Ovarian Cancer Treatment
Ovarian cancer treatment most often consists of a combination of surgery and chemotherapy, but some patients can benefit from additional treatment methods, such as radiation, hormone therapy and immunotherapy. The recommended treatment plan can vary based on several key factors, including the type and stage of the cancer as well as the patient’s overall health and preferences.
At Moffitt Cancer Center, we offer a multispecialty approach to ovarian cancer care through which each patient has access to multiple experts—not just one physician—in a single location. Every week, a group of highly specialized medical professionals conducts a tumor board review to discuss the patient’s pathology in detail. To ensure the best possible care, each recommended treatment plan incorporates input from gynecologic oncologists, pathologists, radiologists, radiation oncologists, genetic counselors, and supportive care providers.
Surgery is typically step one in ovarian cancer treatment
When treating ovarian cancer, surgery is often needed to determine the extent of the cancer and whether it has spread. A gynecologic oncologist might remove tissue samples, lymph nodes and abdominal fluid for further testing. If, during this procedure, a gynecologic oncologist determines that cancer has spread, he or she will remove as much cancer as possible at that time. Having the skill to remove cancer to an optimal level whenever possible is essential to give the best possible survival chance and outcomes for our patients. This surgical skill is one thing that defines a Moffitt gynecologic oncologist and gives our patients an advantage as they start their treatment.
Several surgical techniques are available for treatment of ovarian cancer, including:
- Unilateral salpingo-oophorectomy – Removes one ovary and one fallopian tube, both of which are located on the same side of the body
- Bilateral salpingo-oophorectomy – Removes both ovaries and fallopian tubes
- Hysterectomy – Removes the uterus and cervix, along with the surrounding tissues, the ovaries and the upper part of the vagina
- Lymph node dissection – Removes the lymph nodes in the pelvic and para-aortic areas
- Omentectomy – Removes the thin tissue that covers the stomach and large intestine
- Cytoreductive/debulking surgery – Removes as much tumor as is safely possible, which might entail the removal of tissue from nearby organs, such as the gallbladder, spleen, stomach, bladder or colon
The choice of surgical technique will depend on factors that are specific to the patient, including the type of ovarian cancer she has, what stage it’s in and whether she’s of child-bearing age.
Chemotherapy’s role in ovarian cancer treatment
Chemotherapy is the use of drugs that circulate in the bloodstream and kill cancer cells. When treating ovarian cancer, chemotherapy can be prescribed before surgery to shrink large tumors so they’re easier to remove. Generally, however, chemotherapy is used after cancer surgery to destroy small areas of cancer cells that may remain in the patient’s body. This form of treatment may also be used to kill cancer cells that have metastasized (spread to other parts of the body).
Although chemotherapy can be administered orally, most of the drugs used to treat ovarian cancer are administered intravenously by injecting them directly into a vein, or intraperitoneally by placing a catheter in the patient’s abdomen to deliver chemotherapy directly into the pelvic area.
Doctors have a variety of chemotherapy drugs to choose from when treating ovarian cancer. Treatment often involves selecting and combining different drugs based on the patient’s overall health and how effective the medications have been in treating her type of cancer. Some of the most commonly prescribed chemotherapy drugs used to treat ovarian cancer are:
The dosages and duration of chemotherapy can vary widely, but it’s common for patients to receive one dose every three weeks for three to six cycles. The drug selection, dosages, and duration of chemotherapy can also depend on whether the patient is receiving initial treatments for ovarian cancer or for a recurrence of the malignancy.
How radiation fits into ovarian cancer treatment
Radiation therapy is a cancer treatment that aims high-energy X-rays at cancerous cells to kill them. It’s rarely used to directly treat ovarian cancer because chemotherapy has proven more effective. But radiation therapy might be prescribed in addition to other treatments to target cancer cells that have spread beyond the ovarian tumor site.
Immunotherapy, a promising treatment for ovarian cancer
Like chemotherapy, immunotherapy uses drugs to treat ovarian cancer. However, unlike chemotherapy, the drugs selected don’t attack the cancerous cells directly. Instead, they target facets of the patient’s natural immune system to boost its ability to recognize and fight cancer. Among the different immunotherapies being developed are poly ADP-ribose polymerase (PARP) inhibitors, a form of targeted therapy. In clinical trials, treatment that includes PARP inhibitors has been shown to help delay the recurrence of ovarian cancer. This is significant because about 70% of women treated for ovarian cancer experience a relapse within two years of their initial treatment.
Hormone therapy for some types of ovarian cancer
The use of hormones or hormone-blocking drugs may be part of a treatment plan for patients with ovarian stromal tumors. It is rarely prescribed for patients with epithelial ovarian cancer, which is the most common form of the disease.
Is ovarian cancer curable?
Many women who develop ovarian cancer have no noticeable symptoms, which leads to most ovarian cancer diagnoses occurring in the later stages of the disease when it’s more difficult to treat. The overall five-year relative survival rate for ovarian cancer is about 49%. However, it’s important to note that a patient’s prognosis depends on many factors, including her general health condition, the type of ovarian cancer she has and what stage it’s in when treatment begins.
At Moffitt Cancer Center, we’re dedicated to uprooting the traditional cancer treatment models to accelerate new developments that lead to better outcomes for our patients. For example, there are signs that our PARP inhibitor treatments may have curative properties for ovarian cancer, though more research is needed.
Additionally, when ovarian cancer patients turn to Moffitt, their treatment may involve some newer biologically targeted approaches based on the patient’s inherited or the cancer cells’ genetics. Moffitt is one of the very few places in the country to have its own separate genetics tumor board, which reviews our patients’ molecular genetics and makes recommendations for the best current treatment or any available clinical studies. Having the best therapy as part of the initial treatment is one of the most important things that can be done to have the longest possible survival.
Connect with the experts at Moffitt
After a cancer diagnosis, every day counts. We are providing every new patient with rapid access to a cancer expert, and we develop personalized treatment plans tailored to the needs of each patient.
If you'd like to discuss ovarian cancer treatment options with our team of ovarian cancer experts, please call 1-888-663-3488 or schedule an appointment online. Virtual visit appointments may be available. No referral is necessary.
Medically reviewed by Robert Wenham, MD, Chair, Gynecologic Oncology Program
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