What is the recurrence of ovarian cancer?

Recurrence of ovarian cancer may be caused by factors such as residual cancer cells, development of drug resistance, immune evasion, genetic mutations, incomplete treatment plans, etc. It can be controlled through secondary surgery, replacement of chemotherapy plans, targeted therapy, immunotherapy, hormonal treatment, etc.

1. Remaining cancer cells

Failure to completely remove microscopic lesions during surgery may lead to recurrence. Residual lesions are often caused by unclear tumor boundaries or occult metastasis, and may be accompanied by dull pelvic pain or abnormally elevated CA125 levels. Treatment needs to be combined with imaging evaluation followed by secondary tumor reduction surgery. After surgery, adjuvant chemotherapy can be combined with drugs such as paclitaxel injection, carboplatin injection, and bevacizumab injection.

2. Development of drug resistance

Decreased sensitivity to chemotherapy drugs is a common mechanism of recurrence. Tumor cells develop drug resistance through activation of drug efflux pumps or enhanced DNA repair, which is often manifested in the rebound of tumor markers during treatment. Second-line drugs such as topotecan capsules and gemcitabine injection can be used instead, or new dosage forms such as liposomal doxorubicin can be used to break through the resistance barrier.

3. Immune escape

The tumor microenvironment inhibits immune cell function and promotes recurrence. High expression of PD-L1 protein leads to T cell inactivation, which is common in patients with recurrent serous carcinoma. Immune checkpoint inhibitors such as pembrolizumab injection can relieve immune suppression, and adverse reactions such as abnormal thyroid function and liver function need to be monitored during medication.

4. Gene mutation

New mutations in genes such as BRCA1/2 drive tumor regrowth. Patients with hereditary ovarian cancer are at higher risk of recurrence, which may be accompanied by breast or peritoneal metastasis. PARP inhibitors such as olaparib tablets can target mutated cells through synthetic lethal effects, and genetic testing is required to confirm the mutation status before treatment.

5. The treatment plan is incomplete

Insufficient treatment cycles or insufficient dosage in the early stage lead to recurrence. Some patients reduce the dose without authorization due to poor tolerance, or fail to complete the standard chemotherapy course. Platinum drug sensitivity needs to be re-evaluated after recurrence. When using drugs such as nedaplatin injection, it is recommended to adjust the dose through blood concentration monitoring.

Patients with recurrent ovarian cancer should maintain a high-protein diet such as fish, eggs, and milk, and supplement with appropriate amounts of cruciferous vegetables such as broccoli. Moderately perform low-intensity exercise such as yoga to improve lymphatic drainage, and regularly detect CA125 and HE4 indicators. Keep the perineum clean during treatment and avoid bathing in the bath to prevent infection. Psychological counseling can help relieve treatment anxiety, and you can participate in professional mutual aid groups for cancer patients.