Treatment Overview

Types of treatment

The choice of treatment and the long-term outcome (prognosis) for women who have ovarian cancer depends on the type and stage of cancer. Your age, overall health, quality of life, and desire to have children must also be considered.

The main treatment choices are:

• Surgery to find out if you have cancer and to treat it. This may include taking biopsies to check for the spread of cancer. For more information, see Surgery.
• Chemotherapy, which uses medicines to kill cancer cells. It is recommended after surgery for most stages of ovarian cancer. For more information, see Medications.

Women with more advanced ovarian cancer may have part of their chemotherapy before surgery and the rest of it after surgery. This can make the surgery safer for these women.

Radiation therapy may be used to destroy cancer cells using high-dose X-rays or other high-energy rays. For more information, see Other Treatment.

For more information about specific ovarian cancer treatments, see the topics:

Ovarian Cancer – Health Professional Information [NCI PDQ].

Ovarian Cancer – Patient Information [NCI PDQ].

Side effects of treatment

Most treatments for ovarian cancer cause side effects. They may differ, depending on the type of treatment and your age and overall health.

• Side effects of surgery depend on the extent of your surgery. If the doctor removes your ovaries, you will no longer be able to bear children. And if you were still menstruating before your surgery, you will start menopause.
• Side effects of chemotherapy may include loss of appetite, nausea, vomiting, fatigue, and hair loss. There is also an increased chance of getting a serious infection.

Radiation treatment also can cause side effects. For more information, see Other Treatment.

Home treatment may help you manage the side effects. For more information, see Home Treatment.

Advanced-stage ovarian cancer

Surgery in advanced-stage ovarian cancer involves removing as much of the cancer as possible. The uterus, the tissue lining the abdominal wall (omentum), and any areas of visible cancer are removed. This may include surgery on the intestines, urinary system, or spleen, or scraping of the diaphragm to remove all the cancer. The long-term outcome is better if no cancer cells remain.

Clinical trials

Your doctor may talk to you about being in a clinical trial of a treatment such as immunotherapy or targeted therapy.

Coping with emotions

When you first find out that you have cancer, you may feel scared or angry. Or you may feel very calm. It's normal to have a wide range of feelings and for those feelings to change quickly. Some people find that it helps to talk about their feelings with family and friends.

If your emotional reaction to cancer gets in the way of your ability to make decisions about your health, it's important to talk with your doctor. Your cancer treatment center may offer psychological or financial services. And a local chapter of the American Cancer Society can help you find a support group.

Body image and sexual problems

Your feelings about your body may change after treatment for cancer. Managing body image issues may involve talking about your concerns with your partner and discussing your feelings with your doctor. Your doctor may also be able to refer you to groups that can offer support and information.

Sexual problems can be caused by the physical or emotional effects of cancer or its treatment. Some women may feel less sexual pleasure or lose their desire to be intimate. For more information, see the topic Sexual Problems in Women.

Follow-up care

After treatment for ovarian cancer, it's important to receive follow-up care, because ovarian cancer may come back (recur). Your doctor will set up a schedule of checkups and tests.

If the cancer recurs or spreads (metastasizes), it's usually treated with chemotherapy. Surgery may also be done. Or your doctor may recommend that you join a clinical trial for treatment with surgery or immunotherapy.

The long-term outcome for recurrent ovarian cancer depends on whether the cancer has spread. Even with no sign of cancer after treatment, 3 to 5 out of 10 women who are treated for ovarian cancer have cancer return within 5 years. This also means that cancer doesn't recur within 5 years in 5 to 7 out of 10 women.⁸

Palliative care

Cancer treatment has two main goals: curing cancer and making your quality of life as good as possible. Palliative care can improve your quality of life by helping you manage your symptoms. It also can help you with other concerns that you may have when you are living with a serious illness.

For some people who have advanced cancer, a time comes when treatment to cure cancer no longer seems like a good choice. This can be because the side effects, time, and costs of treatment are greater than the promise of cure or relief. But this isn't the end of treatment. You and your doctor can decide when you may be ready for hospice care.

It can be hard to decide when to stop treatment to prolong your life and shift the focus to end-of-life care. For more information, see the topics:

• Palliative Care.
• Hospice Care.
• Care at the End of Life.