Ovarian Cancer Treatment Options at Virginia Oncology Associates
Your ovarian cancer doctor can describe your ovarian cancer treatment choices and the expected results. Most women have surgery and chemotherapy. Rarely, is radiation therapy used. Ovarian cancer treatments are administered either through local therapy or systemic therapy:
- Local therapy: Surgery and radiation therapy are considered to be local therapies. These therapies remove or destroy ovarian cancer in the pelvis. When ovarian cancer has spread to other parts of the body, local therapy may be used to control the disease in those specific areas.
- Intraperitoneal chemotherapy: Chemotherapy can be given directly into the abdomen and pelvis through a thin tube. The drugs destroy or control cancer in the abdomen and pelvis.
- Systemic chemotherapy: When chemotherapy is taken by mouth or injected into a vein, the drugs enter the bloodstream and destroy or control cancer throughout the body.
Women diagnosed with ovarian cancer typically receive a combination of the following treatments:
Treatment for ovarian cancer can affect cancer cells in the pelvis, in the abdomen, or throughout the body. You may want to know how treatment may change your normal activities. A gynecologic oncologist will work with you to develop a treatment plan that meets your medical and personal needs.
The treatment for ovarian cancer typically involves surgery. For many women, laparoscopic surgery is used. Laparoscopic surgeries eliminate the need for a large abdominal incision to remove the cancer, making them minimally invasive and less traumatic to the body. Hospital stays are shorter, and recovery tends to be faster. This type of surgery can be done with a laparoscope or with the da Vinci® robotic system, which makes minimally invasive surgery available to more patients.
If ovarian cancer is detected, the gynecologic surgeon may need to remove the following:
- one or both ovaries and fallopian tubes (salpingo-oophorectomy)
- the uterus (hysterectomy)
- the omentum (the thin, fatty tissue covering the intestines)
- lymph nodes that are nearby, especially if cancer appears to have spread beyond the ovaries
- tissue samples from the pelvis and the abdomen
- If cancer has spread, the surgeon removes as much of it as possible. This is known as “debulking” surgery. Since the ovaries drive hormone production, surgeons will try to avoid removing both ovaries.
If you have early, stage I ovarian cancer, the surgical method can depend on if you want to get pregnant and have children in the future. Some women with very early ovarian cancer may decide to have only one ovary, one fallopian tube, and the omentum removed. Read more about gynecologic oncology surgery offered at Virginia Oncology Associates.
Chemotherapy for Ovarian Cancer Treatment
Chemotherapy uses anticancer drugs to kill cancer cells. The timing of chemotherapy is based on the stage of ovarian cancer. Most women receive chemotherapy for ovarian cancer after surgery, but sometimes women receive it before surgery.
Usually, more than one drug is given. Chemotherapy drugs for ovarian cancer can be given in different ways:
- By vein (IV): The drugs can be given through a thin tube inserted into a vein.
- By vein and directly into the abdomen: Some women get IV chemotherapy along with intraperitoneal (IP) chemotherapy. For IP chemotherapy, the drugs are given through a thin tube inserted into the abdomen.
- By mouth: Some drugs for ovarian cancer can be given by mouth.
Chemotherapy is given in cycles, and each treatment cycle is followed by a rest period. The duration of the rest period and the number of cycles depends on the type of anticancer drug used. You may receive your treatment in a clinic, at the doctor’s office, or at home. Some patients may need to stay in the hospital during treatment.
Targeted Therapy for Ovarian Cancer Treatment
Targeted therapy is a special type of chemotherapy using drugs or other substances to find and attack specific cancer cells. Unlike traditional chemotherapy, which attacks all cells, this treatment specifically identifies cancer cells, and normal cells are less likely to be damaged.
Each targeted therapy works differently, but they all alter the way cancer cells grow, divide, repair, and interact with other cells.
- Monoclonal antibody therapy is a type of targeted therapy in which the antibodies attach to the substances and kill cancer cells, block their growth, or keep them from spreading.
- Bevacizumab is a monoclonal antibody that can be used with chemotherapy for treating ovarian epithelial cancer, fallopian tube cancer, or primary peritoneal cancer that has recurred.
- Poly (ADP-ribose) polymerase inhibitors (PARP inhibitors) are targeted therapy drugs that block DNA repair and may cause cancer cells to die. PARP inhibitor therapy is being studied in treating ovarian epithelial cancer that remains after chemotherapy.
Targeted therapies for ovarian cancer can be used in different combinations based on the cancer's stage and the health of the patient. Targeted therapy may be prescribed as oral pills or given by vein.
Radiation therapy is rarely used in the initial treatment of ovarian cancer, but it may be used to relieve pain and other problems caused by the disease. It can also treat small, localized recurrent cancer. Radiation therapy for ovarian cancer treatment is continuously being researched for use as a standard treatment method. Radiotherapy is given at a hospital or clinic. Each treatment takes only a few minutes.
Immunotherapy for Ovarian Cancer Treatment
Immunotherapy is a cancer treatment method that uses our own body's immune system to recognize, target, control, and eliminate certain types of cancer cells. They help the immune system with the following:
- detecting and attaching to cancer cells while leaving healthy cells undamaged
- adapting to changes in the cancer by re-evaluating and launching a new attack
- “remembering” the cancer cells to be able to target and kill them if cancer recurs
- encouraging immune cells to maximize their cancer-fighting ability
Gynecologic oncologists might recommend immunotherapy as part of the treatment plan for patients with resistance to chemotherapy, recurring ovarian cancer, or ovarian cancer at stage 2 or higher. The following immunotherapy drugs are approved for ovarian cancer, with a few more in the process of being approved:
- Targeted antibody-drug Bevacizumab (Avastin), an anti-angiogenic monoclonal antibody that deprives the cancer cells of the blood supply they need to grow. This is approved for ovarian cancer patients that are newly diagnosed or relapsed and is often used in combination with chemotherapy.
- Two immunomodulatory that have been fast-tracked for approval for advanced ovarian cancer (the research is being reviewed sooner because of promising results):
- Dostarlimab (Jemperli) for platinum-resistant ovarian cancer
- Pembrolizumab (Keytruda).
The Latest Ovarian Cancer Treatments Available in Virginia
For compassionate cancer care and the latest ovarian cancer treatments available in southeast Virginia and eastern North Carolina, contact the gynecologic oncologists at Virginia Oncology Associates. We specialize in the treatment of gynecologic cancer, including medical and surgical oncology treatments, integrative medicine, clinical research, and patient support. Our cancer centers are located in Chesapeake, Suffolk, and Norfolk, Virginia.