DOCTORS here have come up with a treatment approach for a rare condition associated with tumours in the ovary, and have recommended it as the way to go in a scientific journal.
The condition, known as paraneoplastic encephalitis is an acute inflammation of the brain which sets in when an ovarian cancer triggers the patient's over active immune system to attack the brain.
The patient may then suffer from fits, confusion or have memory problems. Left untreated, permanent and severe brain damage or death can result.
Doctors here recommend that chemotherapy be considered as one of the main treatments for ovarian cancer in patients showing symptoms of paraneoplastic encephalitis.
From treating five such cases here, they have found that chemotherapy seems to prevent the immune system from attacking the brain.
This is a departure from the traditional practice of removing ovarian tumours through surgery only, preferred because chemotherapy given to a woman of reproductive age can cause infertility.
Dr Tan Min-Han an associate consultant at the National Cancer Centre Singapore's department of medical oncology, explained that, until now, the chemotherapy route of pumping toxic drugs into the body to kill the ovarian cancer cells is taken only when surgery does not work, since it produces severe side effects.
But now there is an argument for it.
It is not known how common paraneoplastic encephalitis is because international figures are unavailable. But based on estimates, under 1 per cent of patients with cancers develop the condition, said Dr Tan.
This form of encephalitis came to light in 2007, when 12 American cancer patients came down with it.
Since then, about five patients here have been diagnosed with it.
Those at risk are typically women be tween the ages of 16 and 35 and those with breast, lung or ovarian cancers, but no other medical history.
Rare as this encephalitis is, customer service officer, Dewi Hermawati, now 27, once suffered from it. Three years ago, she developed fits, fever and confusion.
She was unable to communicate, was unaware of her surroundings and was often violent, said her sister Linda Nurhayati, 22.
"Our family thought she was possessed and took her to see different bomohs and healers, but nothing worked," she said, tearing at the memory.
At the hospital, where a cyst was found in her left ovary, doctors suspected this was linked to her fits.
But even after the cyst was removed through surgery, Ms Dewi's confused state persisted. Dr Tan and his team then put her on an aggressive regimen of chemotherapy.
The single woman has completely recovered, although she sees a gynaecologist to monitor her fertility.
Dr Tan said the treatment method has not been shown to work with breast or lung cancers and is thus being recommended only for those with ovarian tumours.