Chemotherapy is one of the main ways to treat ovarian cancer. It uses anticancer drugs, which are usually given intravenously. The drugs kill or slow the growth of the cancer. You will almost always have chemotherapy and surgery to treat ovarian cancer, even with early stage disease.
The doctor who treats you with chemotherapy is called a gynecologic oncologist or a medical oncologist. Gynecologic oncologists are subspecialists with advanced training in the diagnosis, treatment, and surveillance of female cancers including ovarian cancer.
Chemotherapy for ovarian cancer usually involves more than one drug. You may want to know details about the drugs you're taking. You may also want to know about their common side effects. Ask your doctor or nurse to go over this information with you.
About 1 to 4 weeks after surgery to remove ovarian tumors, you will likely begin chemotherapy. You will most likely have it for about 6 months.
How often you receive treatment will depend on the type of chemotherapy you receive. The chemotherapy regimen will vary depending on the stage of the cancer and the amount of residual cancer remaining after cytoreductive (tumor debulking) surgery. You may have chemotherapy every day, every week, every few weeks, or even once a month.
You may receive the drugs intravenously, meaning by vein, through an IV. This is known as systemic therapy. The drugs enter the bloodstream and reach all areas of your body. This makes the treatment especially effective if your cancer has spread beyond the ovaries.
Another way you may receive the drugs is by injection directly into your abdomen. This is called intraperitoneal chemotherapy. Recent clinical trials show that using both delivery methods (intravenous and intraperitoneal) extends the survival of women with advanced ovarian cancer. Occasionally drugs that are given by mouth can also be used.
Most chemotherapy is given in a doctor's office or in the outpatient part of the hospital. The treatments can last several hours each.
There are several drugs your doctor may choose from. Your doctor may recommend more than one at the same time. This is called combination chemotherapy. Sometimes this works better. These are the chemotherapy drugs typically used to treat ovarian cancer:
Platinum agents such as Paraplatin (carboplatin) and Cisplatin. These are the drugs doctors most often use to treat ovarian cancer. They work by creating breaks in the genetic material inside each cell called DNA. This leads to cell death.
Taxanes, such as Taxol (paclitaxel) and Taxotere (docetaxel). These prevent cells from dividing. This class of drugs is used in combination with cisplatin or carboplatin.
Anthracyclines, such as Adriamycin (doxorubicin) and Doxil (liposomal doxorubicin). These are drugs often used if cancer recurs, or comes back.
Gemcitabine. This drug is often used if cancer recurs.
Topotecan. This drug is often used if cancer recurs.
Bevacizumab. This blocks tumors from growing new blood vessels. It is sometimes combined with chemotherapy or used as a single agent for maintenance treatment.
The side effects of chemotherapy depend on which drugs are given and at what dose. You may or may not experience a particular side effect, depending on your overall health and other medications you may be taking. Your doctor may give you instructions or medicines that can prevent or help control these side effects:
Blood cells. When drugs affect your blood cells, you may be more likely to get infections, bruise or bleed easily, and feel very weak and tired. Your doctor or nurse will check blood counts and suggest medicines that can help your body make new blood cells and recover sooner. They may also reduce your dose or postpone a treatment if your blood counts become too low.
Cells in hair roots. Some drugs can cause hair loss. Your hair will grow back, but it may be somewhat different in color and texture.
Cells in the digestive tract. Certain drugs can cause poor appetite, nausea and vomiting, diarrhea, or mouth and lip sores. Please tell your health care team if you experience these problems.
Some patients may notice hearing loss, joint pain, and tingling or numbness in the hands or feet. These side effects usually go away after treatment ends. You should report these symptoms to your doctor or nurse as soon as you notice them.