Dubai resident ‘who always felt full after having few spoons of food’ diagnosed with stage 3 cancer

The exact cause of Salma’s cancer remains multifactorial, potentially involving family history and hormonal imbalances

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Angel Tesorero

Published: Tue 2 Jul 2024, 7:36 PM

Last updated: Tue 2 Jul 2024, 10:15 PM

After taking only a few spoonfuls of food, Salma Sheikh, 41, felt she was already full. She was unable to finish a full meal and her early satiety was uncommon, along with the abdominal pain that she experienced for the past nine months. When she consulted a doctor last month, she was found to have Stage 3 ovarian cancer.

The loss of appetite, lower abdominal pain, abdominal distension or bloated abdomen, and weakness also brought significant anxiety to Salma (a Pakistani expat whose name was changed for this story).

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Initial scans showed large mass in both her ovaries. This prompted Dr Keerthi Banavara Ravi, consultant Surgical Oncology at Zulekha Hospital Dubai, to conduct further medical examination.

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Dr Keerthi then detected moderate ascites or fluid collection in her abdomen and substantial pelvic masses that confirmed the diagnosis of primary bilateral ovarian cancer with the disease spreading to her upper abdomen.

Salma underwent diagnostic laparoscopy or the use of a surgical tiny video camera (laparoscope) to assess the intra-abdominal extent of the disease. The procedure revealed widespread abdominal involvement and a serious condition in which cancer cells or tumours measured over 25 mm. Subsequent biopsy also confirmed high-grade cancer tissues of the ovaries

Urgent medical intervention

Because it was an advanced Stage 3 ovarian cancer, a more aggressive and immediate treatment plan was devised. It involved the administration of chemotherapy drugs before surgical extraction of the tumour and hyperthermic intraperitoneal chemotherapy (HIPEC), that was done after the cancerous tumours were surgically removed. Heated chemotherapy drugs were applied directly inside the abdomen to eliminate the remaining cancerous cells.

Dr Bharadwaj Ponnada, medical oncologist at Zulekha Hospital Dubai, administered four cycles of neoadjuvant intravenous chemotherapy. This treatment significantly reduced Salma’s ascites and improved her general condition and appetite.

15-hour supra-major surgery

Salma subsequently underwent a 15-hour supra-major surgery, where Dr Keerthi and his surgical team performed the intricate procedure that involved removing all the visible cancer from Salma’s abdomen.

This included the ovaries, uterus, fallopian tubes, pelvic peritoneum, rectum, and all peritoneal and omental tissue in the upper abdomen and sub-diaphragmatic regions.

Once the visible cancerous tumours were surgically removed, then heated chemotherapy drugs were applied directly inside Salma’s abdomen to eliminate the remaining cancerous cells. This procedure, which lasted around 90 minutes, involved bathing the entire peritoneal cavity with heated chemotherapy (heated to 42°C) to eradicate any residual microscopic cancer cells.

Back to normal diet

Khaleej Times was told Salma is now making a remarkable recovery. She is also maintaining a normal diet and engaging in everyday activities. She has successfully completed two additional cycles of chemotherapy post-surgery, which she has tolerated well.

Doctors noted that given the advanced stage of the cancer at diagnosis, there is a 40 per cent chance of recurrence, which can be mitigated through ongoing chemotherapy and targeted therapy.

The exact cause of Salma’s cancer remains multifactorial, potentially involving family history and hormonal imbalances. A genetic assay (testing) is currently underway to provide further insights.

Go for early detection

Dr Keerthi said: “Early detection of ovarian cancers significantly reduces the extent of surgery and treatment-related morbidity, leading to better outcomes. Regular ultrasounds and CA (cancer antigen) 125 measurements are crucial, especially for individuals with a strong family history of ovarian cancers. Abnormal ultrasound findings should always be investigated."

He also assured: “Advanced ovarian cancers can be effectively treated with the latest modalities such as cytoreductive surgery and HIPEC, allowing patients to lead normal lives post-treatment.”

“The expertise, team spirit and experience of the surgical and medical oncology teams are critical in managing advanced cancers successfully,” he added.

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Angel Tesorero

Published: Tue 2 Jul 2024, 7:36 PM

Last updated: Tue 2 Jul 2024, 10:15 PM

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