When cancer returns after a period of remission, it is considered a recurrence. Around 70 percent of patients diagnosed with ovarian cancer will have a recurrence.
A recurrence can be scary, and it’s natural to jump to worst-case scenarios when you hear the words, “Your cancer is back.” If you or a loved one are experiencing a recurrence, it’s important to keep in mind that every person is different. For all their importance, statistics are just that—representations of a wide range of individuals and outcomes.
Data has shown that statistically speaking, recurrent ovarian cancer is treatable, but is rarely completely curable. Your approach to a recurrence will depend on a number of factors, all of which should be discussed with your gynecologic oncologist. Researchers have made significant advances in maintenance therapies in recent years, which means more people are managing ovarian cancer as a chronic disease for longer periods of time, and there are women who have had a recurrence, who then go on to be NED (No Evidence of Disease). Cancer type, available treatment options (including clinical trials, if applicable), potential treatment side effects and toxicity, and more, should all play a role in your strategy for managing an ovarian cancer recurrence.
One of the most significant factors in determining a patient’s risk of recurrence is the stage of the cancer at diagnosis:
- Patients diagnosed in stage 1 have a 10 percent chance of recurrence.
- Patients diagnosed in stage 2 have a 30 percent chance of recurrence.
- Patients diagnosed in stage 3 have a 70 to 90 percent chance of recurrence.
- Patients diagnosed in stage 4 have a 90 to 95 percent chance of recurrence.
You can find more information on managing ovarian cancer recurrence in videos from our 2020 National Conference.
If ovarian cancer does recur after surgery, it can present in different ways, either localized to another part of the body, or as a widespread recurrence.
The effectiveness and type of treatment for recurrent ovarian cancer depends on what kind of chemotherapy the patient received in the past, the side effects associated with previous treatments, the extent of the recurrent cancer and the length of time since the last treatment was finished called the “time to recurrence,” which researchers often call “progression-free survival.”
The “time to recurrence” is the amount of time between your response to a prior platinum-based chemotherapy and the time of the recurrence.
- If the time to recurrence is less than six months, the ovarian cancer is classified as platinum-resistant, and the woman will be treated with usually one other type of chemotherapy drug. Women are encouraged to consider participating in a clinical trial that might offer an opportunity to take a new investigational drug that could be helpful.
- If the time to recurrence is more than six months, the ovarian cancer is classified as platinum-sensitive and the woman will be treated with a platinum-based drug again and another chemotherapy agent.
During treatment for recurrence, it is very important to have a continual dialogue with your doctor about the benefits of treatment, with respect to remission and survival, versus the risks of the side effects that hurt the quality of your life. If you do choose treatment in recurrence, there are several options based on your previous treatments.
Chemotherapy is used to stop the progression of cancer and prolong the patient’s survival. Sometimes, surgery is used to relieve symptoms, such as a blocked bowel caused by the recurrence. In select patients, surgery for debulking of cancer is also an option. It is important to stress again that you, in consultation with your doctor, should set realistic goals for what to expect from treatment. This may mean weighing the possible positive outcomes of a new treatment against the possible negative ones. At some point, a woman may decide that continuing treatment is unlikely to improve her health or survival. A woman must be certain that she is comfortable with her decision whatever it is.