Ovarian Cancer Treatment by Leading Ovarian Cancer Doctors

Ovarian cancer treatment typically includes surgery, chemotherapy, radiation therapy or a combination of therapy. The stage of ovarian cancer dictates the extent of the surgery needed to remove the ovarian cancer. 

Stage I ovarian cancer may involve the removal of just one ovary while Stage IV ovarian cancer may involve the removal of ovaries, fallopian tubes, and uterus, as well as lymph nodes, abdominal tissues and other areas to which the ovarian cancer may have spread. Sometimes surgery is not an option because the patient is not a good candidate for surgery due to multiple chronic medical conditions. Chemotherapy to help shrink the ovarian tumor often may be the best treatment option for these patients. 

The doctors of The Lya Segall Ovarian Cancer Institute at Mercy are skilled at removing ovarian cancer at any stage, guided by their extensive expertise and carefully-honed surgical skills. Minimally invasive surgery, robotic surgery and traditional open surgery are surgical options offered by the experienced ovarian cancer specialists at Mercy. 

HIPEC (Hyperthermic Intraperitoneal Chemotherapy) has been used to treat cancers in the abdominal cavity. HIPEC is a heated chemotherapy solution that is used in conjunction with cytoreductive surgery. Cytoreductive surgery is performed first to remove visible tumors from the abdominal area. Following the surgery, heated chemotherapy solution is added to the abdominal cavity to destroy non-visible or microscopic tumor cells that may remain after surgery. Heat helps kill the cancer cells and also enhances the effect of chemotherapy. 

HIPEC as a standard treatment for ovarian cancer is being researched by gynecologic oncologists and surgical oncologists. At Mercy, Dr. Teresa Diaz-Montes of The Lya Segall Ovarian Cancer Institute is conducting clinical trials to advance the research on the benefits of using HIPEC to treat ovarian cancer.

Chemotherapy often is used in the treatment of ovarian cancer. For patients who are not surgical candidates, chemotherapy may be used to shrink the ovarian tumor and manage the symptoms. For patients who have had surgery to remove an ovarian tumor, chemotherapy is used for the management of advanced stages of ovarian cancer.

The stage of the ovarian cancer diagnosis often dictates the course of chemotherapy treatment. Typical guidelines include:

• Minimum of three cycles of chemotherapy for some Stage 1 epithelial ovarian cancers
• Minimum of six cycles of chemotherapy administered every three weeks for Stage 2 and above epithelial ovarian cancers

Depending on the type and cycle of chemotherapy treatment, patients may be given medication to take prior to the treatments to better tolerate the therapy.

Women undergoing chemotherapy for ovarian cancer will have blood tests periodically throughout treatment. Blood tests will be conducted:

• At the beginning of chemotherapy treatment to evaluate tumor markers
• Every week after chemotherapy begins to evaluate blood count, metabolic panel and potassium and magnesium levels
• Between chemotherapy cycles to evaluate tumor markers

Throughout the chemotherapy treatment process, patients can expect:

• To be assessed by their gynecologic oncologists during every chemotherapy cycle
• To have a pelvic exam every other cycle or at the end of the final cycle depending on the gynecologic oncologist’s preference
• To be evaluated by a nurse to determine if a port placement is necessary to receive the chemotherapy
• To be assessed by a social worker dedicated to the needs of patients with ovarian cancer

Radiation therapy is another ovarian cancer treatment that utilizes high energy X-rays to damage or kill cancer cells, preventing them from growing or dividing. While radiation therapy is uncommon as a first or main treatment option for ovarian cancer, it may sometimes be useful in treating recurrent ovarian cancer or cancer that is confined to a small area. Radiation therapy may also be useful for patients who cannot tolerate chemotherapy drugs.

Radiation therapy for ovarian cancer treatment may be administered externally from a machine outside the body and applied directly to the tumor site. In some cases, internal radiation therapy, known as brachytherapy, may be used. Brachytherapy involves placing a small amount of radioactive material inside the body - in or near the cancer.

Radiation therapy for ovarian cancer typically entails daily treatments over the course of 3 to 5 weeks, but may vary depending on individual circumstances. Individual treatments generally only last a few minutes with little discomfort. Side effects from radiation therapy vary, but may include fatigue, mild skin reactions, upset stomach and diarrhea.

The gynecologic oncologists continue to follow patients with epithelial ovarian cancer, the most common form of ovarian cancer, after their initial treatments have been completed. Patient appointments are every 3-4 months for the first two years, every 3-6 months for the next three years, and then one time per year after the total of five years. 

During these follow-up appointments, a pelvic exam will be conducted, blood tests (CA-125) or other tumor markers that were initially elevated will be monitored and appropriate radiologic examinations will be conducted. 

Patients are encouraged to contact any member of The Ovarian Cancer Institute staff at any time if there are questions or concerns. For additional information on ovarian cancer, cancer resources at Mercy and nutrition information please see our helpful resources.