Ovarian Cancer Treatment in Hyderabad

Overview

Understanding Ovarian Cancer

Ovarian cancer is the most lethal gynaecological malignancy — largely because 70% of cases present at Stage III or IV, when the tumour has already spread to the peritoneum, omentum, and other abdominal organs. High-grade serous carcinoma (HGSC) is the most common and most aggressive subtype; low-grade serous, clear cell, endometrioid, and mucinous carcinomas behave differently and require tailored management.

The foundation of ovarian cancer treatment is complete surgical cytoreduction — removing all visible tumour deposits — followed by platinum-based chemotherapy. The landmark LION trial and subsequent data have firmly established that the surgical goal should be CC0 (complete cytoreduction, zero residual disease). Each millimetre of residual disease reduces survival. This requires a surgeon who can perform the full scope of abdominal surgery: bowel resection, splenectomy, diaphragm resection, liver surface resection, and peritonectomy.

The OVHIPEC-1 trial demonstrated a 3.5-month improvement in overall survival with the addition of HIPEC to interval cytoreductive surgery — with no increase in serious adverse events. HIPEC is now incorporated into the treatment pathway for ovarian cancer at major centres worldwide, and I offer this in Hyderabad.

At a Glance

Most common subtype: High-grade serous carcinoma (HGSC)
Staging at presentation: Stage III–IV in 70% of patients
Primary treatment: Cytoreductive surgery + platinum/taxane chemotherapy
Role of HIPEC: Proven survival benefit at interval surgery (OVHIPEC-1)
BRCA mutations: Present in 15–20% — affects chemosensitivity and PARP inhibitor eligibility

Warning Signs

Symptoms of Ovarian Cancer

Ovarian cancer is often called “the silent killer” because early symptoms are vague — but they are not truly silent. Persistent symptoms should always prompt evaluation.

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Abdominal Bloating

Persistent bloating that is new, unexplained, and occurring more than 12 times per month.

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Difficulty Eating / Early Satiety

Feeling full quickly or unable to eat normally — a subtle but important warning sign.

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Pelvic or Abdominal Pain

Persistent lower abdominal or pelvic pain, particularly if new and unexplained.

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Urinary Urgency/Frequency

Needing to urinate more often or more urgently than normal without infection.

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Weight Loss or Gain

Unexpected changes in weight; abdominal enlargement from ascites.

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Post-Menopausal Bleeding

Any vaginal bleeding after menopause requires immediate investigation.

Our Approach

Surgical Treatment of Ovarian Cancer

Primary cytoreductive surgery (PCS) or interval cytoreductive surgery (ICS, after 3 cycles of neoadjuvant chemotherapy) are both valid approaches — the choice depends on the patient’s fitness and the likelihood of achieving CC0 at the first operation. I assess resectability using Fagotti laparoscopy score and radiological staging before recommending primary vs interval surgery.

The surgical procedure involves bilateral salpingo-oophorectomy, total hysterectomy, omentectomy, peritonectomy of involved surfaces, and resection of any organ segments bearing tumour — this may include sigmoid colectomy, splenectomy, diaphragm stripping, and partial liver resection. The goal is always CC0 — any visible residual disease worsens prognosis.

HIPEC (cisplatin-based) is administered immediately after achieving CC0, directly into the heated abdominal cavity for 90 minutes. For platinum-resistant recurrent ovarian cancer with peritoneal involvement, PIPAC offers a valuable minimally invasive treatment option repeated at 6-week intervals with low systemic toxicity.

Surgical Procedure
Ovarian Cancer Debulking + HIPEC

Complete cytoreductive surgery aiming for CC0 residual disease, combined with intraperitoneal HIPEC.

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Surgical Procedure
PIPAC for Recurrent Ovarian Cancer

Minimally invasive aerosol chemotherapy for platinum-resistant recurrent peritoneal disease.

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Why Choose Us

Expertise You Can Trust

Dr. Mohammed Imaduddin brings internationally trained surgical skills and a patient-first philosophy to every case.

500+
Complex Oncological Surgeries Performed
15+
Years in Surgical Oncology
3
International Training Centres (Hannover, Charité, AIIMS)
FACS
Fellow of the American College of Surgeons

Common Questions

Frequently Asked Questions

Answers to the most important questions I receive from ovarian cancer patients.

What does “complete cytoreduction” mean for ovarian cancer?
“Complete cytoreduction” means removing all visible tumour so that no residual disease remains — termed CC0. CC1 means residual nodules ≤ 2.5 mm, CC2 means residual up to 2.5 cm. Every study confirms that CC0 provides the best survival. To achieve CC0, the surgeon must be willing to perform whatever organ resection is needed — bowel, spleen, diaphragm — not just remove the ovaries and uterus. This is why referral to a high-volume specialist centre matters.
Should I have surgery first or chemotherapy first?
Both are valid pathways. Primary surgery is preferred if CC0 can be achieved safely at the outset. Neoadjuvant chemotherapy (NACT) followed by interval surgery is preferred when primary CC0 is unlikely, when the patient is not fit for major surgery upfront, or when BRCA mutation status is still pending. The CHORUS and EORTC 55971 trials showed equivalent survival between the two pathways when CC0 was achieved. The key is CC0 — not which pathway gets you there.
What is HIPEC and does it help ovarian cancer?
HIPEC (hyperthermic intraperitoneal chemotherapy) involves circulating heated cisplatin directly in the abdominal cavity for 90 minutes immediately after cytoreductive surgery. The heat enhances drug penetration and overcomes platinum resistance. The OVHIPEC-1 randomised trial (van Driel et al., NEJM 2018) showed that HIPEC added to interval cytoreductive surgery improved median overall survival by 3.5 months (45.7 vs 33.9 months) with no increase in serious complications. HIPEC is now recommended in national guidelines in the Netherlands and several European countries.
What happens if ovarian cancer recurs?
Recurrence after first-line treatment is unfortunately common in advanced ovarian cancer. Management depends on the platinum-free interval: platinum-sensitive recurrence (>6 months) responds well to re-treatment with platinum chemotherapy; platinum-resistant recurrence (<6 months) is more challenging. Surgical re-debulking at recurrence (secondary CRS) can benefit selected patients. For peritoneal recurrence, PIPAC offers a low-toxicity option. PARP inhibitors (olaparib, niraparib) as maintenance therapy have significantly improved progression-free survival, especially in BRCA-mutated patients.
Should I be tested for BRCA mutations?
Yes — all patients with ovarian cancer (especially high-grade serous histology) should have germline BRCA1/2 testing regardless of family history. BRCA mutations are found in 15–20% of HGSC. A positive result has two important implications: first, it predicts better response to platinum chemotherapy and eligibility for PARP inhibitor maintenance; second, it identifies at-risk family members who can then undergo genetic counselling and risk-reduction surgery.

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Every cancer journey is different. I offer a detailed, unhurried consultation to help you understand your options and make informed decisions.

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