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Ovarian Cancer Treatment and Surgery in India

Ovarian Cancer:

Ovarian cancer is cancer that develops in the ovaries. The ovaries are part of a woman's reproductive system. They are located in the pelvis on either side of the uterus. Each ovary is about the size of an almond. The ovaries make the female hormones progesterone and estrogen and also release eggs into the fallopian tubes. Types of Ovarian Cancer

Epithelial ovarian cancer - Within epithelial ovarian cancer there are six subtypes. Each is derived from a different type of tissue in the lower genital tract or Mullerian tract. However, within invasive cancers there is not a great deal of difference in prognosis for the first three and the distinction is mainly a pathological one.

� Serous - This form accounts for around 70% of cases and is therefore the most common type.

� Mucinous - This accounts for a further 10%. These tumours have a slightly worse prognosis than serous tumours.

� Endometrioid - These tumours (5%) are more likely to be associated with disease in the uterus (womb) and sometimes an ovary is found to be affected when a woman is diagnosed with endometrial cancer.

� Clear cell - These tumours (around 3-4%) have a poorer prognosis and tend to behave more aggressively.

� Boderline Tumour - 10-15% of ovarian cancers are borderline tumours, also known as tumours of low malignant potential. They tend to remain confined to the ovary for long periods and usually occur in premenopausal women.

� Germ cell tumours - Germ cell tumours of the ovary make up 3% of malignant ovarian tumours, so they are rare, just one-tenth as common as germ cell tumours of the testis.

Causes of Ovarian Cancer:

The cause of ovarian cancer is not known.

Risk Factors related to Ovarian Cancer:

Child-bearing history - Women who have not had children are slightly more likely to develop ovarian cancer than women who have, although the risk is still very low.

Hormonal factors - Starting your periods early or having a late menopause slightly increases your risk of ovarian cancer. Using hormone replacement therapy (HRT) can slightly increase the risk.

Infertility - Some research has shown that infertility may slightly increase the risk of developing ovarian cancer.

Health factors - Having endometriosis – a condition where the womb lining grows outside the womb – may increase your risk of ovarian cancer.

Diet and body weight - Being overweight may increase your risk of developing ovarian cancer. Eating a diet high in animal fats and low in fresh fruit and vegetables may also increase your risk.

Other symptoms may include:

� Nausea, indigestion, increased gas, constipation or diarrhea, lack of appetite

� Extreme fatigue

� Shortness of breath

� Backaches

Screening and Diagnosis of Ovarian Cancer:

While no early detection tool exists for all women, several tests exist for women who are at a high risk. If a woman has ovarian

cancer symptoms, a strong family history, or a genetic predisposition such as a BRCA mutation, doctors may monitor her with

one of three tests or a combination of them:

� Blood Test - A CA-125 blood test is not considered a good screening test for ovarian cancer. However, it may be done

if a woman: has symptoms of ovarian cancer or has already been diagnosed with ovarian cancer to determine how

well treatment is working

� Transvaginal Ultrasound - A transvaginal ultrasound is a test used to examine a woman’s reproductive organs and

bladder.

� Pelvic Exam - A pelvic exam should be a part of a woman’s regular female health exam. A pelvic examination may

reveal an ovarian or abdominal mass. Ovarian cancer is rarely detected in a pelvic exam and usually in an advanced

stage if it is.

The above tests are most effective when used in combination with each other. Doctors may also use a CT scan or PET scan

as part of the diagnostic process however the only definitive way to determine if a patient has ovarian cancer is through

surgery and biopsy. No lab or imaging test has ever been shown to be able to diagnose ovarian cancer in its early stages.

Stagesof Ovarian Cancer:

There are four stages of ovarian cancer. Your doctor will determine your stage of ovarian cancer. Ovarian cancer is treated

differently depending on which stage you are diagnosed with.

