Ovarian Cancer Treatments
Treatment for ovarian cancer can involve many different approaches. These approaches can be local and/or systemic. Local treatments treat the tumor without affecting the rest of the body, like surgery. Systemic treatments, like chemotherapy, 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 decisions are based on many factors, including:1
- The specific 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 that you and your doctor can decide together
Treatment can be different for each person, since it is tailored to each woman and her situation.
Who is part of the treatment team?
Your treatment team can be made up of many different kinds of healthcare professionals, including:1
- Gynecologic oncologist
- Radiation oncologist
- Medical oncologist
- Nurse practitioners
- Physician assistant
- Oncology nurses
- Social workers
- Sex counselors
- Genetic counselors
Types of treatment for advanced ovarian cancer
The standard types of treatment for ovarian cancer can include:1,2
- Radiation therapy, though this is not typically given as a main treatment
- Chemotherapy, including intraperitoneal chemotherapy (a treatment that delivers chemotherapy drugs directly into the abdominal cavity through a catheter, or thin tube)
- Hormone therapy
- Targeted therapy
There are also clinical trials looking at new drugs, including immunotherapy drugs. Talk with your doctor if you are interested in participating in a clinical trial.
Surgery is a local therapy used to treat some forms of 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 omentum (the layer of fatty tissue covering the abdominal organs)
The goal of surgery is to take out as much cancer as possible and to help provide information to stage the cancer. The extent of surgery will be determined by the spread of the cancer.
If your cancer is advanced, you may have chemotherapy before surgery. This will help shrink the cancer and make it easier to remove.2
Radiation therapy is not typically used as a main treatment for ovarian cancer. However, 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 kill cancer cells. The rays are targeted to the tumor area. This means it is a local treatment. Typically for ovarian cancer treatment, a machine aims the rays at the specific area and focuses the treatment there.
The treatment itself is very short, but getting the person receiving the radiation and the equipment into position for treatment takes additional time. Radiation therapy is usually given 5 days a week for several weeks.3
Chemotherapy uses drugs to kill 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 through the body and then attack them.
In most cases, chemotherapy is given orally or intravenously (through a vein). During intraperitoneal chemotherapy (IP), the drugs are injected through a catheter directly into the abdominal cavity.4
Chemotherapy is usually used after surgery. In some cases, it may be used before surgery to shrink tumors and make it easier for a surgeon to remove them. Combination chemotherapy, or use of more than 1 drug at the same time, is often used. In epithelial ovarian cancer, the combination usually includes a platinum compound chemotherapy drug (often cisplatin or carboplatin) and a taxane chemotherapy drug (possibly paclitaxel or docetaxel).4
For these epithelial ovarian cancers, chemotherapy is usually given every 3 to 4 weeks for 3 to 6 cycles of treatment. This 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 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. Estrogen can sometimes stimulate cancer cell growth. Hormone therapy drugs help to reduce or stop the circulation of estrogen or even turn off estrogen production.5
The drugs can either be injected or taken orally in pill form, depending on the drug being used.
Targeted therapy identifies and attacks cancer cells while trying to minimize damage to healthy cells. They attack the inner workings of the abnormal cells that differ from normal, healthy cells by attaching to a protein, interfering with rebuilding DNA, or another mechanism.6
These therapies are often used with ovarian cancer that has come back (called recurrent cancer) or not responded to other therapies.2
Targeted therapies used for ovarian cancer include:6
- Angiogenesis inhibitors
- PARP inhibitors
- Drugs that target NTRK gene changes
Cancer cells are able to evade the body’s natural immune response system by disguising as normal, native cells. Immunotherapy drugs work by helping a person’s immune system to more effectively identify, target, and attack cancer cells.7
Tissue-agnostic therapy is a type of treatment that treats various forms of cancer as long as the cancer has a specific molecular change or biomarker that is targeted by the treatment. This is different 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 are clinical trials that 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
Things to consider
Treatment for ovarian cancer can vary from person to person. It is a good idea to talk with your treatment team about your proposed course of treatment and any questions you might have. Together, you can work on putting together the right treatment plan for you.