Cancer is confined to one or both ovaries. Treatment starts with surgery (for staging and to remove the cancer). The uterus, both fallopian tubes and ovaries are often all removed. Unilateral salpingo-oophorectomy may be performed in young women, if fertility preservation is desired, and if the cancer is very early stage.
Cancer spreads within the pelvic region. Ovarian cancer treatment also starts with surgery for staging (determining how widespread the cancer is), removal of the uterus, both fallopian tubes and both ovaries (hysterectomy and bilateral salpingo-oophorectomy or BSO), and cytoreduction (removing as much of the cancer as possible). Treatment usually also includes chemotherapy.
Cancer spreads to other body parts within the abdomen(Average Stage of Diagnosis: Stage IIIC). As much of the cancer as possible is removed,…
and staging is performed to examine how far the cancer has spread. Surgery may include removal of the uterus, both fallopian tubes, both ovaries, omentum, and other tissues to which the cancer may have spread (such as the intestines). Following surgery, chemotherapy is usually given (adjuvant chemotherapy). In some cases, chemotherapy is given before surgery takes place (neoadjuvant chemotherapy).
Cancer spreads beyond the abdomen. This stage of disease may be treated in a similar fashion to stage III disease with surgery and/or chemotherapy.
Surgery is used to physically remove the cancer (or as much of the cancer as possible) from the body and determine how widespread the cancer is. Nearly all women with ovarian cancer will be required to have some type of surgery in their treatment process. Surgery has two main objectives:
Staging: Confirms the diagnosis and establishes how far the cancer has spread.
Cytoreduction: Removes as much of the cancer as possible.
Hysterectomy– removal of uterus
Bilateral salpingo-oophorectomy– removal of both fallopian tubes and both ovaries
Women with ovarian cancer will usually have a hysterectomy and bilateral salpingo-oophorectomy, along with staging procedures. In certain circumstances, for example in young women, who desire fertility preservation and in whom the cancer appears to be very early stage, the affected ovary and fallopian tube may be removed, in addition to sampling of other tissues to ensure no additional spread has occurred. (www.cancer.org and www.oncolink.com)
Administered by Gynecologic Oncologist or Medical Oncologist
Chemotherapy treatment is the use of cytotoxic drugs to destroy cancer cells. Chemotherapy for ovarian cancer is often a combination of 2 or more drugs given cyclically (every 3-4 weeks). Pairing medicines together is often more effective than using a single agent. There is a large variety of chemotherapy drugs available to treat ovarian cancer and chemotherapy can be given either intravenously (IV) or intraperitoneally (IP). Occasionally the tumor will be very large and chemotherapy will be prescribed before the surgery to shrink the tumor; this is referred to as neoadjuvant therapy. Neoadjuvant therapy makes it easier to remove as much of the tumor as possible during surgery. After surgery you may be prescribed “adjuvant” chemotherapy to destroy remaining cancer cells that are still present in the body. (http://www.cancerresearchuk.org/about-cancer/type/ovarian-cancer/treatment/surgery-for-ovarian-cancer) and (www.cancer.org)
Common chemotherapy drugs:
Cisplatin (brand name: Platinol®)
Carboplatin (brand name: Paraplatin®)
Paclitaxel (brand name: Taxol®)
Docetaxel (brand name: Taxotere®)
Other Drugs include:
Albumin bound paclitaxel (brand name: Abraxane®)
Altretamine (brand name: Hexalen®)
Capecitabine (brand name: Xeloda®)
Cyclophosphamide (brand name: Cytoxan®)
Etoposide (brand names: Etopophos®, Toposar®)
Gemcitabine (brand name: Gemzar®)
Ifosfamide (brand name: Ifex®)
Irinotecan (brand name: Camptosar®)
Liposomal doxorubicin (brand name: Doxil®)
Melphalan (brand name: Alkeran®)
Pemetrexed (brand name: Alimta®)
Topotecan (brand name: Hycamtin®)
Vinorelbine (brand name: Navelbine®)
Common side effects:
Nausea and vomiting
Loss of appetite
Loss of hair
Increased chance of infection
Bleeding or bruising after minor cuts or injuries
Hand and foot rashes
Low blood counts
Targeted therapy uses a class of drugs that destroy cancer cells while minimizing damage to normal, heathy cells. This is achieved by designing drugs that affect critical functions required for tumor cells to survive. Many of these drugs target the same mutations that cause a cell to become cancerous. Mutational analysis is often required to determine if a targeted therapy is appropriate. Fewer side effects are associated with targeted therapies compared to chemotherapy.
For some cancers the majority of patients will have an appropriate target for a specific targeted therapy. For other cancers, patients must receive a tumor tissue test to determine eligibility for a targeted therapy. If a patient’s tumor tissue displays specific gene mutations that are targets for targeted therapy they would be a candidate of targeted therapy. (cancer.org) At times a blood sample may be used to determine if a patient qualifies for a targeted therapy.
Although targeted therapy doesn’t affect the body the same way that standard chemotherapy does patients still may experience side effects. There is a large variety of targeted therapy drugs and the side effect of each varies depending on what each drug targets. Some drugs target substances that are found more prevalently on cancer cells, but are also found on healthy cells. Side effects occur when targeted therapy drugs affect healthy cells.
Some targeted therapy drugs cause more side effects than others. When drugs attack more than one target there is a greater chance of experiencing side effects. Not every person will get every side effect. Some patients get few side effects if any. Talk with your doctor about which side effects you are at risk for with your specific treatment regimen.
Common targeted therapy drugs:
Common Side effects:
High blood pressure
Problems with bleeding or blood clotting
Problems with wound healing
Low blood cell counts
Other side effects may include:
Nausea and vomiting
Diarrhea or constipation
Shortness of breath or trouble breathing
Feeling tired all the time
Swelling in the hands and feet
Damage to organs such as the thyroid gland, liver, or kidneys
Increased risks of certain infections
Muscle and joint pain
Blood cancer (rare)
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