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Ovarian Cancer

Controlling the symptoms of advanced ovarian cancer

Surgery and chemotherapy aim to destroy the cancer or limit its growth (see 'Surgery' and 'Chemotherapy'). Alongside these treatments patients may also receive treatments to ease or relieve the symptoms. These treatments are not intended to cure or influence the course of the disease but can help maintain quality of life.

A common symptom is an uncomfortable swelling of the abdomen due to a build-up of fluid known as ascites. This fluid will be removed during any surgical operation, but two women we talked to had their ascites drained to relieve the pressure of the swelling while tests were being done to discover the cause of their illness and before any surgery was planned. This was done by inserting a fine tube through the muscle wall of the abdomen (using a local anaesthetic) and slowly draining off the fluid.

 

Had her ascitic fluid drained to relieve her discomfort while still having diagnostic tests.

Had her ascitic fluid drained to relieve her discomfort while still having diagnostic tests.

Age at interview: 62
Sex: Female
Age at diagnosis: 61
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He was very good because he could see I was in such distress with the ascites and he made a, found a bed for me that night and he came in that evening and did a paracentesis and I actually had six litres of fluid drained off me. Six litres of fluid, which appeared to have been invisible to various other people. I felt a lot thinner afterwards but I didn't really feel, I thought I would feel better but I didn't, I felt really battered and ill.

A woman who became tired and breathless during chemotherapy was told this was due to a pulmonary embolism (a blood clot in an artery that supplies the lungs), which occurs more commonly in cancer patients. This was successfully treated with the anti-clotting drug warfarin.

Sometimes an ovarian cancer presses on one or both ureters which carry the urine from the kidneys to the bladder and block the flow. A woman described having a tube inserted to drain the urine from her kidney into a bag strapped to her leg.

 

Had a tube inserted to drain urine from an obstructed kidney to a bag strapped to her leg.

Had a tube inserted to drain urine from an obstructed kidney to a bag strapped to her leg.

Age at interview: 53
Sex: Female
Age at diagnosis: 52
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And when I had an ultrasound at the beginning of February they found that my left kidney wasn't draining, and so basically all of the chemotherapy that was going into my system - anything going into my system - wasn't draining, it was just sitting there in pockets, and so they halted the chemotherapy after two sessions to try to resolve the kidney problem and they did two surgical attempts to put the stent through the ureter so there would be drainage into the bladder but both attempts were unsuccessful.

I was kind of awake during the surgery and it was kind of like they hit a brick wall, the doctor described it as scar tissue but I'm not sure that that's what it is and I don't know if they know what it is, so in the meantime I've had to kind of adjust to having a cable, an open wound in my back and a leg-bag that drains everything from that kidney and that's kind of been, is probably as equal and traumatic as definitely going through chemotherapy.

Pressure from the cancer can also block the intestine. In some cases blockages were successfully cleared with enemas, but one woman who had repeated blockages eventually had an operation to remove the affected part of her bowel, which reduced her appetite and her digestion.

 

Had a bowel blockage cleared using an enema.

Had a bowel blockage cleared using an enema.

Age at interview: 57
Sex: Female
Age at diagnosis: 56
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I had a blockage at one point, which was pretty scary. Woke up one morning feeling okay, had breakfast and then about an hour later started to get bad pain, really bad pain, lay down for a while and you know when you're going to be sick, and so without being too graphic, I vomited for about an hour and then rang the nurses, somebody rang the nurses and they said 'well you must come in and bring an overnight bag because, just in case'. I got hold of my daughter, who immediately rushed round, and it was awful for her to see me like that, but anyway, she took me in and I was still vomiting in her car. 

The pain was quite horrible, they gave me something for the pain and it didn't have any effect, then I had to have an x-ray, is it an x-ray or a scan? Well I don't remember much about the day because the stuff they were giving me, that was all a bit of a blur as well, and but they kept me in for a couple of nights because I had a blockage and I was supposed to pass it and I had all this purge stuff which didn't work, they couldn't believe it, and finally had a couple of enemas and somehow we got rid of the blockage
 

Had several bowel blockages and eventually had an operation to remove the affected piece of bowel.

Had several bowel blockages and eventually had an operation to remove the affected piece of bowel.

Age at interview: 63
Sex: Female
Age at diagnosis: 52
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Then at the end of August 2000 I had yet another bowel blockage and was taken into hospital as an emergency and the bowel was rested again. Each time I started gently on solid food the thing would happen again. I also had various tests to see if there was anything in my bowel or in my stomach, which I found very trying. In fact the last lot made me so ill that I thought that the sedatives or whatever they had given me must have caused that. 

