Chemotherapy for Ovarian Cancer

Ovarian cancer begins in the ovaries, a pair of small female reproductive glands responsible for producing eggs and hormones, such as estrogen and progesterone. The cancer begins with harmful cellular changes that lead to uncontrolled cell growth. The abnormal cells then build up, bind together and form tumors in the ovaries.

Although ovarian cancer can occur at any age, it primarily affects women 50 and older. In addition to advanced age, other risk factors include a family history of ovarian or breast cancer, an inherited breast cancer gene mutation, such as BRCA1 or BRCA2, and endometriosis. However, the exact cause is often unclear, and many women who develop ovarian tumors have no known risk factors.

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Early-stage ovarian cancer is usually “silent.” As the tumor progresses, it may begin to produce noticeable symptoms, which are often vague and easily misattributed to other, more common and less serious conditions, such as irritable bowel syndrome (IBS) and urinary tract infections (UTIs). Warning signs can include abdominal bloating, pelvic pain, urinary urgency or frequency, appetite changes and unexplained fatigue. These symptoms should not be ignored.

The diagnostic process for ovarian cancer typically involves a combination of pelvic examination, imaging tests, such as ultrasound or computed tomography (CT) scans, a CA-125 blood test and sometimes a surgical biopsy to confirm the presence and type of cancer. After confirming the diagnosis, the physician will work with the patient to develop a tailored treatment plan, which may include a combination of surgery and chemotherapy. Other possible options are radiation therapy, immunotherapy and clinical trials.

When is chemotherapy used for ovarian cancer?

In many cases, chemotherapy is part of a comprehensive treatment plan for ovarian cancer. Sometimes, chemo is given before surgery to shrink the tumor and make it easier to remove. Ovarian cancer surgery often involves removing the ovaries, fallopian tubes and possibly the uterus and cervix, along with any other tissues affected by the cancer, such as the omentum, nearby lymph nodes and parts of the colon or other abdominal organs. The goal is to remove all visible cancer cells. After surgery, chemotherapy may be used to target any remaining microscopic cancer cells and help reduce the risk of recurrence.

Chemotherapy can also be used as the primary treatment for ovarian cancer if surgery is not feasible due to the patient's health or the extent of cancer spread. Additionally, chemo is frequently used to address ovarian cancer that has returned after initial treatment is completed.

What does chemotherapy for ovarian cancer involve?

Chemotherapy for ovarian cancer typically involves a combination of powerful medications, which may be delivered intravenously or, less commonly, directly into the abdominal cavity through intraperitoneal infusion. The most frequently used drug regimen includes a platinum-based agent, such as carboplatin or cisplatin, paired with a taxane drug, such as paclitaxel or docetaxel.

Usually, chemotherapy is administered in cycles, with each period of active treatment followed by a period of rest to allow the body time to recover. Although the total number of cycles can vary depending on the type and stage of the tumor, most ovarian cancer patients receive six cycles over several months.

What happens during chemotherapy for ovarian cancer?

Before starting treatment, the patient will undergo a series of blood tests to evaluate their blood cell counts and organ function. These tests can help the physician confirm that key health markers fall within safe ranges, which is critical given the intensity of chemotherapy. While this powerful treatment can effectively target cancer cells, it can also suppress bone marrow activity and stress vital organs. If the liver or kidneys are not functioning properly, the body may struggle to process and eliminate the chemo drugs, potentially leading to serious complications, such as systemic toxicity. Pre-treatment blood work can help reduce these risks and support the safe and effective delivery of chemotherapy.

During each chemotherapy session, the patient will receive the prescribed medications through an intravenous (IV) line or port, usually in an outpatient infusion center. Each session can last up to several hours, depending on the specific drug regimen.

Throughout chemotherapy, the patient will be monitored closely for side effects, and their chemo schedule or drug dosages will be adjusted as needed. Anti-nausea medications and other supportive treatments may be given alongside the chemo drugs to manage any side effects and improve the patient’s comfort.

What are the possible side effects of chemotherapy for ovarian cancer?

Chemotherapy is a systemic treatment that enters the bloodstream and travels throughout the body to target rapidly dividing cells, including cancer cells that may have spread beyond the original tumor site. However, because chemo drugs cannot distinguish between cancerous and healthy cells, they may also affect normal cells that replicate quickly, such as those in the hair follicles, digestive tract and bone marrow. As a result, the patient may experience side effects, such as fatigue, hair loss, nausea, vomiting and loss of appetite.

During chemotherapy, some patients develop anemia due to reduced red blood cell counts, recurrent infections due to reduced white blood cell counts or easy bleeding and bruising due to reduced platelet counts. Additionally, certain chemo drugs, such as paclitaxel, are known to cause peripheral neuropathy, which may lead to numbness or tingling in the hands and feet. Some women may also experience changes in their menstrual cycle or enter early menopause as a result of treatment.

What are the risks and possible complications of chemotherapy for ovarian cancer?

Although chemotherapy is generally well tolerated under careful medical supervision, it does involve certain risks. Severe allergic reactions can occur, particularly with drugs like paclitaxel. Prolonged low blood cell counts may increase the risk of serious infections and bleeding complications. Some chemo agents can also cause organ toxicity, potentially affecting the kidneys, liver or nervous system, especially with high doses or extended use. In rare cases, long-term complications may include secondary cancers or heart damage. For these reasons, the patient should promptly report any unusual or worsening symptoms to their healthcare team to ensure timely evaluation and management.

What to expect during recovery from chemotherapy for ovarian cancer

Recovery from chemo is typically gradual and can vary based on the patient’s overall health, the intensity of the treatment and the severity of any side effects. Most patients begin to regain energy within a few weeks after completing their final treatment cycle, though general fatigue and appetite changes may persist longer. Regular follow-up visits will be important to address any lingering effects and to monitor for signs of cancer recurrence. Emotional and psychological recovery is also an essential part of the healing process, and many patients find value in counseling, support groups or survivorship care programs. With appropriate support and time, most side effects are manageable and tend to improve or resolve.

How effective is chemotherapy for ovarian cancer?

As a cornerstone of ovarian cancer treatment, chemotherapy has been shown to significantly improve outcomes, especially when combined with surgery. Its effectiveness can vary based on several factors, including the type and stage of the tumor, how much of it remains after surgery and how the patient responds to treatment. For many patients, chemotherapy leads to remission, though recurrence is possible, particularly with advanced-stage ovarian cancer. In recurrent cases, chemo can still play an important role in controlling the progression of the tumor and improving the patient’s quality of life.

Benefit from world-class care at Moffitt Cancer Center

Chemotherapy for ovarian cancer is available at all Moffitt locations, and we do not require referrals. If you would like more information, you can request an appointment with a specialist in our gynecological clinic by calling 1-888-663-3488 or submitting a new patient registration form online.