Ovarian Cancer: Treatment Choices
The information here focuses on treatment for epithelial ovarian cancer. Other types of ovarian cancer are rare.
Your treatment options depend on how much cancer there is, if and how far it has spread (stage), and gene changes in the cancer cells. Your age, overall health, desire to have children, and preferences are also key.
Cancer may just be in one ovary or may have spread into nearby areas in the pelvis. If so, it’s called local or early-stage cancer. If it has spread to distant parts of the body (such as your lungs, belly, liver, or bones), it’s called metastatic or advanced ovarian cancer. It’s important that your treatment team learn as much as they can about the cancer. You'll likely be treated by a gynecologic oncologist. This specialist has advanced training in the diagnosis and treatment of female cancers, such as ovarian cancer.
Learning about your treatment options
You'll likely have many questions and concerns about your treatment options. You may want to know how you’ll feel and how your body will work after treatment. You may also want to know if you’ll have to change your normal activities.
Your healthcare provider is the best person to answer your questions. They can tell you what your treatment choices are, how well they’re expected to work, and what the risks and side effects are. A specific treatment might be advised. Or you may be offered more than one and asked to decide which one you’d like to use. It can be hard to make this decision. It's important to take the time you need to make the best decision.
Deciding on the best plan may take some time. Talk with your healthcare provider about how much time you can take to explore your options. You may want to get a second opinion before making a decision. You may also want to include your family and friends in this process. Ask questions and learn as much as you need to make the decision that's best for you.
Types of treatment for ovarian cancer
Your healthcare provider may advise a combination of treatments. For instance, in most cases, ovarian cancer is treated with surgery followed by chemotherapy (chemo). But sometimes chemo is given before surgery. This is done to shrink the cancer and make it easier to remove.
These are the treatments most often used for ovarian cancer:
Surgery can be used to diagnose and stage ovarian cancer, as well as treat it. The main goal of surgery is to take out all of the tumor or tumors. Your surgeon removes tissue and it's checked for cancer cells. The tissues most often removed include the uterus (hysterectomy), both ovaries, and both fallopian tubes. Sometimes nearby tissues and lymph nodes are also removed and tested.
Even if the ovarian cancer has spread beyond the ovaries, surgically removing as much of the cancer as possible can give you a better chance for survival. This is called debulking.
This treatment uses medicines to slow the growth of or kill the cancer. It also reduces the chance of it coming back. Chemo is advised in most cases, even for early-stage disease. It may be given by IV (intravenously). Or it may be put right into your belly (abdomen). This is called IP (intraperitoneal) chemo.
Chemo may be given before, during, or after surgery. It might be the only treatment used if surgery can't be done.
This treatment uses high-energy X-rays to kill cancer cells. It’s rarely used to treat ovarian cancer. But it may be used to ease symptoms caused by ovarian cancer that has spread to the bone or brain. External beam radiation therapy is most often used. This type of radiation comes from a machine that aims strong rays of energy at the tumor from outside of the body.
Targeted therapy uses medicines made to focus on parts of cancer cells that make them different from normal, healthy cells. For instance, they might affect certain genes or proteins that help the cancer cells grow and spread. Because of this targeting, these medicines cause less damage to normal cells.
Making treatment decisions
It’s a good idea to learn as much as you can about your cancer and your treatment choices. Your healthcare provider is the best person to answer your questions and explain things to you. These talks can help you work together to make decisions about the treatment plan that's best for you.
Make sure you ask how treatment may affect your life. Ask how it may affect your diet, mood, energy level, sexual function, sleep habits, and how you look. If you want to have children in the future, ask how treatment will affect your fertility and what your options are before treatment starts. Find out if treatment will put you into menopause. Ask how well you can expect the treatment to work. Ask about the risks of treatment and possible side effects you might have, both short- and long-term. The American Cancer Society, the National Cancer Institute , and the Foundation for Women's Cancer also offer information about ovarian cancer.