Health Guide

Treatment of ovarian cancer

Treatment for ovarian cancer usually involves surgery and chemotherapy. Radiotherapy may also be used. These treatments may be used alone or together.

Surgery

The first treatment for ovarian cancer is usually surgery. Since confirmation of cancer usually follows the operation, it is important to discuss all the possible options with the gynaecological oncologist prior to surgery. The surgery involves an operation known as a laparotomy. A vertical cut is made in the abdomen which allows the doctor to find and to remove as much of the tumour as possible.

The surgery involves the removal of both ovaries, the fallopian tubes, the uterus (womb), the omentum (the membrane that covers the abdominal organs) and some of the lymph glands. It is sometimes necessary to remove part of the bowel as well. The extent of the surgery depends on how far the cancer has spread and on your general health.

After the operation, samples of the ovary, lymph glands and other organs are sent to the laboratory for further examination. The results of these biopsies will provide information that may assist in making decisions about further treatment.

Following Surgery

As this is major surgery you would expect to remain in hospital for several days.

Whilst in hospital you will discuss the operation, the results of the biopsies and further treatment with your doctor. Further treatment, such as chemotherapy is usually required for treating ovarian cancer. You will also discuss with your doctor other considerations relating to the resumption of physical activities.

The nursing staff and social workers are also there to offer emotional support during this period.

Chemotherapy

This is the treatment of cancer by drugs; the aim is to kill cancer cells whilst doing the least damage to normal cells.

Chemotherapy may be offered to women with ovarian cancer following surgery. This works best if it is started soon after the operation. The first course of chemotherapy is often given whilst you are still in hospital following surgery. Subsequent treatments may necessitate an overnight stay though it is more likely that you will be treated as a day patient. This will depend on the drugs administered and on how well you are feeling.

Chemotherapy side effects vary according to the particular drugs used. Side effects are temporary and can be controlled by medications and adjusting chemotherapy treatments. It is important to ask the specialist about all the types of side effects likely to occur. The most troublesome side effect is usually nausea and vomiting although these symptoms can be allayed by modern drugs. There may be some temporary thinning or loss of hair which will grow back when the chemotherapy is complete.


Menopause

After your ovaries and uterus have been removed you will no longer have periods and you will go through menopause if this has not already occurred.

The symptoms of hot flushes and vaginal dryness may be more pronounced than amongst women who have experienced menopause naturally over a period of time.

Hormone replacement therapy may be given to alleviate the symptoms of menopause. The hormone oestrogen is given to replace the natural oestrogen that your ovaries would normally produce. There are still some unanswered questions about hormone replacement therapy. You may wish to discuss the pro’s and con’s of hormone replacement therapy with your doctor.


Lymphoedema

Lymphoedema is the swelling of parts of the body. Following treatment for ovarian cancer this may occur in the legs. If the lymph glands in your pelvis have been removed this may prevent effective drainage of fluid from one or both legs and result in swelling.

Your doctor may give you advice as to how to minimise the swelling and it may also assist you to consult a specialist physiotherapist.


Follow-up

After your treatment is over you will require regular check-ups. To start with these may be as often as every month and they will gradually become less frequent.

Follow-up involves physical examinations and blood tests for tumour markers.

Further chemotherapy may be recommended by your doctor if your cancer has not responded to the initial treatment. The choice of drugs will depend on previous treatment as well as on the aims of the treatment.