Question asked by: 
Barbara, Lancashire
Date asked: 
Oct 2014

What does the future hold now I’ve had a recurrence? Will the tumours keep reappearing? If so, is there any information or statistics as to how long before they do? I feel fine at the moment but will recurrent tumours weaken my body and make me feel ill?

What does the future hold now I’ve had a recurrence?
No two women are the same.
Response by Professor Iain McNeish, Professor of Gynaecological Oncology

If ovarian cancer returns, it’s very difficult to remove it permanently. Even with surgery it’s likely to recur at some point. For some this may be after many years, for others a lot less. No two women are the same.

Surgery is generally only offered if the cancer comes back as one or two small tumours that are close to each other. It’s also important that the original operation went well (ie there was no obvious cancer remaining), and more than a year has passed since the end of the first treatment.

If surgery is an option, most oncologists offer chemotherapy afterwards too. It’s unusual for surgery to be performed more than twice because if cancer recurs again, it tends to do so in several places, not just one.

Radiotherapy isn’t commonly given for ovarian cancer. In fact there are generally only two circumstances when it’s given. Firstly, if cancer comes back in one or two sites, but can’t be removed surgically. Secondly, in women with lots of tumours, radiotherapy can be helpful if one in particular is causing problems. Localised radiotherapy can help to stop bleeding or reduce pain.

This is a very difficult time for any woman. Knowing that there are lots of things that can be done to reduce, or even remove the tumour, may help.

The most difficult part of remission is not knowing how long it will last.
Response by Alison Craven

Once ovarian cancer has recurred, treatment is aimed at controlling the disease to achieve a remission period, which may last for a few months or several years. Many ladies have several remission periods intertwined with various treatments over a number of years.

The most difficult part of remission is not knowing how long it will last.

Treatment may vary each time it’s needed, depending on what is most suitable for that specific pattern of cancer activity. There are no hard and fast rules as to how many times a particular type of treatment can be used. It will depend on the nature of the recurrence, your response to previous treatments and general wellbeing.

There’s no right or wrong way to feel.
Response by Dr Alison Farmer, Oncology Nurse

Coming to terms with recurrence takes time and there’s no right or wrong way to feel. When we hear shocking news it’s often human nature to protect ourselves and go into denial. Feeling like you ‘have your head in the sand’ is normal.

I’m pleased you feel well at the moment, but this can make coming to terms with recurrence harder. It’s difficult to accept you’re ill if you have no symptoms. Gradually you will accept it though. Whilst it’s hard to believe, many women manage to accept their cancer as a chronic disease and find enjoyment in life.

There’s no quick and easy way to come to terms with recurrence, but some people find that sharing their experiences with people in a similar situation is helpful. Your clinical nurse specialist (CNS) might be able to put you in touch with other women with recurrent ovarian cancer, or a support group.

Setting small, achievable goals may also help – perhaps fitness related or ones involving pleasant activities.

Remember that your feelings and what you need (information, support) are likely to change over time. Your CNS and medical team will be there to support you through your experience.