Ovarian cancer is treated with one or a combination of treatments, most commonly surgery and chemotherapy. Each treatment option is described below, followed by an outline of the treatments based on the stage of the disease. Treatment options and recommendations depend on several factors, including the type and stage of cancer, possible side effects, the patient’s preferences and overall health, and personal considerations, such as the woman′s age and if she is planning to have children. Women with ovarian cancer may have concerns about if or how their treatment may affect their sexual function and fertility, and these topics should be discussed with the health care team before treatment begins.
Take time to learn about your treatment options and be sure to ask questions about things that are unclear. Also, talk about the goals of each treatment with your doctor and what you can expect while receiving the treatment. Learn more about making treatment decisions.
Surgery is usually the main treatment for ovarian cancer. A gynecologic oncologist is a doctor that specializes in gynecological cancer surgery (including ovarian cancer) and chemotherapy.
As mentioned in Diagnosis, surgery is often needed to find out the complete extent of disease. The goal is to provide an accurate stage, because in up to 30% of women with apparently early disease (after imaging tests) there is actually spread to other organs.
To determine whether the cancer has spread, the surgeon will remove lymph nodes, tissue samples, and fluid from the abdomen for testing. If, during the surgery, it is clear that the cancer has spread, the surgeon removes as much of the cancer as possible in order to reduce the amount of cancer that will need more treatment with chemotherapy or radiation therapy.
There are several surgical options for ovarian cancer, sometimes done during the same surgery:
Salpingo-oophorectomy. This surgery involves removal of the ovaries and fallopian tubes. If both ovaries and both fallopian tubes are removed, it is called a bilateral salpingo-oophorectomy. If the woman wants to become pregnant in the future and has early-stage cancer, it may be possible to remove only one ovary and one fallopian tube if the cancer is located in only one ovary. That surgery is called a unilateral salpingo-oophorectomy. For women with a germ cell tumor, surgery often only needs to remove only the ovary with the tumor, which preserves the woman’s ability to bear children.
Hysterectomy. This surgery focuses on the removal of a woman’s uterus and, if necessary, surrounding tissue. If only the uterus is removed, it is called a partial hysterectomy. A total hysterectomy is when a woman’s uterus and cervix are removed.
Lymph node dissection. The surgeon may remove lymph nodes in the pelvis and paraortic areas.
Omentectomy. This is surgery to remove the thin tissue that covers the stomach and large intestine.
Cytoreductive/debulking surgery. For women with later-stage ovarian cancer, the goal of this surgery is to remove as much tumor as is safely possible. This may include removing tissue from nearby organs, such as the spleen, gallbladder, stomach, bladder, or colon. It is felt such a procedure can reduce a person’s symptoms and can help increase the effectiveness of treatment, such as chemotherapy, given after surgery to control the disease that remains. Debulking surgery should be performed by an experienced gynecologic oncologist. Talk with your doctor before surgery about the risks and benefits of this procedure and ask about the surgeon’s experience with debulking surgery for ovarian cancer.