Ovarian Cancer Treatments & Therapies



treatments & therapies

All information is compiled from the American Cancer Society and Dana-Farber Cancer Institute

The primary treatments and therapies for ovarian cancer are surgery, chemotherapy and radiation therapy. In some cases, two or even all of these treatments may be recommended.

surgery

If you are diagnosed with ovarian cancer, the scope of the surgery you will require and the impact it may have on your future fertility is a function of your overall health and the extent to which your cancer has spread. For the 19% of women whose cancer is detected before it spreads beyond the ovaries, surgery may be limited to just the affected ovary or ovaries. For the majority of ovarian cancer diagnoses, however, cancer that has spread beyond the ovaries necessitates more extensive surgery.

Surgery for ovarian cancer has two main goals: staging and debulking. Staging the cancer determines the extent to which it has spread beyond the ovary, which in turn determines the appropriate course of treatment.

Types of surgery may include:

Samples of tissues and fluids collected during surgery will also be examined for cancer cells.

The other important component of surgery is debulking, which removes as much of the tumor as possible, leaving behind only the absolute minimum. With successful debulking, the prognosis for patients improves dramatically.

Having an experienced gynecologic oncologist perform your surgery can help ensure that your cancer is appropriately and effectively staged and debulked the first time. A typical hospital stay for ovarian cancer surgery can range from 3 to 7 days following the operation. Patients can usually resume normal activities within 4 to 6 weeks.

what is chemotherapy?

Chemotherapy (chemo) is the use of drugs to treat cancer. Chemotherapy is often a systemic treatment, where the drugs enter the bloodstream, thus reaching all areas of the body. Systemic chemo can be useful for cancers that have metastasized (spread), and most of the time, involves using drugs that are injected intravenously or taken orally. For some cases of ovarian cancer, chemotherapy may also be injected through a catheter directly into the abdominal cavity. This is called intraperitoneal (IP) chemotherapy.

Chemotherapy typically consists of a combination of two or more drugs, given in cycles of every 3- to 4-weeks. Most oncologists in the U.S. believe that combination chemotherapy is more effective in treating ovarian cancer than just using one drug alone.

epithelial ovarian cancer

Combination therapy using a platinum compound, such as cisplatin or carboplatin, and a taxane, such as paclitaxel (Taxol®) or docetaxel (Taxotere®), is the standard approach. For IV chemotherapy, most doctors favor carboplatin over cisplatin, because it has fewer side effects and is equally as effective.

The typical course of chemotherapy for epithelial ovarian cancer involves 3 to 6 cycles. A cycle is a schedule that allows regular doses of a drug, followed by a rest period. Different drugs have varying cycles, and your oncologist will prescribe the particular cycle or schedule for your chemotherapy.

Epithelial ovarian cancer tends to respond to chemotherapy, but the cancer cells may eventually begin to grow again. Tumor recurrence can be treated with additional cycles of the same chemotherapy used the first time. In some cases, different drugs are used. Some of these are topotecan, anthracyclines such as doxorubicin (Adriamycin®) and liposomal doxorubicin (Doxil®), gemcitabine (Gemzar®), cyclophosphamide (Cytoxan®), vinorelbine (Navelbine®), hexamethylmelamine, ifosfamide (Ifos®), and etoposide (VP-16).

radiation therapy

Radiation therapy utilizes high energy x-rays to kill cancer cells. These x-rays may be given in a procedure that is much like having a diagnostic x-ray. Radiation therapy was used more often in the past, but now it is rarely used as the main treatment for ovarian cancer.

what are common side effects of chemotherapy?

Naturally, you may be apprehensive about undergoing chemotherapy, especially after talking with others who have experienced it before. Keep in mind that what can be expected from chemotherapy, from the type, severity and duration of its side effects to its overall efficacy, will vary greatly from person to person.

The following list from the American Cancer Society includes the most commonly reported symptoms, but it’s important to remember that not everyone gets all of the symptoms:

Chemotherapy may also cause changes in other parts of your body:

Be sure to discuss your chemotherapy plan with your healthcare team so that you can learn more about:

targeted therapy

Targeted therapy is a new type of cancer treatment that uses drugs or other substances to identify and attack cancer cells, while doing little damage to normal cells. Each type of targeted therapy works differently, but all alter the way a cancer cell grows, divides, repairs itself or interacts with other normal, healthy cells.

The targeted therapy drug that has been studied the most in ovarian cancer is bevacizumab (Avastin®). This drug helps block the signal that cancer cells send out to nourish new tumors. In studies, bevacizumab has been shown to shrink or slow the growth of advanced ovarian cancers. Clinical trials to see if bevacizumab works even better when given along with chemotherapy have shown promising results in terms of shrinking (or stopping the growth of) tumors. But, there have been problems with patients developing holes in the bowel wall during treatment—a complication which can be fatal. Scientists are still studying the safest way to give this drug with other forms of chemotherapy. Bevacizumab isn't yet approved by the Food and Drug Administration to treat ovarian cancer, but it has been approved in the treatment of other cancers.


bringing strength to a sensitive situation

For certain women with ovarian cancer, the treatment can be just as difficult to tolerate as the disease. Hypersensitivity or allergic reactions to the prescribed medications or chemotherapy can stand in the way of proper treatment. Ovations for the Cure of Ovarian Cancer actively supports the Desensitization Program at Brigham and Women’s Hospital. Through this extremely innovative program, women with ovarian cancer are able to overcome sensitivity to therapy and receive the treatment so vital to survival. After all, just because women are sensitive, it doesn’t mean they can’t be strong.

Click on the links below to download articles covering more information on this important topic.

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When you're allergic to your RX

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Carboplatin hypersensitivity

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Rapid inpatient/outpatient desensitization for chemotherapy hypersensitivity

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Rapid desensitization for hypersensitivity reactions to Paclitaxel and Docetaxel

All information is compiled from the American Cancer Society and Dana-Farber Cancer Institute