Treatments

A diagnosis of ovarian cancer means you will need to make a number of decisions about treatment.

In this section, we’ll look at the different treatments available, including:

Try to gather as much information as possible about your treatment options and don’t be afraid to ask questions. You need good information to make the best decisions for your health.

Your treatment options will vary depending on the type, size and location of the tumour, as well as your overall health. Remember, everyone is different and your doctor will focus on the best treatment options to suit you. If you’re a younger woman and you want to take measures to preserve your fertility, then you should have this discussion with your oncologist early.

Treatment for ovarian cancer usually involves surgery to remove the tumour or cancerous cells. This may be all you need if you have early stage ovarian cancer, however if the cancer has spread, you may need chemotherapy and/or targeted therapies. Radiotherapy is not usually used in the treatment of ovarian cancer.

Surgery

Surgery for ovarian cancer aims to remove as much of the tumour or cancerous cells as possible. The extent of surgery will depend on the type and size of the tumour.

Discuss all options with your surgeon because sometimes the type of the surgery you need will change during the operation so it’s important to be prepared for all eventualities.

Surgery usually involves the removal of one or both of the ovaries. If the cancer has spread beyond the ovaries, then surgery can also involve the removal of the fallopian tubes, the uterus, the cervix, the omentum (the layer of fatty tissue that covers the internal organs), the appendix, nearby lymph nodes and, in some cases, part of the bowel or other affected organs.

The length of time it takes to recover from surgery will vary. You are likely to be in hospital for a few days and to be sore for some time. Surgery for ovarian cancer is a major operation so you’ll need to take things easy for a while.

If you were still having periods before surgery, then the removal of your ovaries will mean you will enter early menopause which may result in a number of side-effects. You can discuss treatment options for these with your medical team.

Chemotherapy

Surgery for ovarian cancer is often followed by chemotherapy. Chemotherapy medicines work to destroy the cancer cells or control their growth. When you have chemotherapy, you are usually given a combination of two or more medicines intravenously (through the vein). Chemotherapy is most commonly given every three to four weeks over a period of several months.

Chemotherapy kills rapidly growing cells like cancer cells, but can also kill other healthy cells that grow quickly, such as those in the bone marrow, digestive tract and hair follicles. Chemotherapy treatment can lead to a number of side-effects, including:

  • Nausea and vomiting
  • Hair loss,
  • Fatigue
  • Increased risk of infection.

If you’re experiencing side-effects as a result of chemotherapy, speak to your medical team about the best way to manage these. There are medicines that can be used to effectively control or minimise side-effects.

Targeted Therapies

Advances in cancer treatment have seen the development of targeted therapies. These involve the use of medicines which specifically identify and attack cancer cells without usually damaging normal cells. They can be an effective form of treatment for many cancers.

Advanced ovarian cancer can be treated with a targeted therapy known as Avastin® (also known as bevacizumab).

Avastin helps to stop tumour growth by blocking the development of new blood vessels which cancer cells need to grow and spread. Avastin® is often given in combination with chemotherapy for those with advanced ovarian cancer and can be continued for up to 15 months.

Studies have looked at how well Avastin works for women with ovarian cance.

A large clinical study found that women with advanced ovarian cancer, who took Avastin in combination with chemotherapy as their first treatment after surgery, remained free of their disease (their tumours did not grow or spread) for longer, compared with patients who received only chemotherapy.

Another large study was also undertaken in women with ovarian cancer whose disease persists and does not respond to platinum containing chemotherapy (known as recurrent, platinum-resistant disease). The results of this study showed that women who were given Avastin together chemotherapy remained free of their disease for longer, compared to women who received only chemotherapy.

However, Avastin has not been shown to improve overall survival (the length of time you live) in women with advanced ovarian cancer or recurrent platinum-resistant ovarian cancer.

Avastin is not publicly funded in New Zealand for women with advanced or platinum-resistant ovarian cancer so you will have to pay for it yourself.

Avastin is not suitable for everyone. Speak to your doctor about whether Avastin is a suitable treatment for you.

All medicines can have side effects. Sometimes they are serious, most of the time they are not.

Find out more about Avastin, including how it works, side-effects, and costs here.