Treatment for ovarian cancer usually involves a combination of surgery and chemotherapy. Less often, treatment may include radiotherapy. The type of treatment women receive depends on the type and stage of their ovarian cancer and their general health.
Treatment is best managed by a gynaecological oncologist who specialise in treating cancers of the reproductive tract and has very specialised surgical skills.
Ovarian Cancer Australia strongly recommends women are treated by a gynaecological oncologist. And your treatment will be managed by a team of cancer healthcare professionals. Each team member will have specialised skills to provide you with the best possible care during and after your treatment.
If you live in a rural or regional area, you may need to access visiting health professionals or access advice through linked phone and internet services. Many rural centres also have links to the centralised multidisciplinary meetings.
To find the names of individual gynaecological oncologists (many of whom work in multidisciplinary treatment centres), visit the Australian Society of Gynaecologic Oncologists website.
It is important to know not all women will have the same treatment for their ovarian cancer. Your doctor will work out your treatment based on the stage and grade of your cancer as well as what is best for you.
They will discuss all your treatment options in detail with you. They will discuss the benefits as well as the possible side effects. Don’t be afraid to ask questions – it is important you understand all your options.
You may wish to ask for a second opinion from another gynaecological oncologist or medical oncologist at any time during your diagnosis or treatment. Getting a second opinion can help to clear up questions and concerns and allows you to choose which doctor you would prefer to manage your treatment. Most cancer specialists are used to their patients asking for a second opinion. They understand the importance of being sure you are getting the best treatment possible for your situation. So don’t be afraid to ask.
Surgery is the main treatment for ovarian cancer and is used to:
- Confirm the diagnosis of ovarian cancer
- Work out what type of ovarian cancer it is
- Work out the stage and grade of the cancer
- Remove as much of the cancer as possible
The type of operation you have will depend on the stage of your cancer, which may not be known until the surgery begins. This means many women will go into the operation not exactly sure of what is going to be done. This can be worrying. But your surgeon (gynaecological oncologist) will have explained all the possible options to you before your operation. Ask your surgeon to tell you what the surgery will involve and what the different options may be once they know the stage of your cancer.
Your surgeon will also explain the possible risks and side effects of surgery. This may include a discussion about infertility. This can be very difficult for women who still want to have children. If this is the case, ask your doctor to refer you to a fertility specialist.
There is information about infertility and fertility preservation the Finding Out chapter in our Resilience Kit. To read more about fertility-sparing surgery, see the ‘Younger women’ section in the same chapter.
Most women with ovarian cancer will need chemotherapy (chemo). Chemotherapy is anti-cancer drugs (cytotoxics). The aim of the treatment is to either destroy the cells or slow down or stop the growth of the cells while causing the least possible damage to normal cells.
If your ovarian cancer has started to grow outside the ovary, research shows that having chemotherapy after surgery can improve your survival and reduce the risk of the cancer coming back. Some women may have chemotherapy before surgery to help shrink the cancer. Your medical oncologist will talk to you about how chemotherapy may benefit your own situation.
If your cancer comes back (recurs) after your initial treatment, your oncologist may suggest using chemotherapy again, possibly with different drugs.
As well as destroying cancer cells, chemotherapy can also damage healthy cells in your body. This can cause a range of side effects. Side effects depend on the particular drugs used, but also vary from woman to woman and from one chemotherapy cycle to the next.
The Cancer Council has comprehensive booklets and fact sheets about chemotherapy (www.cancer.org.au or call 13 11 20 for a free copy).
Radiotherapy is treatment with special x-rays aimed at the specific site of the cancer. The x-ray damages the DNA or genetic code in the cancer cells and this damage kills the cancer cells when they try to grow.
Radiotherapy is occasionally used as a treatment option for ovarian cancer. It can help remove any cancer cells left after surgery, to reduce the risk of the cancer coming back. It may also be used in advanced ovarian cancer to reduce the size of the cancer and help to relieve symptoms such as pain. If cancer comes back, it may occasionally be in an area that is suitable for radiotherapy – such as a lymph node.
There may be short-term or long-term side effects of radiotherapy. Your healthcare team will discuss these side effects with you.
The Cancer Council has an excellent booklet on radiotherapy (www.cancer.org.au or call 13 11 20 for a free copy).
Biological therapies are a newer type of cancer treatment. They work by changing the way the cells in our body work. They can interfere with the signals or blood supply that make cancers grow or block the DNA repair in cancer cells.
Biological therapies used to treat ovarian cancer include bevacizumab (Avastin®) and olaparib (Lynparza®) to treat patients with BRCA-related ovarian cancer.
Bevacizumab works by stopping the blood supply to the cancer by preventing new blood vessels developing. These drugs are called ‘angiogenesis inhibitors’. Olaparib is a ‘PARP-1 inhibitor’. PARP is a protein in our body that helps damaged cells to mend themselves. Olaparib stops PARP working. Cancer cells with altered BRCA genes depend on PARP to keep their DNA functioning. Taking olaparib stops PARP from mending the DNA cell damage, which means cancer cells don’t survive.
Several new experimental treatments are being investigated to treat women with ovarian cancer, including immunotherapy.
Cancer that comes back is called a ‘recurrence’. A recurrence of ovarian cancer usually means the cancer has started to grow again near where the original cancer began or in another part of your body. It can be difficult to learn your cancer has come back. However, there is still treatment available. The Resilience Kit discusses the emotional impact and possible treatment options if your cancer does come back. You can find out more in the Recurrence section of our website, too.
These are natural therapies used alongside mainstream/conventional cancer treatments (e.g. chemotherapy, radiotherapy), which aim to treat both mind and body. Examples of commonly used complementary therapies include massage, mindfulness meditation and acupuncture. These therapies have not been scientifically proven to treat or cure cancer. However, a few have been shown to help some people feel and cope better with their cancer and its treatments. They work on helping your mind and body feel better. Research shows women with ovarian cancer can benefit in many ways from using complementary therapies.
The Wellbeing section has information about the different types of complementary therapies.
For further information read the Cancer Council’s booklet, Understanding complementary therapies (www.cancer.org.au or call 13 11 20 for a free copy).
After completing treatment and not having such regular contact with your healthcare team, some women feel alone. Remember, your treatment team are still there to support you if needed. Be sure to ask them for contact numbers in case you want to call for advice. You may also begin to worry about the cancer coming back. This is when joining a support group can be helpful. To find out about groups in your area, call the Information and Referral Line on 1300 660 334.
When treatment finishes, it can help to plan a special event with those close to you, or even a holiday to mark the end of your treatment. This can help give your body and mind a rest from all you have been through since your diagnosis.