Ovarian Cancer Treatment Guidelines
General treatment information
After the diagnostic tests are done, your cancer care team will recommend 1 or more treatment options. The main treatments for ovarian cancer are:
Surgery is the main treatment for most ovarian cancers. How much surgery you have depends on how far your cancer has spread and on your general health. For women of childbearing age who have certain kinds of tumors and whose cancer is in the earliest stage, it may be possible to treat the disease without removing both ovaries and the uterus.
Experts recommend that patients see a gynecologic oncologist for surgery. Gynecologic oncologists are specialists who have training and experience in treating, staging, and debulking ovarian cancer. If your cancer isn’t properly staged and debulked, you may need to have more surgery later. It has been shown that gynecologic oncologists are more likely than general surgeons and gynecologists to stage and debulk ovarian cancer optimally.
For other types of ovarian cancer (germ cell tumors and stromal tumors), the main goal of surgery is to remove the cancer.
Chemotherapy (chemo) is the use of drugs to treat cancer. Most often, chemo is a systemic treatment − the drugs are given in a way that lets them enter the bloodstream and reach all areas of the body. Systemic chemo can be useful for cancers that have metastasized (spread). Most of the time, systemic chemo uses drugs that are injected into a vein (IV) or given by mouth. For some cases of ovarian cancer, chemotherapy may also be injected through a catheter (thin tube) directly into the abdominal cavity. This is called intraperitoneal (IP) chemotherapy. Drugs given this way are also absorbed into the bloodstream, so IP chemotherapy is also a type of systemic chemo. This is discussed in more detail later in this section.
Hormone therapy is the use of hormones or hormone-blocking drugs to fight cancer. This type of systemic therapy is rarely used to treat epithelial ovarian cancer, but is more often used to treat ovarian stromal tumors.
Targeted therapy is a newer type of cancer treatment that uses drugs or other substances to identify and attack cancer cells while doing little damage to normal cells. These therapies attack the cancer cells’ inner workings − the programming that makes them different from normal, healthy cells. Each type of targeted therapy works differently, but all alter the way a cancer cell grows, divides, repairs itself, or interacts with other cells.
Radiation therapy uses high energy x-rays or particles to kill cancer cells. These x-rays may be given in a procedure that is much like having a regular (diagnostic) x-ray. In the past radiation was used more often for ovarian cancer, at this time radiation therapy is only rarely used in this country as the main treatment for this cancer. It can be useful in treating areas of cancer spread.
Often, 2 or more different types of treatments are used.
Consider the options without feeling rushed. If there is anything you don’t understand, ask to have it explained. The choice of treatment depends largely on the type of cancer and the stage of the disease. The exact stage may not be known in patients who did not have surgery as their first treatment. Treatment then is based on other available information.
Other factors that could play a part in choosing the best treatment plan might include your general state of health, whether you plan to have children, and other personal considerations. Age alone isn’t a determining factor since several studies have shown that older women tolerate ovarian cancer treatments well. Be sure you understand all the risks and side effects of the various therapies before making a decision about treatment.