Genetic factors - Certain genes defects (BRCA1 and BRCA2) are responsible for a small number of ovarian cancer cases. Women with a personal history of breast cancer or a family history of breast or ovarian cancer have an increased risk for ovarian cancer. About 5–10% of ovarian cancers are caused by the inherited faulty gene in the family. Signs and Symptoms of Ovarian Cancer: Research suggests there are four symptoms that may be associated with ovarian cancer:

� Bloating � Pelvic or Abdominal pain and heaviness � Difficulty eating or feeling full quickly � Urinary urgency or frequency

Stage I The cancer is completely contained within the ovary or ovaries

Stage IA- One ovary involved Stage IB- Both ovaries involved Stage IC- One or both ovaries involved, but with cancer on the surface of

an ovary, rupture of an ovarian cyst malignant ascites or positive abdominal washings.

Stage II The cancer is in one or both of the ovaries and has spread to additional organs located in the pelvis such as the bladder, colon, rectum or uterus.

Stage IIA - Spread to uterus or fallopian tubes Stage IIB - Spread to pelvic peritoneum Stage IIC - Confined to the pelvis, but with malignant ascites or positive abdominal washings

Stage III The cancer is in one or both ovaries and has spread to one or both of the following: the lining of the abdomen or the lymph nodes.

Stage IIIA - Microscopic spread to the upper abdomen Stage IIIB - Cancer nodules less than 2 cm in the abdomen Stage IIIC - Nodules more than 2 cm, or positive pelvic or aortic lymph nodes

Stage IV The most advanced stage of cancer. The cancer has spread from one or both ovaries to additional organs such as the liver or lungs, or there may be cancer cells in the fluid surrounding the lungs.

Treatment for Ovarian Cancer:

Ovarian cancer treatment will depend on a number of factors, including the stage of ovarian cancer and the general health of the patient. The treatment of Ovarian Cancer includes;

� Surgery � Chemotherapy � Radiation therapy

Surgery for Ovarian Cancer - Ovarian cancer surgery is the usual initial treatment for most women. There are several types of surgery for ovarian cancer. The type of surgery recommended will depend on the extent of the ovarian cancer.

Following are some examples of Ovarian Cancer Surgery.

� Unilateral salpingo-oophorectomy: A surgical procedure to remove one ovary and one fallopian tube.

� Bilateral salpingo-oophorectomy: A surgical procedure to remove both ovaries and both fallopian tubes.

� Total hysterectomy and bilateral salpingo-oophorectomy: A surgical procedure to remove the uterus, cervix, and both ovaries and fallopian tubes. The types are vaginal hysterectomy, total abdominal hysterectomy, total laparoscopic hysterectomy.

� Partial oophorectomy: A surgical procedure to remove part of one ovary or part of both ovaries.

� Omentectomy: A surgical procedure to remove the omentum (a piece of the tissue lining the abdominal wall).

� Tumor debulking: A surgical procedure in which as much of the tumor as possible is removed. Some tumors may not be able to be completely removed.

� Lymph node biopsy: Ovarian cancer staging during surgery (to find out whether the cancer has spread) generally involves removing lymph nodes

� Radiation Therapy for Ovarian Cancer - Doctors don't often use radiotherapy to treat ovarian cancer. But occasionally they may suggest it after surgery for stage 1 or stage 2 ovarian cancers. This is to help kill off any cancer cells left behind and so lower the risk of the cancer coming back.

For advanced ovarian cancer, you may have radiotherapy to try to shrink tumours and reduce symptoms. You can have the treatment to any part of the body where the cancer is causing problems. You might hear this called palliative radiotherapy.

Chemotherapy for Ovarian Cancer - Chemotherapy uses anti-cancer or 'cytotoxic' drugs to destroy cancer cells. You are most likely to be offered chemotherapy after your surgery if your cancer is Stage 1c or higher. But you may have it if you have an earlier stage cancer that your doctor thinks may be faster growing (high grade). You can also have chemotherapy for ovarian cancer that has come back after you were first treated. You are most likely to have chemotherapy drugs for ovarian cancer as injections through a vein into your bloodstream. Some research has looked at giving chemotherapy into the abdomen. This is known as intraperitoneal chemotherapy.

