Navigating and understanding ovarian cancer treatment options are critical for getting optimal care. All treatment decisions should be made by a patient in consultation with their medical professional team.
The standard treatment for ovarian cancer consists of debulking surgery followed by six rounds of chemotherapy. One recent study found that just 37 percent of women receive this standard treatment, despite evidence showing that it is the most effective.
The goal of treatment for ovarian cancer is to surgically remove as much of the cancer as possible through the debulking and then to provide what is called adjuvant, or additional therapy, such as chemotherapy, to kill any possibly remaining cancer cells in the body.
Radiation therapy, or radiotherapeutic procedures, which may use high energy rays to kill cancer cells that remain after surgery, are not typically utilized in ovarian cancer.
What happens if you are diagnosed with ovarian cancer?
Before surgery, a doctor, preferably a gynecologic oncologist, will explain the nature of the operation and the extent of tissue that will be removed. During the operation, the doctor will assess how far the tumor has spread, to determine the stage of the cancer, and will give tissue samples to a pathologist, who will determine the grade of the cancer.
After the operation, the doctor will discuss the nature of the chemotherapy that will be given, which will depend on the stage of the disease and how much of the tumor was removed. A doctor might also offer a patient the possibility of enrolling in a clinical trial, if she meets the criteria for the research study.
Making a list of questions before an appointment with a doctor can be useful because the shock and stress of the diagnosis can make it hard to remember things and medical care can be complicated and difficult to understand. Taking notes of the doctor’s responses or having a friend or relative with you during appointments can be helpful.
Here are some questions the National Cancer Institute suggests you might consider asking a doctor early in treatment:
- What is the stage of my disease? Has the cancer spread from the ovaries? If so, to where?
- What are my treatment choices? Do you recommend intraperitoneal chemotherapy for me? Why or why not?
- Would a clinical trial be appropriate for me?
- Will I need more than one kind of treatment?
- What are the expected benefits of each kind of treatment?
- What are the risks and possible side effects of each treatment? What can we do to control side effects? Will they go away after treatment ends?
- What can I do to prepare for treatment?
- How long will I need to stay in the hospital? Can I get chemotherapy at my local hospital since it is too far to drive to a major medical center?
- What is the treatment likely to cost? Will my insurance cover the cost?
- How will treatment affect my normal activities?
- Will treatment cause me to go through early menopause?
- Will I be able to get pregnant and have children after treatment?
- How often should I have checkups after treatment?
If a patient doesn’t feel comfortable with a doctor or wants to seek a second opinion concerning treatment and care, they have the right to do so.
Gynecologic Oncologists and Treatment
A gynecologic oncologist is a specialist in treating women’s reproductive cancers. Women with ovarian cancer are strongly encouraged to seek care from one of these specialists.
Multiple studies conducted over the past decade have shown that an ovarian cancer patient’s chance of survival is significantly improved when her surgery is performed by a gynecologic oncologist. One analysis of multiple studies found that women whose surgeries were performed by gynecologic oncologists had a median survival time that was 50 percent greater than women whose surgeries were done by general gynecologists or other surgeons inexperienced in optimal debulking procedures.
Sometimes referred to as cytoreductive surgery, debulking involves removal of as much of the tumor as possible. As part of the debulking procedure, doctors try to stage the disease definitively and identify the optimal treatment for the cancer. Proper staging and optimal debulking translate into improved overall survival for women at any stage of ovarian cancer.
Gynecologic oncologists have greater success in treating ovarian cancer as a result of their tendency to perform more aggressive surgery. Women whose tumors have been reduced to less than one centimeter have a better response to chemotherapy and improved survival rate. Gynecologic oncologists also are more likely to perform the multiple peritoneal and lymph node biopsies necessary to ensure adequate surgical staging.
To locate a gynecologic oncologist near you, visit the Foundation for Women’s Cancer website.