Ovarian Cancer Treatment Cost in India

Discover cost-effective and high-quality ovarian cancer treatment in India. Dr. Aditi Bhatt’s recent article provides essential insights into cytoreductive surgery for advanced ovarian cancer. India offers world-class medical facilities and expert oncologists at a fraction of the cost compared to many Western countries, making it a top destination for international patients seeking affordable yet top-notch care. Explore your treatment options and learn more about how India can be the solution you’ve been looking for in the battle against ovarian cancer. Visit the article to get a comprehensive understanding of what patients and caregivers should know about this life-saving procedure and its associated costs.

Ovarian cancer is usually diagnosed in an advanced stage when the cancer has spread to the whole abdominal cavity. Ovarian cancer has a propensity to spread to the inner lining of the abdominal cavity, call the peritoneum. 75% or more of the patients will have widespread involvement of the peritoneum (termed as stage 3) and few of these will have simultaneous involvement of the chest cavity as well (termed as stage 4). The standard treatment of advanced ovarian cancer comprises of surgery (to completely remove the tumor) and chemotherapy (6 courses of chemotherapy for majority of the patients).

The surgery that is performed to remove the tumor from the abdominal cavity or peritoneum is called ‘cytoreductive surgery’. Cytoreductive surgery involves removal of the peritoneum bearing the tumor (known as peritonectomy) and resection of any of the organs that are involved by the tumor. The uterus with both ovaries and fallopian tubes are removed for all patients with advanced ovarian cancer. In addition, segments of the large intestine, small intestine, the gall bladder and the spleen may be removed if required.

The main goal of the surgery is to leave behind no visible tumor. At the same time, surgery should have no long-term consequences on the patien’s day-to-day life enabling her to lead a normal life once the recovery period after surgery is over.

Some patients with very extensive disease that cannot be removed completely, are given few courses of chemotherapy first to shrink the tumor and surgery if performed after that.

What are the challenges for a surgeon performing this surgery?

The surgeon had to be well-versed in performing surgery in all parts of the abdominal cavity. The abdominal cavity is thoroughly examined for the presence of tumor nodules which could be present in any part of the cavity. Then surgery is performed to remove these tumors. Some parts of cytoreductive surgery can be technically challenging for any surgeon like dealing with the areas around the liver, removing the tumor from the diaphragm (the muscle that lies between the abdominal cavity and the chest cavity) and from around the stomach and intestines. Surgeons specializing in this surgery are able to remove the tumor completely in more than 90% of the patients. This is important because any tumor that is left behind, will lead to recurrence of the cancer in future.

Another reason why surgery for ovarian cancer is challenging is that a lot of tumor nodules are too tiny to be picked up on the CT scan or PET scan or MRI that is performed before the surgery. Thus, there is always more disease seen during surgery than what is expected from the scans. The surgeon’s challenge is to be sure before going in for surgery that the tumor can be removed completely. A laparoscopy may be performed prior to cytoreductive surgery to determine the exact extent of disease and the feasibility of removing the tumor completely.

Is cytoreductive surgery different from other abdominal cancer surgeries?

Cytoreductive surgery could take between 4-8 hours depending on the extent of disease and the experience of the surgeon. In most cases, the first 1-2 days are spent in the intensive care unit (ICU) and the patient stays in the hospital for 8-14 days, depending on the complexity of the surgery and the patient’s own general health before the surgery, age and other chronic illnesses and the distance of the patient’s residence from the hospital. For other major abdominal surgeries, the average duration is 2-4 hours and a hospital stay of 5-7 days. Many patients will not require to be in the intensive care unit (ICU) after surgery. While many of these surgeries can be performed by laparoscopy or using a surgical robot, the same cannot be done for cytoreductive surgery.

Major abdominal cancer surgeries involve only one region or organ system – for e.g., the liver or the colon or the rectum or the small intestine while multiple regions of the abdominal cavity are addressed during cytoreductive surgery and more than one organ may be removed.

Cytoreductive surgery is always performed by the open route (putting a big cut on the tummy) as there is a high risk of missing disease during laparoscopy and some procedures are not feasible by laparoscopy. Thus, cytoreductive surgery is more complex than the average abdominal cancer surgery, takes longer to perform and requires a longer stay in the intensive care unit and hospital both.

Not surprisingly, therefore, the cost of cytoreductive surgery for ovarian cancer is 20-40% more than that of average abdominal cancer surgeries. The cost could vary depending on how extensive the surgery is- more extensive surgery, requires more resource utilization both during the surgery and stay in the hospital which increases the cost. The hospital stay itself will be longer.

The same could be expected in terms of complications- the more complex the surgery, the greater the risk and occurrence of complications. Fortunately, this is something that could be worked on both before, during and after the surgery. There are specific measures to minimize the complications and make the recovery faster and smoother for the patient. There measures are taken both by the patient and the surgeons and other doctors and medical staff involved in the management of the patient.

One important thing to be borne in mind is that chemotherapy has to be started within 4-6 weeks of surgery. If the chemotherapy is delayed for more than 6-8 weeks after the surgery, the chances of recurrence or the cancer coming back are greatly increased.

Questions to ask before cytoreductive surgery

When you are considering cytoreductive surgery for ovarian cancer, it is helpful to discuss all the following issues with your surgical team-

• How extensive is the disease?
• Is it possible to remove the tumor completely?
• What will be the short and long-term consequences of the surgery?
• How long will it take in the hospital?
• What measures should be taken to fasten the recovery and minimize the complications?

Remember, there is a price to pay for everything-both in terms of the actual cost of surgery and the impact on the patient’s health. Some investments are heavy or tough but also lead to larger gains in terms of survival and preservation of quality of life.