Dr Lim Sheow Lei, senior gynaecology cancer specialist of OncoCare Cancer Centre was featured in an interview on Ovarian Cancer with Global Health & Travel Magazine in 2019. Read on to get updates on novel forms of treatment for Ovarian Cancer.

When a patient in her early fifties was first diagnosed with stage 4 ovarian cancer, she refused treatment and believed that death was imminent.

Eight years later, this patient is living well and has since returned to the workforce. She was persuaded by senior consultant medical oncologist Dr Lim Sheow Lei to undergo surgery and chemotherapy and had responded well to both.

“There is a common misconception that people with advanced stage ovarian cancer cannot be treated, but that’s not true. Patients can still live very well with surgery and chemo,” said Dr Lim from OncoCare Cancer Centre (Singapore). Even in advanced stages, the cancer remains within the abdominal cavity for most patients.

“It is not uncommon for patients to live for five years or longer with treatment,” added Dr Lim.

With advances in targeted treatment and the release of new drugs in the market, Dr Lim is confident that the battle with ovarian cancer – the fifth cause of cancer-related deaths among women – will be promising in the near future.

Heated chemotherapy
Patients suffering from an advanced spread of ovarian cancer now have the option to undergo a relatively new type of heated chemotherapy known as Hyperthermic Intraperitoneal Chemotherapy (HIPEC).

Unlike traditional chemotherapy, which circulates throughout the entire body via the bloodstream, HIPEC directly targets cancer cells in the abdomen, sparing all other organs.

“HIPEC works for ovarian cancer patients is because ovarian cancer tends to spread within the abdominal cavity,” said Dr Lim.

She added that heating up the chemotherapy also makes the treatment more effective as cancer cells tend to be more responsive. This method also allows for higher doses of treatment and fewer side effects experienced by patients, said Dr Lim.

Study results published in the New England Journal of Medicine also revealed that chances of survival are ten percent higher when treated using HIPEC. The use of HIPEC has achieved wide acceptance in some countries, and OncoCare Cancer Centre offers this heated chemotherapy treatment in Singapore.

Fewer side effects, better cancer control
Heated chemotherapy aside, a new oral medicine was released in Singapore just two years ago to improve cancer control in late-stage ovarian cancer patients.

Known as Olaparib, these oral tablets are used as a form of maintenance treatment. They best benefit patients with hereditary ovarian cancer (they carry the BRCA gene) or patients who have responded well to regular chemotherapy.

“About ten percent of patients who are on this treatment experience recurring cancer. With this treatment, they actually have very long term cancer control,” said Dr Lim, who added that it is not uncommon for their cancer to be subdued for more than five years.

As Olaparib can be consumed orally, Dr Lim said that it is well-tolerable for patients. “While there are still side effects, they are not as bad as chemo, where patients tend to experience hair loss,” she added.

Olaparib is currently being evaluated as a possible treatment for patients with newly-diagnosed ovarian cancer, regardless of their BRCA status.

“With more studies proving that you don’t need to have the BRCA gene mutation to undergo such treatment, more patients will definitely benefit in future,” said Dr Lim.

No effective screening
What makes ovarian cancer so deadly is that there is no effective and accurate screening test for ovarian cancer.

Said Dr Lim: “Most people think that ovarian cancer can be detected through pap smears, but that’s not true. There are no effective and accurate screening tests, most people find out they have cancer only after experiencing symptoms.”

The symptoms for ovarian cancer are vague, such as abdominal bloating, tiredness or a shortness of breath. They are often mistaken for gastrointestinal problems such as indigestion.
“People should watch their symptoms. If the symptoms persists for more than two weeks, they should get checked immediately,” advised Dr Lim.

While there is no accurate method to detect ovarian cancer, women are encouraged to go for genetic tests to find out if they carry the BRCA gene mutation known to cause ovarian cancer.
“Through such tests, you will know if you are at risk of ovarian cancer. There are then things you can do to prevent cancer; some women remove their ovaries and fallopian tubes after they have children,” said Dr Lim.