Your treatment plan will depend on many factors.
Your treatment will vary based on your situation
There are more than 30 different types of ovarian cancer. Only you and your doctor (hopefully a gynecologic oncologist) can decide what treatment is best for you, the patient. Many factors including age, general health, tumor size and sub type are some of the considerations. Here are some of the most common treatment methods:
Debulking Surgery – Also called cytoreduction, this surgery is used to remove as much of a tumor as possible. The aim of a debulking surgery is to leave behind no tumors larger than 1 cm, which is known as optimally debulked. Debulking may also require removal of all or parts of the colon, omentum, bladder, spleen, gallbladder, stomach, liver, or pancreas depending on if the cancer has metastasized, or spread, to those parts of the body.
Chemotherapy – Chemotherapy drugs target cells during different stages of their life cycles. Cancer cells replicate at a faster rate than normal cells, so chemotherapy targets these more efficiently. However, chemotherapy drugs cannot fully differentiate between cancer cells and healthy cells. There are side effects and long-lasting conditions that come with chemotherapy treatments. There are two main types of chemotherapy:
- Oral – certain oral chemotherapy medications have been approved by the FDA to help treat ovarian cancer. Also called PARP Inhibitors, they are typically administered to women who have recurred. However, many studies are being conducted that indicate they are being used as a front-line regimen, combined with more traditional chemo therapies.
- Intravenous – this method is usually a combination of two or more drugs given intravenously through a vein in the arm or a port that is placed in the chest area. Most cycles are dose-dense, with one infusion every three weeks for six rounds. The standard front-line combination for epithelial, primary peritoneal and Fallopian tube cancers is a platinum compound (cisplatin or carboplatin) and a taxane (paclitaxel or docetaxel).
Neo-Adjuvant Therapy – Neoadjuvant chemotherapy for advanced ovarian cancer was initially administered as an alternative treatment for patients not suitable for primary debulking surgery for various reasons. However, recent studies suggest that neoadjuvant chemotherapy, followed by surgical cytoreduction, is an acceptable management strategy for patients with advanced ovarian cancer. Neoadjuvant therapy can include chemotherapy, radiation therapy, hormone therapy, targeted therapy, or other forms of biological therapy.
Intraperitoneal Therapy – This chemotherapy targets the membrane that lines the abdominal cavity and surrounds the abdominal organs (peritoneum). There are two types of intraperitoneal (IP) chemotherapy. The first can be administered as an outpatient procedure through a port in the abdomen. The second is called Hyperthermic Intraperitoneal Chemotherapy (HIPEC) and is administered in the operating room after a surgery to debulk tumor tissue.
Radiation Therapy – Protocol sometimes indicates the use of high-energy radiation to shrink tumors and kill cancer cells. These include X-rays, gamma rays and other charged particles. This treatment can be delivered by a machine outside of the body (external beam radiation therapy), or from within the body (internal radiation therapy).
Maintenance Therapy – This treatment is given to help keep cancer from coming back after it has disappeared following the initial therapy. It may include treatment with drugs, vaccines, or antibodies that kill cancer cells, and it may be given for a long time.
Additional testing can increase the effectiveness of your treatment
- Tumor/Molecular Profiling – Profiling consists of testing tissue samples to identify a variety of biomarkers in the DNA of that helps doctors better understand, diagnose, stage, and treat cancer on an individual basis. This is also a method for testing for certain enzymes, proteins, and genes to identify which therapies are likely to be most effective.
- Genetic Testing – the process of using medical tests to search for mutations in the genes of an individual. There are many different kinds of tests, but predictive genetic testing can be used to look for gene mutations that might put a person at risk of developing a certain type of cancer. An example would be the genetic testing done to look for mutations in the BRCA1 and BRCA2 genes. These mutations are sometimes precursors to breast and ovarian cancer. There are many other genes that play a role in the development of different types of cancers that can also be identified through genetic testing.
Other options to consider
Each woman’s situation will differ. It is not uncommon to seek a second opinion. Many women may choose to participate in a clinical trial. Achieving a balance between quality of life and quantity of life are very personal decisions that should be discussed with your medical provider. Our team is also available to consult with you and help you decide what is important in your specific circumstances.