Booklet: What You Need to Know about Ovarian Cancer

Methods of Treatment

Ovarian cancer may be treated with surgery, chemotherapy, or radiation therapy. The doctor may use just one method or combine them.

• Surgery is the initial treatment for almost every woman with ovarian cancer.
• Chemotherapy may be used following surgery as adjuvant therapy, to kill any cancer cells that may remain in the body. It may also be used at a later time if there are signs that the cancer has recurred.
• Radiation therapy may be used in a small number of patients to kill cancer cells that may remain in the pelvic area after surgery.

Surgery for ovarian cancer usually involves removal of the ovaries, the uterus, and the fallopian tubes. This operation is called hysterectomy with bilateral salpingo-oophorectomy. (If a woman has a very early, slow-growing tumor and wants to remain able to have a child, the doctor may remove the affected ovary.) If the cancer has spread, the surgeon removes as much of the cancer as possible in a procedure called tumor debulking. Tumor debulking reduces the amount of cancer to be treated with chemotherapy or radiation therapy.

Here are some questions a woman may want to ask her doctor before surgery:

• What kind of operation will I have?
• How will I feel after the operation?
• If I have pain, how will you help me?
• When can I get back to my normal activities?

Chemotherapy for ovarian cancer often involves a combination of drugs. Anticancer drugs are usually given by injection into a vein or by mouth. Either way, chemotherapy is called systemic therapy because the drugs travel all through the body in the bloodstream.

Chemotherapy is usually given in cycles: a treatment period followed by a recovery period, then another treatment period, and so on. A woman may receive chemotherapy as an outpatient at the hospital, at the doctor's office, or at home. Depending on which drugs are used, how they are given, and her general health, a woman may need to stay in the hospital while receiving chemotherapy.

Doctors are studying another way of giving anticancer drugs called intraperitoneal chemotherapy. In this approach, the drugs are put directly into the abdomen through a catheter. In this way, drugs reach the cancer directly. This treatment is given in the hospital.

Here are some questions a patient may want to ask the doctor before chemotherapy:

• What is the goal of this treatment?
• What drugs will I be taking? What should I expect?
• What can be done to help with side effects?
• How will we know if the drugs are working?
• How often will I receive treatment? How long will I be on the treatment?
• Where will I receive this treatment?
• Can I continue my regular activities?

Radiation therapy (also called radiotherapy) is the use of high-energy rays to damage cancer cells and stop them from growing. Radiation may come from a machine (external radiation) or from radioactive material placed into or near the tumor (internal radiation). Like surgery, radiation therapy is local therapy, it affects cancer cells only in the treated area.

For external radiation therapy, the patient goes to the hospital or clinic each day. Usually, the treatments are given 5 days a week for about 5 weeks.

Some women receive a type of internal radiation called intraperitoneal irradiation. Radioactive liquid is put into the abdomen through a catheter. A short hospital stay may be necessary for this treatment.

Here are some questions the patient may want to ask her doctor before radiation therapy:

• What is the goal of this treatment?
• How will the radiation be given?
• When will the treatments begin? When will they end?
• What can be done to help with side effects?
• How will we know if the radiation therapy is working?
• Can I continue my regular activities?

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