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Ovarian Cancer

Known as the "silent cancer," ovarian cancer rarely announces itself until it has reached an advanced stage which is why the expertise of the team managing it matters more than in almost any other cancer.

Shree Hospitals' gynaecologic oncology team delivers advanced ovarian cancer treatment in Mumbai India, from primary cytoreductive surgery to PARP inhibitor maintenance therapy, with the goal of maximising survival and preserving quality of life at every step.

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1800-268-4000

Our Approach to Managing Ovarian Cancer

Managing ovarian cancer well requires more than good surgery it demands a team that thinks ahead. At Shree Hospitals, our ovarian cancer specialists in Mumbai use tumour board deliberation, genetic profiling, and international guideline-based protocols to give every patient the best chance at durable remission. We recognise that most women present at Stage III or beyond and we plan accordingly from day one.

1. Diagnosis & Staging

Ovarian cancer is staged surgically, but pre-operative assessment is critical:

Ultrasound pelvis and abdomen IOTA criteria used to characterise ovarian masses
Contrast-enhanced CT chest, abdomen, pelvis to assess disease extent
CA-125 and HE4 tumour markers along with ROMA score for risk assessment
BRCA testing Mumbai offered to all women diagnosed with epithelial ovarian cancer
MRI pelvis in select cases for better characterisation of complex adnexal masses

2. Primary Cytoreductive Surgery (Debulking)

The most important single determinant of outcome in ovarian cancer is the quality of surgical debulking:

Complete cytoreduction (no residual disease) achieved wherever possible
Procedures may include hysterectomy, bilateral salpingo-oophorectomy, omentectomy, peritonectomy, bowel resection, diaphragm stripping tailored to disease extent
Lymph node dissection performed in selected early-stage cases
Fertility-preserving surgery offered to young women with Stage IA/IC disease

3. Interval Debulking Surgery (IDS)

For patients who are not fit for upfront surgery or have unresectable disease:

3 cycles of neoadjuvant carboplatin-paclitaxel administered first
Response assessed clinically and on CT imaging before surgery
IDS performed with the same completeness goal as primary surgery
Followed by 3 additional cycles of chemotherapy post-operatively

4. Chemotherapy

Platinum-based chemotherapy is the backbone of systemic treatment:

Carboplatin-paclitaxel standard first-line regimen for 6 cycles
Dose-dense weekly paclitaxel in selected patients for improved response rates
Intraperitoneal chemotherapy for optimal debulked Stage III disease in eligible patients
Carboplatin-gemcitabine or carboplatin-liposomal doxorubicin for platinum-sensitive relapse

5. PARP Inhibitor Maintenance

PARP inhibitors have transformed ovarian cancer outcomes in gynaecologic oncology Mumbai:

Olaparib maintenance for BRCA1/2-mutated advanced ovarian cancer after first-line platinum response
Niraparib maintenance for all-comers regardless of BRCA status
Bevacizumab combined with PARP inhibitor in HRD-positive tumours
Maintenance continued for up to 2 years or until disease progression

6. Management of Recurrent Disease

Ovarian cancer frequently recurs and recurrence is not the end of the road:

Platinum-sensitive relapse (>6 months): retreatment with platinum-based doublet + PARP inhibitor
Platinum-resistant relapse: weekly paclitaxel, pegylated liposomal doxorubicin, gemcitabine
Secondary cytoreductive surgery in selected platinum-sensitive relapses with favourable biology
Clinical trial access discussed at each recurrence point

How To Identify Ovarian Cancer

Ovarian cancer symptoms are vague and easily attributed to other causes which is what makes it so dangerous. No reliable screening test exists, making symptom awareness essential:

Persistent bloating — abdomen feels full or swollen most days; not related to eating
Pelvic or abdominal pain — dull, persistent discomfort in the lower abdomen
Difficulty eating or feeling full quickly — even with small meals
Urinary symptoms — urgency or increased frequency without a urinary tract infection
Changes in bowel habit — unexplained constipation or diarrhoea
Unexplained fatigue and unintentional weight change
Abdominal swelling with ascites — may indicate advanced peritoneal spread

Women with a family history of ovarian or breast cancer particularly those of Ashkenazi Jewish descent should discuss BRCA testing in Mumbai with a ovarian cancer specialist in Mumbai at Shree Hospitals.

Important FAQs: Ovarian Cancer

Is there a screening test for ovarian cancer?

Currently, no reliable population screening test exists. CA-125 and ultrasound are used in high-risk women but are not recommended for general screening. Symptom awareness and prompt evaluation remain the most practical early detection strategies.

What does BRCA status mean for my treatment?

BRCA1 and BRCA2 mutations increase lifetime ovarian cancer risk by 20–44%. They also predict better response to platinum chemotherapy and eligibility for PARP inhibitor maintenance which dramatically improves outcomes. BRCA testing in Mumbai is offered to all patients at Shree Hospitals.

Why is surgery so important in ovarian cancer?

Because the amount of tumour left behind after surgery is the strongest predictor of survival. Complete cytoreduction (no residual disease) can double survival outcomes compared to leaving even small amounts of tumour. Surgical quality matters enormously.

Can ovarian cancer be cured?

Stage I disease is curable in over 90% of cases. Most patients, however, present at Stage III or IV, where 5-year survival is 30–50%. Newer maintenance therapies are significantly improving these numbers. Long-term remission is increasingly achievable even in advanced disease.

What is the difference between ovarian cancer subtypes?

High-grade serous carcinoma (HGSC) is the most common (70%) and most aggressive. Clear cell, endometrioid, and mucinous subtypes behave differently and respond to treatment differently. Subtype-specific management is part of our treatment planning at Shree Hospitals.

What happens if ovarian cancer comes back?

Recurrence is common but treatable. Management depends on the platinum-free interval, BRCA status, prior treatments, and performance status. Our team reviews every relapse at the tumour board to design the most appropriate salvage plan.

Treatments For Ovarian Cancer at Shree Hospitals

We offer a complete range of ovarian cancer treatment services, including advanced screening and diagnosis, personalised treatment plans, expert surgical management, minimally invasive surgery where appropriate, chemotherapy, targeted therapy, immunotherapy, radiation therapy in selected cases, genetic counselling and testing, rehabilitation, and long-term survivorship care designed to help patients achieve the best possible outcomes.

Primary Cytoreductive Surgery

Complex surgical procedure to remove all visible ovarian tumour and peritoneal disease. The goal is zero residual disease. May involve omentectomy, bowel resection, peritonectomy, and diaphragm surgery requiring a high-volume gynaecologic oncology team.

Neoadjuvant Chemotherapy + Interval Debulking

Chemotherapy given before surgery to shrink disease, making complete cytoreduction achievable. Followed by interval debulking surgery and then post-operative chemotherapy. Equally effective as primary surgery in appropriately selected patients.

Carboplatin-Paclitaxel Chemotherapy

Standard first-line systemic treatment for ovarian cancer. Six cycles delivered intravenously at Shree Hospitals' oncology day care unit. Forms the foundation of all ovarian cancer treatment in Mumbai India protocols.

PARP Inhibitor Maintenance

Olaparib or niraparib given as daily oral tablets after successful first-line chemotherapy. Dramatically extends progression-free survival particularly in BRCA-mutated disease. Major advance in gynaecologic oncology Mumbai.