Manisha ready for a fight

Nov. 30: Manisha Koirala is due to undergo surgery for ovarian cancer after tests at Mumbai's Jaslok Hospital confirmed the diagnosis of doctors in Kathmandu.

"She was admitted to the hospital on Wednesday evening. Her cancer is in the preliminary stage ' there is no metastasis as yet ' and Manisha has taken it well. She wants to fight it and is extremely positive about recovery. In cancer that's half the battle won," a radiologist at Jaslok said.

The actress was discharged from the hospital this evening after her family said they would prefer to do the surgery abroad, sources said.

Manisha, 42, on whose life Madhur Bhandarkar's Heroine is believed to be loosely based, was brought to Jaslok from hometown Kathmandu after tests conducted in Nepal indicated she had cancer.

"In ovarian cancer, early diagnosis is very important," said top Mumbai gynaecologist Ranjana Dhanu.

Rupinder Sekhon, a senior consultant at the Rajiv Gandhi Cancer Institute and Research Centre in New Delhi, agreed the prognosis for patients and survival rates depend on how early the disease is detected.

The standard treatment involves surgical removal of ovaries followed by chemotherapy, Sekhon said.

Studies suggest eight in 10 patients diagnosed in stage-1 of ovarian cancer are likely to be alive five years after treatment. Survival rates drop to four in 10 patients detected in stage-3 of the disease, Sekhon said.

Manisha took ill on November 21, when she fainted at a public event in Nepal while recovering from a bout of food-poisoning. The actress had tweeted: "Mom's soups and green tea are helping."

"It (ovarian cancer) is hard to detect because it doesn't lead to any distinctive symptoms in the early stages," Sekhon said. Vague symptoms such as a feeling of fullness in the stomach, pain or discomfort in the pelvic area or lower abdomen are at times attributed to indigestion.

"Three in four women are detected in the third stage of the disease where the cancer has moved out of the pelvic region and moved into the abdomen," Sekhon said.

Manisha, who comes from a leading political family of Nepal ' her grandfather B.P. Koirala was the first elected Prime Minister of Nepal, her great-uncle G.P. Koirala also served as Prime Minister and her father Prakash Koirala was a cabinet minister, has of late been involved with social and rights movements in her country.

"She had been a bit overworked because of these engagements and though everybody had noticed over the past couple of months that she was looking a bit frail and pale, it had been put down to her hectic schedule," said a family friend.

"Then she came down with a bad bout of food poisoning and fainted.That's when her family got worried and forced her to get admitted in a Kathmandu hospital," said the friend.

On November 25, Manisha was admitted to Norvic Hospital in Kathmandu and treated at the emergency ward.

Ovarian cancer has no established risk factors, other than a family history and two gene mutations called BRCA1 and BRCA2, Sekhon said. "There is also no routinely recommended screening test that might help in early detection," she said.

Manisha, who made her Bollywood debut in 1991 with the Subhash Ghai blockbuster Saudagar, had been mostly out of sight for the past six-seven years as her acting career fizzled out. She returned to Mumbai earlier this year following trouble in her marriage to Nepalese businessman Samrat Dahal, whom she wed in 2010. The two are not divorced, but separated.

"Manisha was in Kathmandu all of November ' she has got herself a new place after moving out of Samrat's home and has been a frequent visitor to Nepal to oversee the interior work of her new pad," said a family friend.

Her comeback film Ram Gopal Varma's Bhoot Returns, which released this October, has flopped at the box office.