Ovarian Cancer
Treatment and Beyond

Ovarian Cancer Treatment

Treatment for ovarian cancer usually involves a combination of surgery and chemotherapy, with other treatments used in some instances. The stage and type of ovarian cancer also impact treatment options.

We understand all this information may feel overwhelming, but we are always here to support you. If you need help discussing your options, call our Helpline at 866.537.4273 anytime or join one of our support groups.

Surgery

Surgery is often the first treatment for ovarian cancer and should be performed by a gynecologic oncologist. The goal of surgery is to remove all or as much of the cancer as possible and determine how far the cancer has spread. The most common surgery for ovarian cancer is a hysterectomy and bilateral salpingo-oophorectomy (BSO). A hysterectomy is a surgery to remove the uterus, and a BSO removes both ovaries and fallopian tubes.

Because pregnancy isn’t possible after a hysterectomy, fertility-sparing surgery may be an option for some early-stage ovarian cancers.

If the cancer has spread beyond the ovaries, they will attempt to remove as much of the cancer as possible, which is called debulking or cytoreductive surgery.

Chemotherapy

Chemotherapy is the use of medicine(s) designed to kill cancerous cells. It can be given before surgery (neoadjuvant therapy) or after surgery (adjuvant therapy). Platinum-based chemotherapy, which includes carboplatin and cisplatin, is recommended for ovarian cancer. Often, platinum-based chemotherapy is given along with a different type of chemotherapy called a taxane, such as paclitaxel and docetaxel. Most chemotherapy is given through a vein (intravenously).

Targeted Therapy

Targeted therapy is a cancer treatment that uses drugs to identify and attack cancer cells and change how they grow, divide, repair, or interact with other cells. Targeted therapies for ovarian cancer include bevacizumab, PARP inhibitors, and mirvetuximab soravtansine.

Hormone Therapy

Hormone therapy is a treatment option for some types of ovarian cancer that need hormones to grow. It blocks hormones, which slows or stops the growth of the cancer.

Immunotherapy

Immunotherapy uses the body’s immune system to fight cancer and might be an option for treating ovarian cancer in certain situations.

Radiation Therapy

Radiation therapy is used to treat select cases of ovarian cancer, such as when patients have certain types of ovarian cancer, there is isolated and/or minimal recurrence, or to reduce symptoms.

Maintenance Therapy

Maintenance therapy is given to some people after successful initial treatment for ovarian cancer. The goal of maintenance therapy is to reduce the risk of the cancer returning or delay it from coming back. PARP inhibitors and bevacizumab are targeted therapies that can be used for maintenance therapy. The choice of maintenance therapy depends on certain factors.

Managing Treatment Side Effects

Ovarian cancer treatment can cause a variety of unpleasant and sometimes debilitating side effects, including nausea, diarrhea, constipation, neuropathy, fatigue, hair loss, insomnia, “chemo brain,” and menopause. Depending on the severity, they can significantly impact your quality of life. It is essential to speak to your care team, let them know when you have troublesome side effects, and ask about your options for managing them.

We have a variety of past webinars that may also provide you with helpful information for managing your side effects, including:

For more in-depth information about ovarian cancer treatment and beyond, check out the NCCN Guidelines for Patients: Ovarian Cancer.

Surveillance

When there are no signs of ovarian cancer after treatment, you can still expect to see your gynecologic oncologist regularly for monitoring. During those visits, they will perform physical and pelvic exams.

You will see them every two to four months during the first two years and every three to six months for the following three years. After five years, you’ll see them once a year.

If you develop symptoms or there are other reasons to suspect a recurrence, your doctor may order blood and imaging tests.

If your CA-125 level (or other tumor marker) was initially high, they may check it regularly after treatment.

Ovarian Cancer Recurrence

When ovarian cancer comes back, it’s called a recurrence. About 70% of people with ovarian cancer will experience a recurrence, but the likelihood of the cancer returning depends on factors including the stage at diagnosis and type.

Symptoms can indicate a recurrence, so be sure to tell your care team if you have any of the following:

Abdominal pain
Bloating
Fatigue
Constipation
Upset stomach
Unexplained weight loss
Difficulty eating or feeling full quickly
Urinary symptoms (urgency or frequency)

Knowing if you are platinum-sensitive or platinum-resistant is essential if you have a recurrence. Ovarian cancer is platinum-sensitive if it returns more than six months after successful treatment with platinum-based therapy and platinum-resistant if it returns less than six months after successful treatment with platinum-based therapy. This will have treatment implications for you.

It is also recommended that you receive biomarker testing if your ovarian cancer returns. If you have certain biomarkers, it will help guide your treatment for recurrent ovarian cancer.

You are also encouraged to consider a clinical trial if you have persistent or recurrent ovarian cancer.

The NCCN Guidelines for Patients: Ovarian Cancer has helpful information for navigating a recurrence. We also invite you to check out our webinar on Ask the Expert: Recurrent Ovarian Cancer.

Seeking a Second Opinion

It’s always okay to consider getting a second opinion. It can be an important part of advocating for yourself and making sure you feel good about your treatment plan. Getting a second opinion helps ensure you receive the best care. Don’t worry about your doctor’s feelings. It is common for patients to get a second opinion, and most doctors will welcome a second opinion, or they may even suggest it themselves.

To prepare for getting a second opinion, make sure you check with your health insurance about coverage and organize copies of all your records to send to whoever you’re seeing for a second opinion.

Ovarian Cancer Treatment and Beyond