Follow-Up Care Post Ovarian Cancer Surgery:

Continuous follow-up is essential for all ovarian cancer patients. This includes patients whose disease is in remission after treatment. Although most women who develop a recurrence do so within the first 2 years after treatment, ovarian cancer can reappear up to 20 years later.

After surgery and during chemotherapy, ovarian cancer patients may be monitored with CA125 tests. Rising levels of this protein indicate a recurrence and the need for more therapy. In addition, many doctors routinely perform “second-look” surgery after a six- or 12-month course of chemotherapy. This procedure involves opening the abdomen and taking tissue samples in a search for cancer cells. If additional cancer cells are found, chemotherapy is repeated. “Second-look” surgery is somewhat controversial because additional cancer is often found or the cancer recurs. Opponents of a “second look” advocate continuing chemotherapy instead of subjecting patients to more surgery. Your doctor may also order a computed tomography (CT) scan of your chest, abdomen, and pelvic area and a chest x-ray.

Benefits of Ovarian Cancer Treatment and Surgery:

Treatment can be given for different reasons and the potential benefits will vary depending upon your individual situation. In people with early-stage ovarian cancer, surgery is often done with the aim of curing the cancer. You may also be given additional treatments to reduce the risk of it coming back. If the cancer is at a more advanced stage, the treatment may be able to control it, improving symptoms and quality of life.Following surgery, some patients may benefit from additional treatment with chemotherapy to further decrease the risk of cancer recurrence. Chemotherapy may be beneficial in some women with low-risk stage I ovarian cancer; however, because surgery cures more than 90 percent of patients, it is difficult to demonstrate additional benefit from chemotherapy treatment for all patients.Recent studies have resulted in recommendations that certain women will benefit from a combination of intravenous and intraperitoneal chemotherapy. A thorough discussion with your physician regarding this type of chemotherapy should include benefit versus risk, as well as side effects. Although side effects can be unpleasant, for most patients the benefits of treatment usually far outweigh the risks and discomforts. It is important to keep in mind that most patients receiving chemotherapy are able to enjoy an active and good quality of life.

Ovarian Cancer Treatment and Surgery in India:

Private, state-of-the-art hospitals in India creates a setting with many benefits for your ovarian cancer treatment, not only providing a ground-breaking approach to ovarian cancer treatment, but also including access to medical technology and diagnostic tools not readily available in less advanced treatment centers. The program of treatment will begin with an assessment by a multidisciplinary medical team. Indian doctors work with you to establish the parameters of your current medical condition and determine your course of treatment. Health care professionals in Indian Hospitals develop a personalized treatment plan tailored to your unique needs and diagnosis.

Ovarian cancer hospitals in India specialize in advanced, minimally invasive techniques that fight cancer while supporting your quality of life, both during and after treatment. Throughout your ovarian cancer treatment, Indian doctors use supportive therapies, like nutrition therapy and oncology rehabilitation, to help preserve more of your quality of life and reduce treatment-related side effects.

Cities in India that offers high quality Ovarian Cancer Surgery in India are;

Mumbai Hyderabad Kerala

Delhi Pune Goa

Bangalore Nagpur Jaipur

Chennai Gurgaon Chandigarh

Cost of Ovarian Cancer Treatment and Surgery in India:

India provides the same quality of medical care with similar technological solutions and a cost saving of over 50%. India leads the list of medical tourism destinations. The medical and health services range from executive health packages to complicated treatments like ovarian cancer surgery. Medical travelers come to low cost cheap medical tourism hub like India from Western nations to take advantage of the low cost of medical procedures, which are 40 to 80 percent lower in comparison to healthcare costs in their home countries. A cost comparison of various medical treatments can give you the exact idea about the difference:

Medical Treatment Procedure Cost (US$)

