The initial treatment for ovarian cancer usually consists of a combination of chemotherapy (a type of drug given to kill cancer cells) and surgery (a procedure to remove as much of the affected areas as possible).
Your medical team will have a detailed discussion with you about your treatment options and the risks involved, including options to preserve fertility where possible. You should raise any specific concerns you may have with them.
For many women with ovarian cancer, surgery normally includes removing the following:
- the uterus (womb) and cervix
- both ovaries and fallopian tubes (salpingo-oophorectomy)
- the omentum - a layer of fatty tissue that extends downwards from the stomach in front of the abdominal organs to protect them.
It may also involve the removal of any enlarged lymph nodes, or cancer lumps from the peritoneum (the lining that covers the organs inside your abdomen) or other abdominal organs that appear to be affected. Removal of these organs does have side effects. For example, if your surgery has involved removing sections of the lymphatic system (like lymph nodes) you may be at risk of lymphoedema. If possible, your surgeon will discuss these with you beforehand.
In some cases of ovarian cancer, particularly with germ cell tumours, it may be possible just to remove the affected ovary and fallopian tube, leaving behind the other organs, or to make a diagnosis first by removing the affected ovary and only then removing the other organs if this is necessary.
Chemotherapy for ovarian cancer is given to kill any cancer cells that may remain after surgery, or to shrink the tumour to make it easier to operate. The drugs are given through a drip into a vein and the treatment will be given over several hours.
What is it?
Usually you will be offered a combination of carboplatin (a platinum-based chemotherapy) and paclitaxel (a taxane, a type of drug which blocks cancer growth). Sometimes carboplatin will be recommended on its own.
How will chemotherapy affect me?
Chemotherapy affects people in different ways and some people will experience more side effects than others. There are many different medications for any side effects you may experience so do ask your chemotherapy team if you need help.
Possible side effects:
- Your wellbeing - You may find that you tire more easily and you may need to make adjustments to your daily routine to cope with this. It’s important to maintain a healthy lifestyle. Eat well and take regular exercise, as this will help you feel better and cope with the side effects of treatment.
- Feeling or being sick - You will be given anti-sickness medication to take home. If you do vomit you need to contact your chemotherapy team and they will change your prescription.
- Fertility and early menopause - Depending on your treatment, there is some risk of impaired fertility and early menopause even if your surgery is ‘fertility sparing’.
- Losing your hair - Chemotherapy can cause you to lose your hair. Hair loss can sometimes be reduced by the use of a cold cap. Ask your medical team if this is appropriate for you, or speak to them about a referral for a wig, if this is something that worries you.
- Memory loss or ‘chemo brain’- This is quite common after cancer treatment and includes changes in memory, concentration and thinking. It can be very frustrating, but for most people it will improve with time.
- Tiredness and fatigue - Most women feel very tired during chemotherapy so it is important to plan time to recover your energy.
- Changes to your body - Many women experience weight loss as appetite can be affected by treatment. Weight gain can also occur as a side effect of anti-sickness drugs (steroids) given with chemotherapy, as these can stimulate appetite and cause fluid retention. Your Clinical Nurse Specialist (CNS) and local cancer centres can give advice to help you maintain good nutrition during chemotherapy.
For more information on chemotherapy visit our treatment section.
The menopause usually happens naturally between the ages of 45-55 when levels of oestrogen gradually decline and periods stop.
If you have surgery to remove your ovaries, these hormonal changes will happen straight away. This is known as surgical menopause. Surgical menopause can be overwhelming. If possible, discuss how best to manage this with your medical team beforehand. You can ask to be referred to a menopause specialist, who may be part of a gynaecology or sexual health team.
Some women experience symptoms more intensely after a surgical menopause because of the abrupt onset of hormonal changes. Some women will not experience any of these symptoms, some will experience a few, and some will experience all.
- Hot flushes can vary from occasional to very frequent, day and night. They don’t usually last long, but can leave you feeling tired, anxious, frustrated, sweaty and hot, and they can be accompanied by palpitations.
- Emotional symptoms can include irritability, poor concentration, and poor memory. Sometimes addressing the hot flushes can improve these symptoms because it means you can get more sleep.
- Vaginal discomfort and dryness which can lead to painful sex.
- Bladder symptoms can include increased urinary frequency and urgency. These symptoms tend to worsen with time, so seek help sooner rather than later.
- Other bodily changes can include brittle nails, thinning of the skin, hair loss and aches and pains.
In many cases, these symptoms will get better on their own, although it is difficult to predict how long you may have them for. If symptoms are causing problems in your life, you should discuss treatment options, including hormone replacement therapy (HRT), with your CNS or GP.
Find out more information on hormone replacement therapy (HRT).
A surgical menopause changes your hormone levels which can affect how you feel. This is on top of the emotions that you may already be feeling relating to your diagnosis and treatment. You may feel:
- too young to be going through the menopause
- worried about your options to have a baby
- less feminine
- worried about the future.
If this sounds familiar you may benefit from talking to your family and friends about how your feelings are affecting you and your relationships. It may also help to speak to a counsellor or with other women who have experienced the same.
Our information on body image and sexuality offers more advice on how to deal with these emotions.
After a surgical menopause, you will be advised to take measures to ensure that you stay healthy in the years ahead. This will include protecting your bones from osteoporosis and maintaining a healthy heart.
Early menopause can increase the likelihood of developing osteoporosis or loss in bone density which, for some women, may lead to an increased risk of fractures. You should be offered a DEXA scan (an x-ray which measures bone density) to assess the density or strength of your bones, which will help to predict your future risk of fracture. What can help:
- Hormone replacement therapy (HRT) can help prevent loss of bone density.
- A healthy balanced diet that includes around 700mg calcium a day – calcium can be found in dairy, and also in food such as sardines, chocolate, almonds and oranges.
- Taking moderate exercise, both weight bearing (any exercise where you support your weight by standing or through your hands and arms) and aerobic (any exercise which makes you breathe faster), 3-5 times a week is important for bone and heart health.
- Giving up smoking, drinking alcohol in moderation and maintaining a healthy weight will also help.
Find out more
For younger women
- Hormone replacement therapy
- Impact on relationships and family
- Body image and sexuality
- Coping if you have children
- Practical and financial support
This content is primarily taken from A younger woman's guide to ovarian cancer.
Our joint guide produced with Ovacome, Ovarian Cancer Action and The Eve Appeal, provides crucial information, advice and signposting to help younger women through the emotional, physical and psychological impact of a cancer diagnosis.
The information on this page is approved by the Information Standard scheme to ensure that it provides accurate and high-quality information.
Last reviewed: June 2017
Next review: May 2020