But I think the people at the cancer hospital then decided that things had gone far enough and that I should have a bowel bypass operation. And that was a great shock because for the last 2 years before that when I'd gone for clinics and so on they'd mentioned about this operation and they'd present it, it as something extremely life-threatening which they definitely didn't want to do. So it was a sudden shock to find that it was going to happen in a few days time. But I suppose I was in a life-threatening position anyhow at that stage so they felt that the risk was worth it.

Chemotherapy damages normal blood cells causing some patients to become anaemic, but some women became anaemic for other reasons. One woman received regular blood transfusions; another had had a bad experience with a blood transfusion so was given drug treatment to boost her red blood cells.

 

Had regular blood transfusions for her anaemia.

Had regular blood transfusions for her anaemia.

Age at interview: 63
Sex: Female
Age at diagnosis: 52
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And why do you need the transfusions now?

Well we think that it's the tumour that's bleeding and in fact it's, in a way, encouraging that it isn't happening as often as it did before, that I'm still not back to that stage that I was last year before I had the Taxol treatment, 'cos at that, at that point, no, before I had the bypass I was having to have it every 4-5 weeks, which was pretty frequent, and now I'm having it sort of 9, at 9 week intervals, something like that.

And as measured yesterday, again it, the haemoglobin wasn't terribly low. The first time we were actually on holiday and I don't know how I somehow got around. My husband didn't want me to go to clinic because he didn't want the holiday to be cancelled, but when I got back the oncologist took one look at me and he said 'You look awfully pale'. It got down to 6.5 whereas a normal reading is 10 plus, and I sort of felt peculiar and I thought 'Well maybe this is how it's going to be from now on in' not realising that it was, you know, acute anaemia.  

A couple of women we talked to developed pleural effusions (a build-up of fluid around the lungs), which causes breathlessness and chest pain. This was initially treated by draining the fluid through a small tube attached to a syringe. When the problem recurred, a drug that sticks together the membranes lining the cavity was injected via the drainage tube, so preventing fluid from building up there. One of the women needed this done on her other lung too, and also, unusually, fluid draining from the cavity around the heart (pericardial effusion). Unfortunately that caused her heart to stop, but it was soon restarted.

 

Describes the treatment she had for pleural effusions that made her breathless.

Describes the treatment she had for pleural effusions that made her breathless.

Age at interview: 61
Sex: Female
Age at diagnosis: 58
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It was pleural effusions I had and they drain a certain amount and when they decide they're empty they take the drain out. But my pleura was filling up again all the time, and even the morning I came out of hospital they took the drains out that day. But what they did is they filled my pleura this last time with tetracycline, which is a sticky antibiotic, and they said it does tend to stick the pleura together to stop it filling up. But I don't think it's something they do very often because when I asked how long it would last nobody could tell me. And from that day I came out of hospital, touch wood, to this day, it's never happened again.  

 

Describes the second treatment she had for pleural effusions, and fluid round the heart, which...

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Describes the second treatment she had for pleural effusions, and fluid round the heart, which...

Age at interview: 62
Sex: Female
Age at diagnosis: 60
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What had happened was that the fluid had built up again very suddenly. It was not only collapsing the lung, which was causing the breathlessness again, but the fluid had also built up around the heart. I think it must have been the pressure of all that on the diaphragm that was stopping me from eating.  

Anyway they rushed me across to another hospital to operate on the left lung and created also a pericardial window. Apparently around the heart there is a sac which had also filled with the fluid. The operation was pretty dramatic because when the surgeon cut into the sac, apparently it went off like a geyser and the heart arrested. Fortunately I've a strong heart so they got it going again quickly. The surgeon told me afterwards, which was a bit frightening, 'If I hadn't operated on you last night, you would have been dead in twenty-four hours'.

Some people with cancer get pain. The causes of cancer pain are now well understood and it can be effectively controlled. One woman whose cancer recurred, and did not respond well to chemotherapy, talked about having recently been prescribed morphine for her pain.

 

She had recently been put on morphine to control her pain.

She had recently been put on morphine to control her pain.

Age at interview: 57
Sex: Female
Age at diagnosis: 52
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And in fact a few days ago I had to go onto the ward, I was captured by the oncologist, she wouldn't let me go home because I was in denial about the pain that I was in. And so I was taken on the ward for several days and I've started on a regime of morphine. So with this regime of morphine comes a lot of mental pictures because people immediately think 'right, you're on morphine you must be getting nearer to the end', I mean although it's just being used as a pain control it's obvious from the nurses reaction that that's how they are treating me. 


 

Last reviewed June 2016.


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