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Ovarian cancer treatment

This page was reviewed under our medical and editorial policy by

Ruchi Garg, CTCA Enterprise Chair, Gynecologic Oncology.

This page was reviewed on May 17, 2022.

Treatment for ovarian cancer typically depends on many factors, including the cancer type and stage, the potential side effects, the woman’s age and whether she’s planning to have children. Surgery is often the first treatment recommended for ovarian cancer, and may involve the removal of the ovaries and fallopian tubes, uterus, lymph nodes in the area, and surrounding organs and tissue including omentum and appendix. Chemotherapy is usually recommended after surgery for epithelial type ovarian cancers.

Cancer treatments generally fall into two categories.

  • Local treatments: If the cancer is found in a localized spot and hasn’t spread to other areas of the body, it’s usually treated with surgery. Treatment with chemotherapy may depend on the final pathology results.
  • Systemic treatments: If the cancer has spread past its original location, systemic therapies are often recommended combined with debulking surgery

Common treatments for ovarian cancer

Surgery

There are many types of surgical procedures that may be used, depending on the cancer’s stage and original location. These include:

  • Unilateral or bilateral salpingo-oophorectomy, the removal of one or both ovary(ies) and fallopian tube(s)
  • Omentectomy, a fatty apron overlying the intestines where these cancer cells like to spread
  • Hysterectomy, the removal of the uterus and cervix, a common procedure to stage ovarian cancer that may also include:
    • Debulking or removal of the lymph node
    • Removal of appendix and/or other parts of the bowel

For patients with recurrent ovarian cancer, a treatment options are individualized and may include surgery followed by chemotherapy, or chemotherapy on its own.

Learn more about surgery for ovarian cancer

Chemotherapy

Chemotherapy drugs are used to kill cancer cells or prevent their growth. This treatment may be used to shrink large tumors and make surgery easier to perform, or to treat any cancer cells that remain following tumor removal. They’re administered orally, intravenously or directly into the abdomen by catheter, known as hyperthermic intraperitoneal chemotherapy (HIPEC).

Targeted therapy

PARP inhibitors are a form of targeted therapy used to treat ovarian cancer. Designed to block the enzyme named poly ADP-ribose polymerase (PARP) from identifying damaged DNA inside cancer cells, PARP inhibitors may stop cancer cells from repairing themselves. The U.S. Food and Drug Administration has approved certain PARP inhibitor drugs to treat ovarian cancer.

Other treatments for ovarian cancer

There are other ovarian cancer treatments that aren’t as common but still may be used in specific situations.

Radiation therapy

This treatment targets cancer cells in order to kill them or keep them from growing. Radiation therapy may be recommended in rare cases of ovarian cancers where the tumor is isolated to an area and can be targeted with the radiation beam when there are otherwise limited treatment options for the patient.

Hormone therapy

Hormone therapy is designed to deprive ovarian tumor cells of the hormones they need to grow, including estrogen. Hormone therapy for ovarian cancer may be used subsequent to chemotherapy and other therapies. A common regimen of hormone therapy for ovarian cancer patients involves a class of drugs to lower estrogen levels in the body. This type of treatment is more commonly used in rare ovarian stromal tumors.

Clinical trials

Cancer research is ongoing, with many ongoing clinical trials for ovarian cancer therapies. Patients should ask their doctors about the most recent studies and the potential benefits and risks. At CTCA, we have several ongoing trials available to offer a range of treatment options for our patients diagnosed with ovarian cancer.

Fertility preservation

Ovarian egg preservation or ovarian tissue preservation involves freezing ovarian tissue before cancer treatment so women may be able to have children later. Fertility preservation is a common concern for young women diagnosed with cancer, particularly those diagnosed with cancer affecting the reproductive system. In some cases, surgery to remove a tumor may require removal of the ovaries, fallopian tubes, cervix or uterus. Even without surgery, treatments such as chemotherapy and radiation therapy may damage these organs.

If fertility is a concern, we recommend discussing this with your provider prior to beginning any therapy.

Ovarian cancer treatment by stage

Treatment for ovarian cancer typically starts with surgery to remove the tumors and check for cancer in the lymph nodes. The extent of the surgery will depend on the cancer’s stage. Additional treatment with chemotherapy and/or targeted therapy, such as PARP inhibitors or monoclonal antibodies, are also options that will depend on the stage of the cancer.

Stage 1 ovarian cancer treatment

Stage 1 or early ovarian cancers are typically first treated with surgery, which may help determine whether the cancer cells have spread to the lymph nodes in the abdomen.

For some women, surgery may be the only treatment needed for stage 1 ovarian cancer. However, based on factors like genetics, the size of the primary tumor or the cancer’s characteristics, the patient may also benefit from chemotherapy. The cancer cells’ grade, or how they look under a microscope, can also guide the need for chemotherapy.

Stage 2, stage 3 and stage 4 ovarian cancer treatment

If surgery reveals that cancer has spread to the lymph nodes or other structures in the abdomen, doctors classify it as more advanced. For stages 2, 3 and 4 ovarian cancers, the care team may recommend other treatments along with surgery.

Depending on the tumor size, doctors may recommend chemotherapy or targeted therapy before surgery to shrink the tumor. This approach is called neoadjuvant therapy.

Surgery may be followed by chemotherapy (which may be given either through an IV or directly into the abdomen), targeted therapy or both.

More specifically:

  • Stage 2 ovarian cancer treatment is often surgery followed by chemotherapy.
  • Stage 3 ovarian cancer treatment usually involves more extensive surgery, which will remove the reproductive organs and other structures such as the fatty tissue around the stomach and intestines. This is typically followed by several rounds of chemotherapy and targeted therapy. Patients may continue on targeted therapy for a year after chemotherapy ends.
  • Stage 4 ovarian cancer treatment may begin with chemotherapy before surgery and then follow the treatment plan used for stage 3 ovarian cancer. Sometimes combination targeted therapies are recommended. Depending on the stage of the cancer, palliative procedures and medicines may be used to help reduce fluid buildup or blockages and help extend the patient’s life.

Preventive Options

Women concerned about their risk of ovarian cancer should speak with their doctor about whether preventive surgery may be an option. Candidates for preventive surgery may have a:

Learn to identify potential ovarian cancer symptoms

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