Treatment for advanced ovarian cancer can involve several methods. These methods can be local and/or systemic. Local treatments treat the tumor without affecting the rest of the body. Systemic treatments can reach cancer cells throughout the body. You and your doctor will develop a treatment plan that is right for you.1
How is treatment chosen?
Treatment may be different for each person. It is tailored to each situation. Treatment decisions are based on many factors, including:1
- The kind of ovarian cancer you have
- The stage and extent of the cancer
- Your overall health
- Any genetic factors that may be present
- Your treatment preferences
Who is part of the treatment team?
Your treatment team can be made up of several healthcare professionals, including:1
- Gynecologic oncologists
- Radiation oncologists
- Medical oncologists
- Nurse practitioners
- Physician assistants
- Oncology nurses
- Psychologists
- Social workers
- Nutritionists
- Sex counselors
- Genetic counselors
- Pharmacists
- Palliative care specialists
Types of treatment for advanced ovarian cancer
Ovarian cancer is most often treated with a combination of surgery and chemotherapy. But other treatments may be used depending on the diagnosis.1,2
The standard types of treatment for advanced ovarian cancer include:1,2
- Surgery
- Radiation therapy
- Chemotherapy, including intraperitoneal chemotherapy
- Hormone therapy
- Targeted therapy
- Immunotherapy
- Tissue-agnostic therapy
There are also clinical trials looking at new drugs to treat ovarian cancer. Talk with your doctor if you are interested in participating in a clinical trial.
Surgery
Surgery is a local therapy used to treat some forms of advanced ovarian cancer. Depending on the stage of your cancer, surgery may include removal of:2
- One or both ovaries and/or fallopian tubes
- The uterus
- Lymph nodes
- The layer of fatty tissue covering the abdominal organs (omentum)
The goal of surgery is to take out as much cancer as possible. Surgery may also be used to learn which stage the cancer has reached. The spread of the cancer determines the extent of the surgery.2
If your cancer is advanced or you are not a candidate for surgery at first, you may have chemotherapy before surgery. This will help shrink the cancer and make it easier to remove.2
Radiation therapy
Radiation therapy usually is not used as a main treatment for ovarian cancer. But it may be used if the cancer has spread somewhere else, like the brain or spinal cord.3
Radiation therapy uses high-energy X-rays to destroy cancer cells. The rays are targeted to the tumor area. This means it is a local treatment.3
The treatment itself is very short, but getting the patient and the equipment into position takes some time.3
Chemotherapy
Chemotherapy uses drugs to destroy cancer cells throughout the body. This means it is a systemic treatment. Chemotherapy is helpful because it can reach small areas of cancer cells that have moved throughout the body. Then, it can attack them.4
In most cases, chemotherapy is given orally (by mouth) or intravenously (through a vein). During intraperitoneal chemotherapy (IP), chemo drugs are injected through a thin tube (catheter) directly into the abdomen.4
Combination chemotherapy is often used. This refers to the use of more than 1 drug at the same time. For epithelial ovarian cancer, combination therapy usually includes a platinum chemotherapy drug (typically cisplatin or carboplatin) and a taxane chemotherapy drug (typically paclitaxel or docetaxel).4
Chemotherapy cycles can vary based on the stage of your cancer and response to treatment. If the cycles need to be changed, your doctor will discuss that with you.4
Hormone therapy
Hormone therapy uses hormones or hormone-blocking drugs to help fight cancer. It is a kind of systemic therapy that may be used to treat ovarian stromal tumors.5
Estrogen can sometimes stimulate cancer cell growth. Hormone therapy drugs help to reduce or stop the action of estrogen. They may even turn off estrogen production.5
These drugs can be either injected or taken orally in pill form. This depends on the drug being used.5
Targeted therapy
Targeted therapy finds and attacks cancer cells while trying to minimize damage to healthy cells. It attacks the inner workings of cells that differ from normal, healthy cells.2,6
These therapies can be used in different situations. They may be used with ovarian cancer that has come back after treatment (recurrent cancer). They may be used with cancer that has not responded to other therapies. And they may be used as a maintenance therapy after positive response to other therapies. The reason for use varies based on the specific drug.2,6
Targeted therapies used for ovarian cancer include:6
- Angiogenesis inhibitors
- PARP inhibitors
- Drugs that target NTRK gene changes
- Antibody-drug conjugates
Immunotherapy
Cancer cells can escape your body’s natural immune response system by disguising themselves as normal cells. Immunotherapy drugs work by helping your immune system better identify and target cancer cells.7
The types of immunotherapy approved for ovarian cancer include:7
- Monoclonal antibodies
- Checkpoint inhibitors
Tissue-agnostic therapy
Tissue-agnostic therapy treats cancers that have a specific molecular change or biomarker. The treatment targets this change or marker. This works differently from other treatments that depend on the type of tissue or location of the cancer.8
Tissue-agnostic drugs are studied in clinical trials known as “basket trials.” These trials test how well a drug works for treating multiple types of cancer within the same trial. Researchers are currently studying more tissue-agnostic therapies to give people with ovarian cancer other treatment options.8
Other things to consider
Treatment for advanced ovarian cancer can vary from person to person. Talk with your treatment team about your treatment course and any questions you might have. Together, you can work on building the right treatment plan for you.