Ovarian Cancer Overview

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Treating Ovarian Cancer TOPICS

Approach to treatment of ovarian cancer

The first step in treating most stages of ovarian cancer is surgery to remove and stage the cancer. Debulking is also done as needed. Chemotherapy (chemo) is often given after surgery.

Patients who are too weak to have full staging and debulking surgery are sometimes treated with chemo first. If the chemo works and the patient becomes stronger, surgery to debulk the cancer may be done. This is often followed by more chemo.

After treatment, blood tests will be done to see if your CA-125 tumor marker levels are normal.

For some patients, the doctor will recommend giving more chemo after the first treatment even if the cancer appears to be gone. This is called maintenance or consolidation therapy. It is aimed at killing any cancer cells that were left behind after treatment but are too small to be found with medical tests. The goal of consolidation therapy is to keep the cancer from coming back after treatment. It is not clear how helpful this treatment is.

If the cancer has spread to distant sites, like the liver, the lungs, or bone, then it can’t be cured with current treatment. But it can still be treated. The goals of treatment are to help patients feel better and live longer. Surgery may be done to remove the tumor and debulk the cancer, followed by chemo. Or chemo may be given first; then, if the tumors shrink from the chemo, surgery may be done. This is often followed by more chemo. Another option is to limit treatments to those aimed at helping the patient feel better. This type of treatment is called palliative, and is discussed in more detail further on.

Treatment for recurrent or persistent ovarian cancer

When ovarian cancer doesn’t go away with treatment (persistent ovarian cancer) or comes back (recurrent ovarian cancer), more surgery may be recommended. Most patients are then treated with some form of chemotherapy (chemo). Which chemo drugs are used depends on what was used the first time and how well it worked (how long the cancer stayed away). If the cancer comes back in less than 6 months (or if it never went away at all), different chemo drugs usually will be tried. A clinical trial for new treatments may be an option for women whose cancer has come back or not gone away. Ask your doctor if there is a clinical trial for your type of cancer.

Palliative treatments

Palliative treatments are done to help the patient feel better rather than to try to cure the cancer. The most common problems in women whose cancer has come back are fluid buildup (called ascites) and blockage of the intestines (called obstruction). Numbing the skin and putting in a needle to draw off the fluid can give relief from ascites. This will often need to be done again from time to time. It often can relieve symptoms at least for a while and, rarely, might even extend life for some women.

Dealing with the blocked intestines can be harder. Sometimes a stent (a stiff tube) can be put into the large intestine to relieve a blockage. Since this option has a high risk of problems, you should discuss the risks and benefits with your doctor first.

In some patients, surgery can be done to relieve intestinal blockage. This is often only offered to patients who are well enough to get additional treatments (like chemo) after surgery. Often the cancer has grown so much that surgery doesn’t fix the problem. Doctors can place a tube through the skin and into the stomach to drain off the stomach juices. This can help with pain, nausea, and vomiting.

Last Medical Review: 04/22/2013
Last Revised: 02/06/2014