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Ovacome is a national charity providing support to anyone affected by ovarian cancer. We give information about symptoms, diagnosis, treatments and research. Ovacome runs a telephone and email support line and works to raise awareness and give a voice to all those affected by ovarian cancer.

This fact sheet explains what clear cell carcinoma is and how it is treated.

There is a glossary with this fact sheet, to explain words you may not be familiar with.

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What is clear cell carcinoma of the ovary?

Clear cell cancer of the ovary is an uncommon type of epithelial ovarian cancer. It accounts for three to five per cent (three to five in a hundred) of patients with ovarian cancer in the western world and 20 per cent (one in five) in the Far East.

It is likely that the cause of clear cell cancer is different from the more common type of ovarian cancer, serous epithelial ovarian cancer.  The CA 125 tumour marker is not always raised in clear cell cancers, so it may be less reliable.

The prognosis for those with clear cell cancer is greatly influenced by the stage of the disease.

Clear cell cancer may also occur more commonly in those with a history of endometriosis.

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How is it treated?

The first treatment is the same as for the common form of epithelial ovarian cancer – a total abdominal hysterectomy and bilateral salpingo-oophorectomy.and omentectomy (removal of the ovaries, fallopian tubes, uterus (womb) and omentum). In some circumstances removal of the lymph glands in the pelvis and back of the abdomen may also be included.

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A diagram of the female reproductive system

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As well as removing the pelvic organs fluid will be collected from the abdomen for testing for any cancer cells. A pathologist will examine the tissue and fluid removed to decide how advanced the cancer is.

Some tumours are confined to the ovary and so will have a better prognosis; about 20 per cent (one in five) are stage 1. However, in some cases, tumours will have spread through the outer lining (capsule) of the ovary and to other organs including the uterus (womb), fallopian tubes, the lymph glands and the omentum.

Usually post-operative treatment involves chemotherapy (drug therapy). The standard chemotherapy for ovarian cancer is to use two drugs called carboplatin and paclitaxel (Taxol). There is research being carried out into whether other drugs may be as or more effective in treating clear cell cancers.

New research suggests that in some cases of clear cell cancer which is confined to the ovary, chemotherapy may be avoided. For this to be safe more thorough surgery would be required, including the removal of the pelvic and para-aortic lymph glands. These would need to be shown not to contain any cancer cells. If cancer is present, then chemotherapy would be essential.

Recent research from Canada suggests that radiation therapy is effective at protecting against recurrence. It also suggests that intra-peritoneal chemotherapy may be an effective treatment. This has not been accepted into routine clinical practice, but you could discuss it with your consultant.

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What about clinical trials?

Sometimes UK specialists are involved in clinical trials, comparing different types of chemotherapy. You may be invited to take part in a trial and your specialist will give you detailed information about this. Clinical trials are voluntary, so you only take part if you want to.

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What are the side effects of chemotherapy?

You are likely to be recommended to receive the two chemotherapy drugs carboplatin and paclitaxel (Taxol). These will be given as an intravenous infusion (through a drip) once every three weeks for up to six months.

You may experience side effects from the chemotherapy treatment. These might include feeling tired, nausea (feeling sick), hair loss and tingling in your fingertips and toes. Occasionally, you might get pain in your muscles and joints. You will normally take three to six weeks to recover from this.

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What happens after treatment finishes?

After your treatment, you will need to be carefully followed up by your specialist either in the gynaecology clinic or in the oncology clinic, or sometimes in a joint clinic where both your gynaecologist and your oncologist will be present.

You will normally be seen every three months during the first year, every four months during the second year if all is well, and every six months after that, usually up to five years after your treatment.

Your blood may be checked for a chemical protein called CA125, and you may be asked to have scans.

If you are feeling well and have no problems, after five years it is likely you will not have further follow-up care.

If you would like more information on the sources and references for this fact sheet, please call us on 0800 008 7054. 

If you would like to discuss anything about ovarian cancer, please phone our supportline on 0800 008 7054 Monday to Friday between 10am and 5pm.

You can also visit our website at www.ovacome.org.uk.

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Written by Dr Nicholas Reed,

Beatson Oncology Centre, Gartnavel General Hospital, Glasgow

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Disclaimer 

Ovacome fact sheets provide information and support.  We make every effort to ensure the accuracy and reliability of the information at the time of printing.  The information we give is not a substitute for professional medical care.  If you suspect you have cancer you should consult your doctor as quickly as possible.  Ovacome cannot accept liability for any inaccuracy in linked sources.

v.2

Date last updated May 2018

Date for review May 2020

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Glossary

 

Bilateral salpingo-oophorectomy

Removal of ovaries and fallopian tubes.

 

CA125

A protein found in the blood. The amount of CA125 will be higher in those with ovarian cancer.

 

Chemotherapy

Treating cancer with medication, such as cytotoxic drugs (that kill cancer cells).

 

Epithelial ovarian cancer

Ovarian cancer developing from cells covering or lining the ovaries. The most common type of ovarian cancer.

 

Intravenous infusion

How medication is given into the vein over a period of time using a drip.     

 

Lymph glands

Small pearl-like glands connected to the lymph system. They act as filters to bacteria and cancer cells.

 

Omentum

A sheet of fat in the abdomen which protects the intestines.

 

Para-aortic lymph nodes 

A group of lymph nodes that lie near the aorta in front of the lumbar vertebrae.    

 

Pathologist

A specialist who examines parts of the body affected by disease.

 

Post-operative treatment

Treatment after surgery. This is usually chemotherapy or drug therapy.

 

Prognosis

An assessment of how the disease is expected to behave.

 

Stage

Classification given to a cancer depending on how far it has spread. This can be done using x-rays, scans, blood tests or surgery.

 

Total abdominal hysterectomy

Surgically removing the uterus and cervix.

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Did you find this fact sheet helpful? We welcome your feedback. If you have any comments or suggestions, please email [email protected] or call 0207 299 6653.

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