Today, women should be able to maintain an active lifestyle throughout the diagnosis and treatment of ovarian cancer.

When a woman hears the words “you have ovarian cancer,” it is from that very moment that a partnership begins between the woman, her family, and the doctors and nurses caring for her. This partnership is a key element in the treatment and management of ovarian cancer. It is this relationship that will help her tackle any side effect or challenge she may face related to this diagnosis.

The treatment and management of ovarian cancer in the 21st century is revolutionary. Multiple chemotherapeutic agents are being used, along with new and current research looking at medications that target ovarian cancer and have fewer side effects. This research is laying the foundation for healthcare professionals to have the ability to tailor a treatment plan specifically to each woman’s body and individual needs.

Side effect management in ovarian cancer begins with the first office visit and must be comprehensive. Palliative care in ovarian cancer should not be limited to the management of physical side effects related to medication administration. It is vital that healthcare professionals include the management of a woman’s emotional and psychological well-being, as well. When a woman’s physical and emotional well-being are cared for, treating and managing ovarian cancer becomes less challenging.

Side effect management in ovarian cancer is multifaceted.
One size does not fit all.

One of the first questions I ask a woman before she starts her treatment for ovarian cancer is “What are your fears?” Many myths surround cancer treatment and the use of chemotherapy. As an oncology nurse, it is my responsibility to displace the myths and replace them with the truth. I tell women that knowledge is power and the fear of the unknown can be overcome.

Several of the most common side effects a woman may encounter during ovarian cancer treatment include:

• Abdominal bloating, often with constipation, heartburn, and nausea.
• Generalized fatigue (a feeling of not being well rested).
• Hot flashes associated with the removal of the ovaries and the loss of estrogen production, which may lead to irritability, interrupted sleep, and vaginal dryness.
• A decreased immune system and blood count levels, which increases the risk of infection.

Fortunately, not every woman will experience these side effects, and for those who do, most can be managed with the help of your healthcare team.

Side effect management in ovarian cancer is multifaceted. One size does not fit all when it comes to the side effects and the treatment of ovarian cancer.

Women who are experiencing bowel issues may need to be put on a consistent bowel regimen with stool softeners and laxatives, antacids, and anti-nausea medications if necessary.

Women need to listen to their bodies and rest. Taking a short 20 to 30 minute nap can reenergize the body and cut down on the feeling of fatigue. Some women may require a prescription medication to help if fatigue is interfering with their quality of life.

For the woman having symptoms from a lack of estrogen, a prescription for estrogen replacement may be helpful. Talk with your doctor to see if you are eligible for estrogen replacement therapy. The introduction of certain medications, called growth factors, may be needed to help with the drop of certain blood counts during chemotherapy treatment.

Women and healthcare professionals must be flexible and open to incorporating any element that may complement the survivor’s plan of care. These elements may include health promotion with diet and exercise, complementary medicine with massage and art or music therapy, psychotherapy with a counselor or social worker, and the involvement of family and friends. With the development of these kinds of partnerships, successful side effect management is possible.

Today, women should be able to maintain an active lifestyle and a good quality of life throughout the diagnosis and treatment of ovarian cancer. Ovarian cancer may be part of who you are, but it is certainly not all of who you are.

About Wendy Topeka, BSN, RN, OCN

Wendy Topeka is clinical nurse manager for the Gynecologic Oncology Outpatient Infusion Unit at the Cooper Cancer Institute in Voorhees, N.J. This article was originally published in Coping® with Cancer magazine, July/August 2010.

Related Links

• Cooper Cancer Institute

“A yearly Pap test is the main screening test for cervical cancer and the best way to prevent it,” said David P. Warshal, M.D., head of the Division of Gynecologic Oncology at Cooper.

According to the U.S. Centers for Disease Control and Prevention (CDC), cervical cancer is the easiest female cancer to prevent, with regular screening tests and follow-up. Two tests can help prevent cervical cancer or find it early:

• The Pap test (or Pap smear), which looks for pre-cancers—cell changes on the cervix that might become cervical cancer if they are not treated appropriately.
• The HPV (human papillomavirus) test, which looks for the virus that can cause these cell changes.

The Pap test is recommended for all women and can be done in a doctor’s office. During the painless test, the doctor collects a few cells from the cervix and the area around it. The cells are then placed on a slide or in a bottle of liquid and sent to a laboratory. The laboratory checks to be sure that the cells are normal.

If an HPV test is being done in addition to the Pap test, the cells collected during the Pap test will be tested for HPV at the laboratory. Women should talk with their doctor about whether the HPV test is right for them.

“An annual pelvic exam – an office-visit examination of the vagina, cervix, uterus, fallopian tubes, ovaries and rectum – also is important to check for signs of disease,” Dr. Warshal said.

When to Get Screened for Cervical Cancer

According to the CDC, regularly scheduled Pap tests should begin at age 21 or within three years of a female’s first sexual activity, whichever occurs first. The Pap test is one of the most reliable and effective cancer screening tests available. It also can detect other conditions that might need treatment, such as infection.

In addition to the Pap test, the HPV test is used for screening women aged 30 and above, or for women of any age who have unclear Pap test results.

“For women aged 30 and over, whose screening tests have been normal for several years, the chance of developing cervical cancer within the next few years of their last test is very low. That’s why some doctors might extend up to three years the interval between screenings, particularly if HPV testing is negative.  However, regular, yearly pelvic exams are still very important to women’s health,” Dr. Warshal said.

Also important is to continue getting regular Pap tests regardless of advancing age or sexual inactivity. “Post-menopausal women or women who are sexually inactive should not assume that Pap tests for them are unnecessary. If a woman is over 65 and has had normal Pap results for several years, or if a woman has had her cervix removed during a hysterectomy, her doctor might tell her that it’s OK to stop getting Pap tests. But that is a decision to be made in consult with her doctor; otherwise, she should continue with her regular visits and screenings,” Dr. Warshal said.

Cervical Cancer Symptoms

There usually are no noticeable signs of early cervical cancer, but the disease can be detected early with yearly check-ups, including Pap tests to check for abnormal cells. Possible signs of cervical cancer include vaginal bleeding and pelvic pain; however, several other conditions can cause the same symptoms. Be sure to consult a doctor if any of these problems occur:

• Abnormal vaginal bleeding.
• Unusual vaginal discharge.
• Pelvic pain.
• Pain during sexual intercourse.

Remember, the best way to prevent cancer of the cervix is to get regular screenings for the cell changes that can lead to the disease.

“Pap tests almost always can show these cell changes before they turn into cancer. That’s why it’s important for women to get regularly scheduled Pap tests and to follow up with their doctor after any abnormal Pap test result. Abnormal cervical cell changes can be treated to prevent the development of cervical cancer,” Dr. Warshal said.