United States India

Radiation Therapy 15,000 3,000

Chemotherapy 22,000 4,000

Radical Hysterectomy 20,000 5,000

ABOUT INDIA

Located in South Asia, bordered by Pakistan, Nepal, China and Bangladesh, India is South Asia's largest, sovereign, democratic republic. India has an edge over other countries when it comes to offering comprehensive, cost-effective and timely medical care: it also offers an exotic, adventure-filled or cultural -if you wish array of destinations to discover and revel in for the travelers. Indian cities like Mumbai, Hyderabad, Goa, Bangalore, Nagpur, Kerala, Delhi, Pune, Jaipur, Chennai, Gurgaon, and Chandigarh offers best medical tourism service.

Mumbai - Formerly known as Bombay, is the commercial & financial capital city of India. Mumbai is famous for many things, including its thriving Bollywood film industry, teeming bazaars, colonial-style buildings, Art Deco structures and a superb choice of restaurants, often being rated as the dining capital of India. The tourist district of Colaba in Mumbai is a great place to start exploring this great city.

Hyderabad – Hyderabad city is a great place to visit in the state of Andhra Pradesh. The place has witnessed a continuous growth for last many years. Hyderabad has become a tourist hotspot following ever increasing number of tourists during past few years. Hyderabad has a well-founded reputation as one of the safest cities in the world.

Goa - The country's smallest state and famed for its colonial Portuguese and Catholic past, most tourists visit Goa for its endless selection of sandy beaches and coastal attractions. Standing proudly next to the Arabian Sea, Goa is a particularly compact state and often feels like a large town, being easy to travel. Around Goa, tourists will soon realize that the state has much more to offer than simply stunning beaches, fishing, water scooters, windsurfing and scuba diving.

Bangalore - Beauty lies in the eyes of beholder and if you want to see one of the most beautiful places in India then Bangalore is the word for it. Bangalore has earned sobriquets like 'Silicon Valley of India', 'Pub Capital of India', and 'City of Gardens'. Pleasant climate with colorful gardens with lakes and glittering nightlife, Bangalore has made its own attraction for travelers as one of the most charming cities in India,

Nagpur - Nagpur is the largest city in central India, but with its friendly atmosphere and dependable transportation, you’ll instantly feel at home. The city of Nagpur has a well-built infrastructure, is a clean and affluent city which makes a good jumping-off point for a series of trips into the far eastern corner of Maharashtra.

Kerala - Natural beauty, clean air and primordial greenery amidst the vast expanse of water and sky, typifies the state of Kerala – better known as God's own country. Kerala is famous for its alternative medical therapies such as Ayurveda, which help to rejuvenate and revitalize the body. The region is also home to India’s only virgin tropical rain forest – the Silent Valley National Park, supporting an overwhelming range of life forms, many of which are highly endangered, and endemic to this part of the planet.

Delhi - "Welcome to The Capital City of India - New Delhi" Delhi is famous as Capital city of India is located in North India. Delhi is truly a symbol of the old and the new; a blend of ancient well preserved monuments and temples along with jam-packed burger joints and up market shopping malls. Delhi has state of the art Hospitals and the best qualified doctors.

Pune - Once referred to as the Oxford of the east, Pune continues to be a stronghold for academics and culture. An array of factors like availability of efficient and experienced doctors, comparatively low treatment costs, hospital facilities of international standards and many more have made Pune one of the top destinations for medical tourism.

Jaipur - Jaipur is one of the most popular destinations on a tourist's itinerary. The magnificent forts, beautiful havelis and colourful bazaars make Jaipur a popular tourist destination among tourists. Jaipur has pioneered health and medical tourism in India.

Chennai - Chennai is one of the most developed urban centers in the Indian subcontinent. The city forms the capital of Tamil Nadu state and is the fourth largest metropolitan city in India. They have some of the very best hospitals and treatment centers in the world. Each hospital is equipped with state of the art facilities. The technology brought into practice is the very latest, including robotic surgery.

