Mrs. Maria (45) was diagnosed with ovarian cancer measuring nearly 20 cm in 2018. She then underwent surgery. The pathology results showed malignancy, serous adenocarcinoma type that had already spread to fatty tissue (omentum). Mrs. Maria refused to undergo chemotherapy and sought an alternative method with the ECCT device to clear the remaining malignant cells, prevent recurrence, and metastasis. For almost 5 years there was no detected recurrence, but after the pandemic and COVID vaccination, ultrasound results showed recurrent masses at the previous surgical site. Mrs. Maria continued using ECCT without chemotherapy, the solid mass turned into a cyst, and the cytology results of the cyst fluid also showed no malignancy. More than 7 years since she was first diagnosed with cancer, Mrs. Maria’s condition remains relatively normal.

Ovarian and uterine cancer are the leading causes of cancer-related deaths in women in Indonesia. Ovarian cancer is often detected at an advanced stage, making treatment more difficult and survival rates lower. Metastasis to distant organs is the main cause of cancer-related death. In ovarian cancer cases, early spread often occurs to the abdominal cavity or lymph nodes, liver, and lungs.

In Mrs. Maria’s case, the initial spread had already occurred to fatty tissue (omentum) in the abdominal cavity. Ovarian cancer that has spread to the omentum is at an advanced stage, which generally has a worse prognosis compared to early-stage disease.

Serous adenocarcinoma is a type of aggressive ovarian cancer that tends to spread quickly. Although surgery was performed, chemotherapy is often required afterward to eliminate any remaining cancer cells and prevent recurrence. Without chemotherapy, the risk of recurrence and further spread is relatively high. Chemotherapy is an important component in the treatment of ovarian cancer, especially for advanced stages. The goal of chemotherapy is to kill cancer cells that may remain after surgery and to prevent further spread. However, chemotherapy after surgery for ovarian cancer of the serous adenocarcinoma type often only helps in the beginning, with recurrence and spread almost always occurring again, especially in advanced stages.

The recurrence rate of ovarian cancer of the serous adenocarcinoma type that has already spread to the omentum after surgery tends to be high. In general, ovarian cancer that has spread has a higher risk of recurrence compared to early stages. The 5-year survival rate for ovarian cancer of the serous adenocarcinoma type that has spread to the omentum (stage III or IV) is generally below 50% even after surgery and other treatments such as chemotherapy. Serous adenocarcinoma is one of the most common and aggressive types of epithelial ovarian cancer. Spread to the omentum (the fat lining the abdomen) indicates that the cancer has reached an advanced stage, increasing the risk of recurrence and lowering survival rates.

However, Mrs. Maria and her husband firmly refused to undergo chemotherapy and expressed their desire to seek alternatives other than chemotherapy. She never told her oncologist but eventually found another doctor who was willing to recommend the use of the ECCT device. Mrs. Maria then used ECCT to clear remaining malignant cells, prevent recurrence, and metastasis.

Regular evaluations with CT scans and ultrasounds every 3-6 months showed no detected recurrence of masses or spread. She routinely consulted with her oncologist. At first, her doctor kept urging and recommending chemotherapy, but since the scans were always clear and her condition was healthy as if nothing was wrong, her doctor eventually got used to it. Her doctor continued to warn that the shadow of recurrence would always be there, to always remain vigilant.

In early 2023, after the pandemic and COVID vaccination, entering the 5th year since surgery and starting ECCT, ultrasound and CT scan results showed multiple solid and cystic masses in the left ovarian area of the previous surgery site.

Cancer recurrence that had previously been cleared with ECCT often reappeared after the COVID pandemic and vaccination. The reappearance was likely triggered by viral or vaccine deposits in the former cancer area which generally turned into fibrosis (scar tissue) causing inflammation. When inflammation continues for a relatively long time, studies suggest that cells with genetic mutations may reappear as cancer. In several cases observed in ECCT users, recurrence does not always manifest the same as the initial type experienced by the patient. Often, the type of cancer that appears is cystic, a common cancer character that begins with infection.

The recurrent mass experienced by Mrs. Maria also appeared as a mixture of solid and cystic lesions, consistent with characteristics originating from infection. It is also possible that it originated as a recurrence of the initial serous adenocarcinoma mass that had cystic characteristics, but since there had been no recurrence for almost 5 years, the likelihood of recurrence from the initial mass was small.

Mrs. Maria continued using ECCT without chemotherapy to address the new mass that appeared. In less than 8 months after resuming ECCT, the solid mass turned into a cyst, and the cystic mass that was initially present relatively decreased. The cytology results of the cyst fluid also showed no malignancy.

More than 7 years since she was first diagnosed with cancer, Mrs. Maria’s condition remains relatively normal. Wishing continued health for Mrs. Maria (WS).