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Bowel Obstruction in End-Stage Ovarian Cancer

written by: DulceCorazon • edited by: Leigh A. Zaykoski • updated: 8/18/2010

Bowel obstruction is one symptom of end stage ovarian cancer. At this point ovarian cancer has already metastasized to other areas of the body, including the peritoneal cavity.

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    Ovarian cancer is among the common and malignancies in women. If diagnosed early, it is treatable. However, most women manifest the symptoms at the later stage of the cancer. Hence, the prognosis has become poorer and causes the untimely death of many. The exact cause of ovarian cancer is unknown but the risks that increase the development of cancer have been identified.

    If a woman is manifesting symptoms of ovarian cancer, her gynecologist will require her to have a surgery. The surgical procedures help identify the stage of malignancy the woman has. The different stages of ovarian cancer are defined in accordance with the classification devised by the International Federation of Gynecology and Obstetricians or FIGO in conformity with the classification made by TNM.

    Stage 0 - The primary tumor cannot be established

    Stage I - The primary tumor is limited to one or two ovaries. It is further divided into IA, IB and IC depending on the extent of the tumor.

    Stage II - either one or two of the ovaries has tumor plus pelvic extension. It is divided into 3 categories: IIA, IIB and IIC dependent to the extension of the malignancy.

    Stage III - there is tumor in either one or both ovaries with metastasis outside the pelvic area and lymph nodes. It is further divided into IIIA, IIIB and IIIC depending on the size of the tumor growth in areas outside the peritoneal area.

    Stage IV – the tumor has metastasized outside the peritoneal cavity.

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    Symptoms

    There are many symptoms manifested by a woman who is in the end-stage ovarian cancer because the cancer has already spread outside the confinements of the peritoneal cavity. The two major symptoms manifested by end stage ovarian cancer patients are ascites and bowel obstruction. Ascites is the abnormal fluid buildup in the abdomen resulting to abdominal swelling, pain, shortness of breath, vomiting and anorexia.

    Bowel obstruction is the formation of adhesions in either the small or large intestine. The symptoms of small bowel obstruction are cramping abdominal pain that worsen around the umbilical area, passing out green vomitus and bloating. For complete blockage, the patient will have the inability to pass out gas and constipation, while in partial blockage, the patient will have diarrhea and may be able to pass some gas. For large bowel obstruction, symptoms are pain below the umbilical area, generalized abdominal bloating, blood in the stool, weakness, lack of appetite and weight loss.

    Management

    Management of cancer differs in every patient. It is because each one reacts to treatment differently depending on their general health condition. If the medical condition allows the patient to undergo surgery, she is usually recommended to undergo surgical laparotomy with cytoreduction and receive chemotherapy as an adjuvant treatment.

    Bowel obstruction plays an important factor in the quality of life and length of survival of the patient. Hence treatment for bowel obstruction is often planned carefully. In terminally ill individuals medications given are:

    • Analgesics to alleviate pain
    • Anti-emetics to prevent frequent vomiting
    • Anti-cholinergic drug to slow down the peristaltic movements of the digestive tract
    • Corticosteroids to reduce edema and swelling
    • Fluids to prevent electrolyte imbalance and dehydration.
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    References

    Womens Cancer: Ovary

    Figo.org: Staging Classifications and Clinical Practice