Patients Testimonial:

Robinson – Nigeria Ovarian Cancer Surgery for his Mother in India

I am Robinson from Nigeria. I came for my mother’s ovarian cancer surgery in India through Forerunners Healthcare Consultants. My mother was struggling with cancer from 2 years. We had a lot of treatment and medications done in Nigeria for her ovarian caner but it was proving to be just temporary. Nigeria lacks good infrastructure and this can be the main reason for not getting good treatment for my mother’s ovarian cancer surgery.

Then I started searching abroad for an easy alternative. Then my friend referred me Forerunners Healthcare Consultants in India. My friend had his treatment done through the same company, and he told me that he got the best medical facilities and services in India through Forerunners Healthcare Consultants.

I submitted the reports of my mother over the website and gave all the details of my mother. And I was happy to see the fast reply from Forerunners Healthcare Consultants with a detailed message about ovarian cancer surgery in India. I had a brief discussion with Doctor about ovarian cancer surgery India for my mother. We completed all the queries for the ovarian cancer surgery in India. We received a visa invitation for me and my mother to visit India for the ovarian cancer surgery in India for my mother. We got our visa and tickets for India and we were in India after a week.

My mother got the best medical and surgical facilities in India for her ovarian cancer surgery in India. The hospital was very nice with the best and the five star facilities. The staff of the hospital was very nice and helping. And after the ovarian cancer surgery she was feeling more energetic and she never experienced any kind of discomfort due to the pain. I am grateful to the whole team of Forerunners Healthcare Consultants for their help and support for my mother’s ovarian cancer surgery in India.

Knee Replacement Surgery in India

Knee replacement surgery also known as knee arthroplasty is procedure to replace the weight-bearing surfaces of the knee joint to relieve the pain and disability of osteoarthritis. It may be performed for other knee diseases such as rheumatoid arthritis and psoriatic arthritis. The procedure has been proven to help individuals return back to moderately challenging activities such as golf, bicycling, and swimming. Total knees are not designed for jogging, or sports like tennis and skiing (although there certainly are people with total knee replacements that participate in such sports). Knee replacement is a routine surgery performed on over 600,000 people worldwide each year. Over 90% of people who have had Total Knee Replacement experience an improvement in knee pain and function.

Knee Replacement Surgery Candidates A person would be considered a candidate for knee replacement if there is:

• Daily pain • The pain is severe enough to restrict work, recreation and ordinary activities of daily living

• Significant stiffness in the knee

• Significant instability (constant giving way) of the knee • Significant deformity (knock-knees or bow-legs) that hinders normal function of the knee

• Damage from arthritic conditions, such as osteoarthritis, rheumatoid arthritis or post-traumatic arthritis

Success Rate of Knee Replacement Surgery: Knee replacement surgery is recognized as a miracle of modern surgery. Most orthopedic experts consider replacement to be the best method of handling arthritis in the knee. Knee replacements have literally put hundreds of thousands of Americans back on their feet and allowed them to enjoy their golden years.

Knee Replacement Surgery Preparations:

• If you smoke, cut down or quit. Smoking changes blood flow patterns, delays healing and slows recovery.

• If you drink, don't have any alcohol for at least 48 hours before surgery.

• Ask your doctor for pre-surgical exercises. If you are having hip or knee replacement surgery, doing exercises to strengthen your upper body will help you cope with crutches or a walker after surgery.

• Your primary care physician or an internist will conduct a general medical evaluation several weeks before surgery. This examination will assess your health and your risk for anesthesia. The results of this examination should be forwarded to your orthopaedic surgeon, along with a surgical clearance.

• Shortly before your scheduled surgery, you will probably have an orthopedic examination to review the procedure and answer any last-minute questions.

• You may need to take several types of tests, including blood tests, a cardiogram, a urine sample and a chest X-ray. • Advice your surgeon of any medical conditions you have and of all the medications you are taking. You may need to

stop taking certain medications or your surgeon may recommend substitute medications until your surgery. Medications such as corticosteroids, insulin or anti-coagulants will need to be managed before and after surgery.