Treatments for Autoimmune oophoritis
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Ovarian cancer:
Treatment
(Professional Guide to Diseases (Eighth Edition))
According to the staging of the disease and the patient's age, treatment of ovarian cancer requires varying combinations of surgery, chemotherapy and, in some cases, radiation.
Occasionally, in girls or young women with a unilateral encapsulated tumor who wish to maintain fertility, the following conservative approach may be appropriate:
❑resection of the involved ovary
❑biopsies of the omentum and the uninvolved ovary
❑peritoneal washings for cytologic examination of pelvic fluid
❑careful follow-up, including periodic chest X-rays to rule out lung metastasis.
Ovarian cancer usually requires more aggressive treatment, including total abdominal hysterectomy and bilateral salpingo-oophorectomy with tumor resection, omentectomy, appendectomy, lymph node biopsies with lymphadenectomy, tissue biopsies, and peritoneal washings. Complete tumor resection is impossible if the tumor has matted around other organs or if it involves organs that can't be resected. Bilateral salpingo-oophorectomy in a prepubertal girl necessitates hormone replacement therapy, beginning at puberty, to induce the development of secondary sex characteristics.
Chemotherapy extends survival time in most ovarian cancer patients, but it's largely palliative in advanced disease. However, prolonged remissions are being achieved in some patients.
Chemotherapeutic drugs useful in ovarian cancer include carboplatin, docetaxel, cyclophosphamide, doxorubicin, paclitaxel, cisplatin, and topotecan. These drugs are usually given in combination and they may be administered intraperitoneally.
Radiation therapy generally isn't used for ovarian cancer because the resulting myelosuppression would limit the effectiveness of chemotherapy.
Radioisotopes have been used as adjuvant therapy, but they cause small-bowel obstructions and stenosis.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Ovarian cysts:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Follicular cysts generally don’t require treatment because they tend to disappear spontaneously within 60 days. However, if they interfere with daily activities, clomiphene citrate by mouth for 5 days or progesterone I.M. (also for 5 days) re-establishes the ovarian hormonal cycle and induces ovulation. Hormonal contraceptives haven’t been proven to accelerate involution of functional cysts (including both types of lutein cysts and follicular cysts).
Treatment for granulosa-lutein cysts that occur during pregnancy is aimed at relieving symptoms because these cysts diminish during the third trimester and rarely require surgery. Theca-lutein cysts disappear spontaneously after elimination of the hydatidiform mole, destruction of choriocarcinoma, or discontinuation of hCG or clomiphene citrate therapy.
Treatment of polycystic ovarian disease may include the administration of such drugs as clomiphene citrate to induce ovulation, medroxyprogesterone acetate for 10 days of every month for the patient who doesn’t want to become pregnant, or low-dose hormonal contraceptives for the patient who needs reliable contraception.
Surgery, in the form of laparoscopy or exploratory laparotomy with possible ovarian cystectomy or oophorectomy, may become necessary if an ovarian cyst is found to be persistent or suspicious.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Ovarian cancer:
Treatment
(Handbook of Diseases)
Depending on the stage of the disease and the patient’s age, treatment of ovarian cancer requires varying combinations of surgery, chemotherapy and, in some cases, radiation. Cytoreductive surgery, in which the tumor nodules are reduced to as small a size as possible, may increase survival time.
Conservative treatment
Occasionally, in girls or young women with a unilateral encapsulated tumor who wish to maintain fertility, the following conservative approach may be appropriate:
❑ resection of the involved ovary
❑ biopsies of the omentum and the uninvolved ovary
❑ peritoneal washings for cytologic examination of pelvic fluid
❑ careful follow-up, including periodic chest X-rays to rule out lung metastasis.
Aggressive treatment
Ovarian cancer usually requires more aggressive treatment, including total abdominal hysterectomy and bilateral salpingo-oophorectomy with tumor resection, omentectomy, appendectomy, lymph node biopsies with lymphadenectomy, tissue biopsies, and peritoneal washings.
Complete tumor resection is impossible if the tumor has matted around other organs or if it involves organs that can’t be resected. Bilateral salpingo-oophorectomy in a prepubertal girl necessitates hormone replacement therapy, beginning at puberty, to induce the development of secondary sex characteristics.
Chemotherapy extends survival time in most ovarian cancer patients. Unfortunately, it’s largely palliative in advanced disease, but some patients are achieving prolonged remissions and even cures.
Chemotherapeutic drugs may be used alone; however, they’re usually given in combination. They may be administered intraperitoneally. The preferred first-line regimen is paclitaxel and cisplatin (or carboplatin).
Radiation therapy is generally not used for ovarian cancer because the resulting myelosuppression would limit the effectiveness of chemotherapy. It also has limited efficacy.
Other treatments
Radioisotopes have been used as adjuvant therapy, but they cause small-bowel obstructions and stenosis.
In addition, I.V. administration of biological response modifiers — interleukin-2, interferon, and monoclonal antibodies — may be attempted.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Ovarian cysts:
Treatment
(Handbook of Diseases)
The type of cyst dictates the treatment method.
Follicular cysts
Follicular cysts generally don’t require treatment because they tend to disappear spontaneously within 60 days. Although hormonal treatment (such as birth control pills) is frequently prescribed, no evidence exists that it has any effect on treatment or prevention of functional ovarian cyst.
Granulosa-lutein and
theca-lutein cysts
If granulosa-lutein cysts occur during pregnancy, treatment is symptomatic because they diminish during the third trimester and rarely require surgery. Theca-lutein cysts disappear spontaneously after elimination of the hydatidiform mole, destruction of choriocarcinoma, or discontinuation of HCG or clomiphene citrate therapy.
Polycystic ovarian disease
Treatment of polycystic ovarian disease may include the administration of such drugs as clomiphene citrate to induce ovulation, medroxyprogesterone acetate for 10 days of every month for the patient who doesn’t want to become pregnant, or a low-dose hormonal contraceptive for the patient who needs reliable contraception.
Surgery, in the form of laparoscopy or exploratory laparotomy with possible ovarian cystectomy or oophorectomy, may become necessary if an ovarian cyst is found to be persistent or suspicious.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Chronic fatigue and immune dysfunction syndrome:
Treatment
(Handbook of Diseases)
Treatment is aimed at the cause, if one can be found. Supportive therapy includes an anti-inflammatory, an antihistamine, and rest.
Treatment of symptoms may include a tricyclic antidepressant (doxepin), a histamine2-blocker (cimetidine), and an anxiolytic (alprazolam). In some patients, avoidance of environmental irritants and certain foods may help to relieve symptoms.
Experimental treatments include the antiviral acyclovir and selected immunomodulators, such as I.V. gamma globulin, ampligen, and transfer factor.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
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