Ovarian cancer treatments

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. Chemotherapy is usually recommended after surgery.

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 local therapy such as surgery or radiation therapy.
• Systemic treatments: If the cancer has spread past its original location, systemic therapies are often recommended. For ovarian cancer, these may include chemotherapy, hormone therapy and/or targeted therapy.

Ovarian cancer begins in one or both ovaries. Often, surgery is the best way to remove the cancer cells or tumor. Surgery may involve the removal of the ovaries, fallopian tubes and uterus—key organs for women who may want to have children after treatment. For this reason, some patients with ovarian cancer prefer to take a nonsurgical route.

Depending on the diagnosis, a combination of surgery and systemic therapy may be recommended for the best possible outcome.

Below are the most common types of ovarian cancer treatments.

Surgery

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

• Lymph node biopsy, or the removal of all or part of a lymph node, which may be analyzed by a pathologist
• Unilateral salpingo-oophorectomy, the removal of one ovary and one fallopian tube
• Bilateral salpingo-oophorectomy, the removal of both ovaries and fallopian tubes
• Omentectomy, the removal of the tissue in the peritoneum (called the omentum), which includes lymph nodes
• Hysterectomy, the removal of the womb, a common procedure to treat ovarian cancer that has different types:
  • Partial hysterectomy, which removes the uterus
  • Total hysterectomy, which removes the uterus and cervix
  • Total hysterectomy with salpingo-oophorectomy, which removes the uterus, cervix and one ovary and fallopian tube (unilateral salpingo-oophorectomy) or both ovaries and fallopian tubes (bilateral salpingo-oophorectomy)
  • Radical hysterectomy, which removes all of the above, as well as nearby tissues

For patients with recurrent ovarian cancer, a treatment option may be surgery followed by chemotherapy, or chemotherapy on its own. Treating recurrent ovarian cancer with surgery before chemotherapy doesn’t appear to be more effective than chemotherapy alone, according to a 2019 study in The New England Journal of Medicine.

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 intraperitoneal chemotherapy).

At Cancer Treatment Centers of America^® (CTCA), our gynecologic oncologists treat ovarian cancer with a comprehensive and personalized approach, which may include various chemotherapy drug combinations. These chemotherapy drugs are often identified with the use of advanced genomic testing.

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.

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 remove them or keep them from growing. Radiation therapy may be recommended if the cancer has spread beyond the abdomen to nearby organs or other areas of the body.

• External beam radiation, which is similar to an X-ray, is the most common kind of radiation for ovarian cancer. It’s rarely used on its own as the sole cancer treatment. Instead, it may be used to target cancer cells in the abdomen or another part of the body, such as the spinal cord.
• Intraperitoneal radiation therapy is a new process still being studied for advanced ovarian cancer treatment. It involves radioactive liquid being put directly into the abdomen through a catheter.

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 is often used in conjunction with chemotherapy and other therapies. A common regimen of hormone therapy for ovarian cancer patients involves a combination of drugs to lower estrogen levels in the body. In some cases, hormone therapy may be used to increase progesterone levels, which may prevent cancer cells from growing.

This type of treatment—which is either hormones or hormone-blocking drugs—is most often used to treat rare ovarian stromal tumors (cancer in the cells that produce female hormones).

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 possible benefits and risks.

Fertility preservation

Ovarian cortex cryopreservation 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.

Ovarian cortex cryopreservation may offer women the chance to bear children after treatment, if other assisted reproductive technologies are not ideal for their situation.

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:

• Family history of ovarian or breast cancer 
• Condition linked with a high risk of ovarian cancer, such as Lynch syndrome or Peutz-Jeghers syndrome
• BRCA1 or BRCA2 mutation
• Previous breast, colorectal or endometrial cancer diagnosis

Preventive surgical procedures performed to reduce the risk of ovarian cancer include a tubal ligation (tying the fallopian tubes) and a hysterectomy (removing the uterus but not the ovaries).