Therapy of stromal tumors
If the tumor is still very small and the woman still wishes to have children, it is possible to remove only the ovary affected by the tumor with the corresponding fallopian tube. However, when family planning is complete, or if the tumor is large, a radical operation is performed as with epithelial tumors (see above). Subsequently, stromal tumors are irradiated with high-dose X-rays, as they are sensitive to radiation. If the stromal tumor does not respond to radiation therapy, an attempt to reduce the tumor can be made with chemotherapy.
Therapy of germ cell tumors
If the tumor is restricted to one ovary, the ovary and the fallopian tube on the affected side are usually removed (adenectomy). Subsequently, chemotherapy with the chemotherapeutic agents etopside, bleoycin and cisplatin is performed. Since dysgerminomas, unlike other germ cell tumors, are radiation-sensitive, they are irradiated postoperatively with 30-40 Gy.
Consequence of the therapy
Every operation, chemo- and radiotherapy naturally involves side effects and consequences. In the following, however, only some of them will be discussed. If the ovaries are removed in younger women beyond the menopause (climacteric), the sex hormones produced in the ovaries are missing.
This can lead to premature menopausal symptoms with outbreaks of sweating and hot flushes, mood swings and depression as well as sleep disorders. In these patients, the sex hormones can be replaced (substituted) by taking medication and these symptoms can be prevented. If both ovaries are also removed, a natural pregnancy is ruled out, which can be particularly dramatic for younger women.
As a “compromise”, egg cells can be frozen before the start of therapy and, if you wish to have a child, they can be artificially fertilized. In this way, it may be possible to become a mother despite removal of the ovaries. The use of chemotherapy can also lead to further symptoms.
The chemotherapeutic agents have a particular effect on rapidly dividing cells. These are usually the cancer cells, but also intestinal, hair and blood cells. The chemotherapeutic drugs therefore also irritate and partially destroy the other healthy cells. This can manifest itself in disturbances of the intestinal function with vomiting and diarrhea, in hair loss, increased susceptibility to infections and anaemia.
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