Chemotherapy for Ovarian Cancer

Reviewed by: HU Medical Review Board | Last reviewed: March 2023

Chemotherapy is a kind of cancer treatment that uses drugs to kill cancer cells. Some people also call it “chemo.” It can also be called systemic chemotherapy when taken by mouth or injected into a vein. This is because chemo drugs then travel through the entire body, or system, through the bloodstream.1

Chemotherapy uses these powerful drugs to kill fast-growing cells in the body. Cancer cells grow and multiply much faster than healthy, normal cells. This is why chemotherapy is often used to treat cancer.2

How does someone receive systemic chemotherapy?

Systemic chemotherapy is generally taken by mouth or injected into a vein (given intravenously). For ovarian cancer, combination chemotherapy, or several different types of drugs, may be used.3

The exact dosing schedule can vary, depending on the specific medicines you are taking, your overall health, and response to previous cycles.

How does chemotherapy work?

When someone takes a chemotherapy drug by mouth or when it is injected into a vein, the drug then travels through the body, attacking fast-growing cells. The fast-growing cells are often cancer cells. The chemotherapy can stop the growth of the cells or slow it down.1

Even if the cancer cells have traveled to an area of the body away from the initial tumor, systemic chemotherapy can find and attack them since the drug moves throughout the body. However, fast-growing healthy cells may also be affected. This can lead to side effects.1

Systemic chemotherapy versus intraperitoneal chemotherapy

Both systemic chemotherapy and intraperitoneal (IP) chemotherapy are treatments for ovarian cancer, and both use drugs to kill cancer cells. However, there are differences between them.

Systemic chemotherapy allows the medicine to travel throughout the body because of the way it is given. IP chemotherapy is given directly through a catheter into the peritoneal (abdominal) cavity. This means the drugs are concentrated to treat cancer cells in this area. However, chemotherapy given this way can also get into the bloodstream. This can cause the medicine to treat cancer cells outside of the peritoneal cavity. It may also cause side effects elsewhere in the body.2

Chemotherapy to treat ovarian cancer

Chemotherapy for advanced epithelial ovarian cancer typically involves getting 2 chemotherapy drugs together. This is known as combination chemotherapy. This is because the combination of 2 drugs typically works better than using a single drug.3

Most often, the combination involves:3

  • A platinum-compound chemotherapy drug, usually carboplatin (Paraplatin®) or cisplatin (Platinol®)
  • A taxane chemotherapy drug, such as paclitaxel (Taxol®) or docetaxel (Taxotere®)

A person with epithelial ovarian cancer may have 3 to 6 cycles of chemotherapy. This may vary depending on the stage and spread of the cancer, as well as the response to treatment.3

What is neoadjuvant chemotherapy?

Neoadjuvant chemotherapy is chemotherapy given before surgery instead of after surgery. This may help reduce the size of ovarian cancer tumors to make surgery possible. It can also increase the chances of optimal debulking.4

Chemotherapy medications

Chemotherapy drugs used to treat certain forms of epithelial ovarian cancer include:3

  • Albumin-bound paclitaxel (Abraxane®)
  • Altretamine (Hexalen®)
  • Capecitabine (Xeloda®)
  • Carboplatin (Paraplatin®)
  • Cisplatin (Platinol®)
  • Cyclophosphamide (Cytoxan®)
  • Docetaxel (Taxotere)
  • Etoposide (VP-16)
  • Gemcitabine (Gemzar)
  • Ifosfamide (Ifex®)
  • Irinotecan (CPT-11, Camptosar®)
  • Doxorubicin liposomal (Doxil®)
  • Melphalan (Alkeran®)
  • Paclitaxel (Taxol®)
  • Pemetrexed (Alimta®)
  • Topotecan (Hycamtin®)
  • Vinorelbine (Navelbine)

Germ cell ovarian cancer is often treated with combination chemotherapy. The most common combination is called BEP. It contains bleomycin, etoposide (VP-16), and cisplatin (Platinol). If the cancer does not respond or returns following initial treatment, other combinations may be used.3

Ovarian stromal tumors are usually not treated by chemotherapy. When chemotherapy is needed, the combination used most often is platinum-based chemo (paclitaxel/carboplatin, cisplatin/etoposide/bleomycin, or PEB).3

Possible side effects of chemotherapy

Side effects of chemotherapy can vary depending on:1

  • The type of chemotherapy you are getting
  • The dosage
  • What number cycle you are on (some side effects can increase over time)
  • Your overall health
  • How advanced your cancer is

Side effects of some chemotherapy drugs may include:3

  • Nausea and vomiting
  • Hair loss
  • Hand and foot rashes
  • Mouth sores
  • Low white blood cell counts, leading to increased risk of infection
  • Low platelet counts, leading to easy bruising/bleeding
  • Low red blood cell counts, leading to fatigue and/or shortness of breath
  • Fatigue
  • Nerve damage
  • Early menopause

These are not all the possible side effects of chemotherapy. Talk to your doctor about what to expect with the specific drug you are taking or if you experience any changes that concern you during treatment.

Things to consider

Chemotherapy is not right for everyone. Depending on the specific chemotherapy drug, these drugs may be used alone or with other drugs to treat ovarian cancer.

Before beginning chemotherapy, talk to your doctor about any other health issues you have. Also tell your doctor about any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.

If you have questions about chemotherapy, talk with your doctor about whether it may be right for you and the possible side effects, risks, and benefits.

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