Dr. Farr Nezhat is a leading authority on the laparoscopic and robotic management of ovarian cancer and one of the first surgeons to use minimally invasive surgery to treat gynecological malignancies. Patients looking for the best ovarian cancer specialist travel across the world for treatment at his state-of-the-art practice in New York.
What is ovarian cancer?
Ovarian cancer originates in the ovaries and refers to not only ovarian cancer, but also fallopian tube and primary peritoneal cancer.
It is the ninth most common cancer in women and the fifth most deadly.
It is the second most common gynecologic malignancy in developed countries.
In the U.S. it is expected there will be 22,000 new cases and 14,000 cancer-related deaths per year.
The lifetime risk is 1:70 and the average age at diagnosis in the U.S. is 63 years old.
What are the symptoms of ovarian cancer?
Ovarian cancer is often diagnosed at an advanced stage after it has spread to distant areas, making it more difficult to treat. Even when the cancer has spread, its symptoms are often mistaken for other health conditions.
- Abdominal bloating
- Pelvic pain
- Loss of appetite
- Weight loss
- Feeling full quickly upon eating
- Frequent urination
- Changes in bowel habits (constipation, for example)
- Nausea and vomiting
- Lower back pain
What are the risk factors for ovarian cancer?
The cause of ovarian cancer is not known and there is no way to predict who will get it, but there are certain factors which make a woman more likely to develop it.
- Certain genetic mutations (such as BRCA1, BRCA2 and Lynch syndrome)
- Family history of breast or ovarian cancer
- Personal history of breast cancer
- Estrogen replacement therapy without progesterone for more than five years
- Personal history of endometriosis
- Pregnancy and childbirth later in life
- Risk increases with age
What treatment options does Dr. Nezhat offer for ovarian cancer?
Dr. Nezhat specializes in the application of minimally invasive surgical techniques to treat ovarian cancer. He performs all the standard procedures historically performed via open surgery, but he does so through small incisions.
These procedures include hysterectomy, removal of ovaries and tumors, lymph node dissection, omentectomy (removal of fatty tissue attached to the stomach and colon), pelvic washing (irrigation of the pelvic cavity to wash away cancerous cells), tumor debulking, and collection of biopsies.
Biopsies are obtained from various areas, including the lining of the abdomen and sent for pathology evaluation. This is referred to as “staging” and is used to determine the extent and spread of disease.
Sometimes open surgery is required, but the ultimate goal is to utilize the smallest incisions to remove all visible signs of disease and optimize outcome.
Dr. Nezhat wishes to highlight the following peer-reviewed articles published in widely respected journals demonstrating the safety and efficacy of minimally invasive surgical management of ovarian cancer.
- Laparoscopic management of early ovarian and fallopian tube cancers: surgical and survival outcome.
Nezhat FR, Ezzati M, Chuang L, Shamshirsaz AA, Rahaman J, Gretz H. Am J Obstet Gynecol 2009 Jan;200(1):83.e1-6.
- Safety and efficacy of video laparoscopic surgical debulking of recurrent ovarian, fallopian tube, and primary peritoneal cancers.
Nezhat FR, Denoble SM, Cho JE, Brown DN, Soto E, Chuang L, Gretz H, Saharia P. JSLS 2012 Oct-Dec;16(4):511-8.
- The safety and efficacy of laparoscopic surgical staging and debulking of apparent advanced stage ovarian, fallopian tube, and primary peritoneal cancers.
Nezhat FR, DeNoble SM, Liu CS, Cho JE, Brown DN, Chuang L, Gretz H, Saharia P. JSLS 2010 Apr-Jun;14(2):155-68.
- Comparison of perioperative outcomes and complication rates between conventional versus robotic-assisted laparoscopy in the evaluation and management of early, advanced, and recurrent stage ovarian, fallopian tube, and primary peritoneal cancer.
Nezhat FR, Finger TN, Vetere P, Radjabi AR, Vega M, Averbuch L, Khalil S, Altinbas SK, Lax D. Int J Gynecol Cancer 2014 Mar;24(3):600-7.
- A hybrid technique of combined conventional and robotic-assisted laparoscopy for staging and debulking of early, advanced, and recurrent ovarian, fallopian tube, and primary peritoneal cancer.
Nezhat FR, Khalil SS, Finger TN, Vetere PF. Gynecol Surg 2014 11:27.