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Taking Charge: How Is Ovarian Cancer Treated?

The main treatments for ovarian cancer are surgery, chemotherapy and radiation therapy. Often several treatments are used together.

Surgery

Surgical removal of as much of the cancer as possible is an important part of your treatment. If you are diagnosed with ovarian cancer, you should be treated by a gynecologic oncologist — a doctor who is specially trained to perform surgery on cancers of the female reproductive organs. A gynecologic oncologist will also be able to perform any reconstructive procedures that may be needed as part of the cancer removal.

Surgery for ovarian cancer is usually performed with a laparotomy, an abdominal incision. The surgeon will be able to see if the cancer appears on other organs in the pelvis or abdomen, such as the uterus, fallopian tubes, bladder or bowel, and will remove as much of it as possible. If the cancer seems to be confined to the ovary, the surgeon may also wash the abdomen with fluid and then examine the fluid under the microscope to see if it contains any cancer cells.

If possible, the surgeon will try to leave at least one ovary and the uterus if a woman wants to have children after treatment. Types of operations can include removing one ovary (unilateral oophorectomy) or both (bilateral oophorectomy), one fallopian tube (unilateral salpingectomy) or both (bilateral salpingectomy), and removing the uterus (hysterectomy). The surgeon may also need to remove some lymph nodes (lymphadenectomy), and sections of the bowel.

Chemotherapy

Administering drugs to kill cancer cells is called chemotherapy. As with breast and other cancers, anti-cancer drugs are dripped into a vein intravenously, or given by mouth (orally). Sometimes the therapy is injected directly into the pelvic cavity, called intraperitoneal injection.

Chemotherapy is usually systemic, meaning that it travels throughout the body in the bloodstream. This makes it very helpful for treating ovarian cancer that has spread beyond the ovaries (metastases).

Chemotherapy is usually given in cycles — one or more drugs are administered and then there is a rest period. Chemotherapy for epithelial ovarian cancer usually involves six cycles over the course of five to six months. Usually women are treated with a combination of several drugs including a platinum compound such as cisplatin or carboplatin, and a taxane, such as paclitaxel (Taxol).

Epithelial ovarian cancer tends to respond to chemotherapy, but any remaining cells may eventually begin to grow again. If the tumor recurs, your doctor may give you additional treatment with the same drugs, or try other agents.

Germ cell tumors are treated with different drugs. Borderline EOCs and stromal tumors are not usually treated with chemotherapy.

Radiation Therapy

High-energy X-rays may also be used to kill cancer cells. The treatment may be given through an external X-ray beam, or by placing an implant of radioactive material near the tumor.

Treatment Side Effects

Cancer therapy can have side effects. Some of these go away with time, some do not. Common side effects are listed below:

  • Surgery — Removal of both ovaries means that you will go into menopause if you have not previously done so.
  • Chemotherapy — Chemotherapy drugs damage some normal cells that grow rapidly, in addition to killing rapidly growing cancer cells. Temporary side effects of chemotherapy can include nausea and vomiting, loss of appetite, loss of hair, mouth and vaginal sores, changes in the menstrual cycle, and low blood cell counts.


  • Low blood cell counts can in turn result in an increased chance of infection, bleeding or bruising, and tiredness. In very rare instances, women may develop acute myeloid leukemia, a cancer of white blood cells, from anticancer drugs. In younger women, chemotherapy can also damage the ovaries if they have not been removed, creating premature menopause and infertility.

    In general, there are more "chemoprotectants" available than in the past, which help patients to maintain their daily activities while they are undergoing chemotherapy. Drugs that can reduce nausea and vomiting (antiemetics), for example, are often used.
  • Radiation Therapy — Radiation can cause temporary damage to your skin, and fatigue, nausea or diarrhea.

Any side effects you experience from any cancer treatment should be brought to your doctor's attention. Remember that often these side effects can be treated.

Clinical Trials

During your treatment, your doctor may suggest that you take part in a clinical trial. Clinical trials are studies of promising new or experimental drugs or other therapies. Enrollment in any clinical trial is your decision. Talk to your doctor about the possible benefits in your particular situation.

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Reviewed by health care specialists at UCSF Medical Center.

This information is for educational purposes only and is not intended to replace the advice of your doctor or health care provider. We encourage you to discuss with your doctor any questions or concerns you may have.

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San Francisco, CA 94115
Phone: (415) 353-9600
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