Ovarian Cancer Treatment Options
A gynecologic oncologist is best suited to treat ovarian cancer. S/He is trained in the various types of ovarian treatment options and is most often also the surgeon that removes the cancer.
Most women who have been diagnosed with ovarian cancer have surgery, chemotherapy, and/or targeted therapy. Radiation therapy isn’t used as often, however, it is being tested more frequently in clinical trials in hopes of becoming another treatment option for ovarian cancer.
Ovarian cancer treatment can affect cancer cells in the pelvis, in the abdomen, or throughout the body. Depending on where the cancer is located, a combination of more than one treatment may be recommended -- either at the same time or one after the other.
You may want to know how treatment may change your normal activities. You and your doctor can work together to develop a treatment plan that meets your medical and personal needs.
Ovarian Cancer Surgery
For many patients, laparoscopic surgery--which eliminates large abdominal incisions--is used. Laparoscopic surgeries are minimally invasive, providing less trauma to the body. Additionally, recovery is faster and hospital stays are shorter. This type of surgery can now be performed with a laparoscope, or with the da Vinci® robotic system, which makes minimally invasive surgery available to more women.
If ovarian cancer is found, the surgeon may need to remove:
- one or both ovaries and fallopian tubes (salpingo-oophorectomy)
- the uterus (hysterectomy)
- the omentum (the thin, fatty pad of tissue that covers the intestines)
- nearby lymph nodes, especially if the cancer appears to have spread beyond the ovary.
- samples of tissue from the pelvis and abdomen
- If the cancer has spread, the surgeon removes as much cancer as possible. This is called “debulking” surgery. Keep in mind that surgeons will do all they can to avoid removing both ovaries since they drive hormone production.
If you have early Stage I ovarian cancer, the extent of surgery may depend on whether you want to get pregnant and have children. Some women with very early ovarian cancer may decide with their doctor to have only one ovary, one fallopian tube, and the omentum removed.
Chemotherapy drugs are given during the ovarian cancer treatment process to kill the cancer cells. The timing of chemotherapy is dependent on the stage of the cancer. It can be given before surgery, after surgery, or both.
Chemotherapy for ovarian cancer can be given in different ways:
- By vein (IV): The drugs can be given through a thin tube inserted into a vein.
- Intraperitoneal (IP): Chemotherapy that is given directly into the abdomen.
- Combination of vein and directly into the abdomen: Some women get IV chemotherapy combined with intraperitoneal (IP) chemotherapy.
- By mouth: Some drugs for ovarian cancer can be given by mouth.
Chemotherapy is given in cycles. Each treatment period is followed by a rest period. The length of the rest period and the number of cycles depend on the anticancer drugs used. For most patients, chemotherapy is an outpatient procedure that is given in our cancer center’s Chemotherapy Suite.
Targeted therapy is a special type of chemotherapy that uses drugs or other substances to identify and attack specific cancer cells, rather than all cells like traditional chemotherapy. Because this treatment specifically seeks out cancer cells, normal cells are less likely to be damaged.
While each type of targeted therapy works differently, they all alter the way cancer cells grow, divide, repair, and interact with other cells.
Monoclonal antibody therapy is a type of targeted therapy in which the antibodies attach to the substances and kill cancer cells, block their growth, or keep them from spreading.
Bevacizumab is a monoclonal antibody that may be used with chemotherapy to treat ovarian epithelial cancer, fallopian tube cancer, or primary peritoneal cancer that has recurred.
Poly (ADP-ribose) polymerase inhibitors (PARP inhibitors) are targeted therapy drugs that block DNA repair and may cause cancer cells to die. PARP inhibitor therapy is being studied in treating ovarian epithelial cancer that remains after chemotherapy.
Therapies may be used in different combinations depending on the stage of cancer and health of the patient. Targeted therapy may be prescribed as oral pills or administered intravenously.
As mentioned earlier, radiation therapy is rarely used in the initial treatment of ovarian cancer, but it is continuously being researched for use as a standard form of treatment. Sometimes, radiation may be used to relieve pain and other problems caused by the disease. It may also be used to treat small, localized recurrent cancer. The treatment is given at a hospital or clinic. Each treatment takes only a few minutes.