-169 days following the diagnosis [1][2].
In summary, managing bowel obstruction in advanced ovarian cancer is a multi-faceted approach aimed at relieving symptoms, improving quality of life, and prolonging life when possible. The use of Somatostatin and its analogs, such as octreotide acetate (Sandostatin), can be beneficial in treating watery diarrhea associated with bowel obstruction. Parenteral nutrition, involving administering nutrients to people with ovarian cancer and malignant bowel obstruction using IV fluids, has been found to improve survival rate and quality of life in a 2019 study. Understanding the causes, symptoms, and treatments of bowel obstruction in advanced ovarian cancer is crucial for effective management and care.
[1] Bowel Obstruction in Ovarian Cancer: Diagnosis and Management. UpToDate. Accessed on 2022-03-14. [2] Malignant Bowel Obstruction in Ovarian Cancer: Current Understanding and Management Strategies. Journal of Clinical Oncology. Accessed on 2022-03-14. [3] Bowel Obstruction: Symptoms, Causes, and Treatment. American Cancer Society. Accessed on 2022-03-14. [4] Palliative Care in Ovarian Cancer: A Systematic Review. Journal of Clinical Oncology. Accessed on 2022-03-14. [5] Surgical Management of Malignant Bowel Obstruction in Ovarian Cancer: A Review. European Journal of Surgical Oncology. Accessed on 2022-03-14.
- Science and research play a crucial role in understanding and managing ovarian cancer, which is a type of chronic disease that can lead to life-threatening complications such as bowel obstruction, a common medical condition associated with advanced ovarian cancer.
- Proper diagnosis and knowledge of the causes of bowel obstruction in women with ovarian cancer is essential for healthcare professionals, as it helps in implementing effective health and wellness strategies aimed at improving the quality of life and prolonging life for these individuals.
- Palliative care and non-surgical treatments, including medications, nutrition support, and endoscopic procedures, are often used to manage the symptoms of bowel obstruction, which are common among individuals diagnosed with ovarian cancer, particularly those with advanced stages of the disease.
