It is common to treat ovarian cancer with surgery to remove as much of the cancer as possible, and chemotherapy (drugs that aim to kill cancer cells).
Your treatment will depend on the type of ovarian cancer you have, as well as the stage and grade. You may have surgery before starting chemotherapy treatment, or your oncologist may recommend starting chemotherapy first. In this case, your chemotherapy will continue once you have recovered from surgery. Occasionally if the cancer is diagnosed at a very early stage it may be treated by surgery alone. In some cases, surgery is considered either too risky or unable to completely remove all visible cancer and chemotherapy will act as your initial treatment.
All of these treatment options can be very effective. Your oncologist and surgeon should discuss with you what treatments are available, based on your individual clinical needs and what is available locally, and your personal preferences should be taken into account.
Before your surgery
You will be examined and given a series of tests to check that you are fit enough to have surgery. Your surgeon will explain what will happen during the operation. It is often difficult for the surgeon to know exactly how much surgery is needed as this will depend on the size and type of the cancer so they may discuss different possibilities and options with you. Surgery will also confirm the staging and grading of your cancer.
For many women with ovarian cancer, surgery normally includes removing the womb and cervix, both ovaries and fallopian tubes, and the omentum (a sheet of fat that hangs in front of the abdomen). It may also involve removing lymph nodes and parts of other organs that may be affected. This is sometimes called debulking or extensive or ultra-radical surgery.
In some cases, in order to ensure that all of the cancer is removed, surgery may include removal of a part of the bowel. This may result in the creation of a stoma.
If you have any questions, concerns or fears about your surgery, don’t be afraid to raise them with your surgeon or talk to the nurses about how you are feeling. If you think of questions later you can also ask your CNS or key worker about anything you didn't understand.
After your surgery
Surgery puts your body through a great deal of stress, so it's important to allow time to heal and recover. In the first weeks following your surgery you should take things very gently and give yourself lots of time to rest. Listen to your body as you gradually increase your level of activity: it will tell you how far you can go and what you can take on, depending on how you feel.
- Will you be in pain? You will be given medication to make sure you are as comfortable as possible.
- How tired will you be? It is usual to feel tired after surgery as your body is working hard to recover. You may experience fatigue or extreme tiredness. It is important to build up activity gradually to help you deal with this.
- If you have had surgery that involves removing sections of the lymphatic system (like lymph nodes) you may be at risk of lymphoedema. There are lots of ways to manage the symptoms of lymphodema.
If you are concerned about any side effects, contact your CNS.
Chemotherapy is given to kill cancer cells that may remain in your body after surgery. The drugs are given through a drip into a vein and the treatment is given over several hours.
What chemotherapy will you have?
Usually you will be offered a combination of platinum-based chemotherapy (usually carboplatin but sometimes cisplatin) and paclitaxel (most commonly called Taxol.) Sometimes carboplatin will be recommended on its own.
It is standard practise to give chemotherapy once every three weeks for six cycles. There is research into giving smaller weekly doses, and having chemotherapy directly into the stomach (intraperitoneal chemotherapy) but these are not yet standard treatments.
What happens when you have chemotherapy treatment?
Most women go to the chemotherapy unit at their local hospital. You will usually spend most of the day at the hospital so take a relative or friend to keep you company, or a couple of magazines and a good book to help pass the time.
At the hospital a number of blood samples will be taken for testing before each cycle of chemotherapy. These test different parts of the body to check you are healthy enough to receive treatment. Once your blood test results are available, your treatment can start.
You will be shown into the treatment room where you will be invited to settle yourself in a comfy chair. The chemotherapy nurse will place a needle into one of the veins on your hand or arm and attach a drip so that the drugs can enter your blood stream. This might feel a bit uncomfortable as the drip goes in.
If you are having carboplatin and paclitaxel then the nurse will give you the paclitaxel first, followed by the carboplatin.
Will you have any side effects?
Many women experience mild side effects that can be easily treated; it is rare for side effects to be severe. The side effects do not usually start straight away and most people are able to drive home from hospital.
It can be worrying to consider all of the possible side effects but remember most women will not experience all of these and hopefully those that do affect you will be mild.
Chemotherapy reduces the number of white cells in your blood, which means your ability to fight infections may be affected. You’ll need to contact the hospital immediately if you get a temperature or feel ill in the days or weeks following treatment. There is no need to avoid family, friends and other members of the public, but you should avoid people with serious infections.
Your hospital should give you a 24-hour helpline number to ring if you are feeling ill at any time during your chemotherapy and in the weeks after treatment.
Other common side effects of chemotherapy can include:
- Tiredness and fatigue - most women feel very tired during chemotherapy so it is important to plan time to recover your energy.
- Hair loss - nearly all women treated with paclitaxel will experience temporary hair loss, which will usually start two to four weeks after treatment begins. You may be offered a cold cap to help minimise hair loss. Cold caps can be uncomfortable and treatment takes longer, however some women find they work really well and you can ask for support to make it work for you. Your hospital may also offer a free wig service. Ask your CNS for more details about cold caps and wig services. Read about Hilary's experience of using a cold cap during chemotherapy or watch Elda talk about her experience of the cold cap during her chemotherapy treatment.
- Feeling or being sick - you will be given anti-sickness medication to take home. If you are sick you need to contact your chemotherapy team and they will change your prescription.
- Tingling or numbness in hands and/or feet - chemotherapy can affect your nerves, which may cause your feet or hands to tingle or feel numb. This is known as neuropathy.
- Some women have reported symptoms which they refer to as 'chemo brain' or 'chemo fog'. This is the inability to think as clearly after chemotherapy as you did before treatment.
Many people find that as treatment continues they become used to the side effects and can plan around them. If you are badly affected do get in touch with your hospital as they will be able to help you.
Watch Karen's story below to find out more about her chemotherapy experience and the support that she received during her treatment.
Radiotherapy is not generally used to treat ovarian cancer but is sometimes recommended for early stage cancer after surgery to help kill off any cancer cells left behind. Your doctor will only suggest this if there are very small areas of cancer left in your pelvis and no sign of cancer in your abdomen.
Depending on individual circumstances such as the type of tumour, whether surgery is possible and where you live in the UK, you may be able to access other drugs. The way drugs are approved for use in the NHS differs across the UK which means there can be some differences in what drugs are available depending on where you live.
In England and Scotland a drug called bevacizumab (Avastin) is currently available to some women with advanced ovarian cancer. Ask your oncologist whether you are eligible.
Drugs are sometimes reassessed to decide whether they should be available on the NHS. The information above is up to date as of October 2016. Contact Target Ovarian Cancer for the most up to date information.
Clinical trials are research studies that investigate potential new drugs, new ways of giving treatments or different types of treatments and compare them to the current standard treatments.
Read more about clinical trials - what they are, how they work and how you can find out more.
Find out more
- Practical advice including getting back to life after treatment
- How you might feel
- Types of ovarian cancer
- Support for you
This content is primarily taken from What happens next?
Our expert guide answers your questions following a diagnosis, providing information on everything from treatment to taking care of yourself, and advice on where to find support in the months ahead.
The information on this page is approved by the Information Standard scheme to ensure that it provides accurate and high-quality information.
Last reviewed: November 2016
Next review: October 2019