During the epidemic, how do patients with ovarian cancer arrange treatment?

The treatment of ovarian cancer is mainly combined with surgery (chemotherapy and targeted drugs), and the treatment period is long. It requires multiple repeated visits to the patient. Regardless of surgery or drug treatment, it has a certain degree of impact on the patient’s immune system. Therefore, during the epidemic, the diagnosis and treatment of ovarian cancer patients need to be adjusted accordingly. According to the characteristics of ovarian cancer patients themselves and the process of diagnosis and treatment, the following recommendations are made for the diagnosis and treatment of ovarian cancer patients and their families during the epidemic period.

How to arrange treatment during an outbreak

Initially treated patients:

Ovarian cancer has a larger surgical range and trauma, and it is more likely to be transfused during and after surgery. In addition, the patient’s own resistance decreases after surgery, and it is easy to cause secondary infection. Therefore, it is recommended that patients postpone surgery, and neoadjuvant chemotherapy may be considered under the premise of a clear diagnosis. For patients receiving adjuvant chemotherapy, chemotherapy can be performed as scheduled or with an appropriate extended interval. During the treatment process, you should discuss with the competent doctor possible adverse reactions such as bone marrow suppression and gastrointestinal reactions, and prevent the occurrence of adverse reactions as much as possible, for example, preventive injection of long-acting colony cell stimulating factor to reduce the risk of serious leukopenia At the same time, it can also reduce the frequency of going out to check the blood routine. If the patient has serious adverse reactions during chemotherapy, the interval between chemotherapy should be extended appropriately and the chemotherapy should be started after the adverse reactions recover.

Patients with relapse treatment:

When the patient relapses, the treatment plan and timing should be determined according to the specific situation. If the patient is only a tumor marker elevated, and the imaging examination does not indicate a lesion (biochemical recurrence), you can temporarily observe or oral progesterone such as megestrol. When the patient’s imaging or physical examination shows tumor lesions (clinical recurrence), comprehensive judgment can be made based on the patient’s tumor burden, clinical symptoms, and general conditions. If the patient’s condition needs to start chemotherapy as soon as possible, chemotherapy should be given after fully evaluating the risks associated with chemotherapy, and at the same time prevent adverse reactions such as bone marrow suppression.

If the patient has started chemotherapy and there are no obvious adverse reactions, chemotherapy can be scheduled. If the patient has serious adverse reactions in chemotherapy, the interval between chemotherapy should be extended appropriately and the chemotherapy should be started after the adverse reactions recover. Some patients who have undergone multiple cycles of chemotherapy in the past are generally in poor condition, have poor bone marrow function, or have relapsed drug resistance and poor efficacy of back-line treatment. Oral medications such as PARP inhibitors can continue to be used according to the treatment plan if there are no obvious adverse reactions. But should pay attention to monitoring blood routines, etc., the occurrence of leukopenia, anemia and thrombocytopenia should be actively dealt with, if necessary, suspend medication.

Patients who are followed up during the treatment interval:

If there is no obvious discomfort during the follow-up after the treatment, the patient can communicate with the competent doctor to extend the follow-up interval appropriately. If the patient only needs blood test routines, liver and kidney function and other items, it can be checked at a nearby medical institution and other people with less flow. If you have obvious symptoms such as bloating, you need to consider going to the hospital. You can make an appointment online and pay attention to wearing a mask and taking protective measures.

Patient diet and life advice

Do not go out or reduce going out; wear masks correctly in public places. Wash hands frequently and correctly. Strengthen exercise, work regularly, and maintain indoor air circulation. For patients with tumors with a weak body, they need to strengthen nutrition and enhance immunity.

Nutritional balance, scientific diet; adjust the diet according to the disease status, such as patients with oral mucosal inflammation and oral pain due to treatment, eat less irritating food, light diet. Combining work and rest, do some moderate exercise according to the physical condition; do a good job of self-condition monitoring, such as whether the existing symptoms are aggravated or new symptoms, adverse reactions of drug treatment, etc., and communicate closely with your own doctor.

Symptoms such as fever, fatigue, and coughing persist and persist, so you should go to a local fever clinic for investigation as soon as possible. Excluding fever patients with new coronavirus infection and leukopenia may be related to tumor treatment, and need to go to the hospital emergency department for further examination and treatment.

Under the epidemic situation, we must adjust the patient’s diagnosis and treatment according to the situation of the patient and the epidemic situation on the premise of grasping the treatment principles, and advocate online consultation and local hospital consultation to reduce unnecessary staff turnover. It is hoped that the majority of patients will eliminate anxiety, cooperate with the treatment, overcome the difficulties together and recover soon.