Management of intestinal obstruction in the patient with ovarian cancer

Intestinal obstruction in the patient with ovarian cancer is a difficult si tuation for both patient and physician, In women presenting with ovarian ca ncer, obstruction is almost never complete. These women should undergo aggr essive bowel surgery only if it is part of an optimal surgical cytoreductio n, Women known to have ovarian cancer who develop intestinal obstruction ha ve a poor prognosis: Few will live more than a year from the time of obstru ction. Some, however, have an excellent performance status, and would be re latively unimpaired were it not for their obstruction. These women, who usu ally have a discrete obstruction and still display some response to chemoth erapy, may benefit from surgical correction of the obstruction. Women who a re not candidates for surgery can be effectively palliated pharmacologicall y so that they are comfortable with the obstruction, often without intestin al drainage. Algorithms are available to assist in the management of ovaria n cancer patients with obstruction, but ultimately the treatment decision r ests with the patient, The oncologist must use his or her knowledge and cli nical judgment to help the patient develop an appropriate, individualized p lan.