Treating Ovarian Cancer: Treatment Options, Side Effects, and More

Ovarian cancer has a reputation for being difficult to treat, but years of research have started to bring change. If you've been diagnosed with ovarian cancer, you may have a wider range of treatment options than you realize.

According to Dr. Leslie Boyd, a gynecologic oncologist at NYU Langone Health's Perlmutter Cancer Center, many recently diagnosed patients come to their first appointment with no hope. 'One of the most important things that I impart to them in our initial visit is that, in fact, we have tremendous therapy for ovarian cancer now,' Boyd told Healthline.

It can be challenging to talk to your doctor about your treatment options, especially if you're worried about the future. Here, you'll find questions that can help guide you through the conversation.

Ovarian cancer starts in the ovaries or far end of the fallopian tubes. Screening options are limited. By the time the cancer is diagnosed, it may have spread to the pelvis, abdomen, or other parts of the body.

Surgery is one of the main treatments for ovarian cancer. In most cases, one of the first big decisions is whether to start with surgery or chemotherapy. 'The initial course of treatment is primarily determined by the extent of disease,' Boyd explained.

Imaging tests, such as CT scans, and other diagnostic procedures help your doctor determine if surgery is a good first step. They'll also consider factors such as your age, overall health, and any other medical conditions you have.

'We look at an overall picture of the patient and how we can best tailor care,' Boyd added.

Not all surgeries for ovarian cancer are the same. Surgery may involve removing only one ovary and fallopian tube. In some cases, it might involve removing both ovaries and fallopian tubes.

In more advanced cases, surgery may mean removing both ovaries, fallopian tubes, the uterus, nearby lymph nodes, and a fold of fatty tissue known as the omentum. If the cancer has spread to other parts of the pelvis or abdomen, the surgeon may use debulking surgery to remove as much of it as possible. They might also have to remove a portion of the colon, bladder, or other organs.

In addition to or instead of surgery, your doctor might recommend other treatments. Here's a brief summary of the most common options:

• Chemotherapy: One or more medications are used to kill cancer cells.
• Radiation therapy: High-energy X-rays or particles are used to kill cancer cells.
• Hormone therapy: Hormones or hormone-blocking drugs are used to shift the balance of hormones in your body, which affects how some types of cancer grow.
• Targeted therapy: Drugs or other substances are used to target the inner workings of cancer cells. In most cases, your doctor will only prescribe this type of treatment if the cancer doesn't respond to other treatments or returns after treatment.
• Supportive or palliative care: Medications or other treatments are used to relieve pain and improve quality of life. This supportive care can be combined with surgery, chemotherapy, or other treatments.
• Therapies provided as part of a clinical trial: New and experimental treatments are offered as part of a study to see if they work effectively.

Boyd told Healthline that clinical trials are often an option for patients at NYU Langone, including for those who are newly diagnosed. 'We have one the largest clinical trial portfolios in the tri-state area,' she said. 'That means that in addition to giving the optimal standard treatments, we usually have a clinical trial available to give cutting-edge therapy.'

Treatment for ovarian cancer isn't one-size-fits-all. Boyd explained that it depends on many factors.

'As a physician, I see myself primarily as a counselor,' she said. 'I know a lot of the facts and the data behind what I'm offering, but I don't know as much about my patients' lifestyle, and what their fears and concerns are.'

It may seem challenging to talk to your doctor about your priorities for treatment, but Boyd emphasized that being frank and honest makes a difference. 'It's really helpful when I have someone who comes to the table with their concerns and their needs so that we can address them forthrightly.'

For example, if you're considering your options for pregnancy or having biological children, it's important to let your doctor know right away. They can help you learn how different approaches might affect your fertility. In some cases, they might suggest a procedure to retrieve eggs from your ovaries before you start treatment.

In general, for most people, the best treatment plan for ovarian cancer depends in part on:

• the specific type of ovarian cancer
• the location and extent of the cancer, including whether or not it has spread
• your family planning goals, if any
• your overall health and personal preferences

To start the conversation with your doctor, it helps to ask clear questions. You may want to bring a supportive friend or family member to take notes, so that you can think over the information at home. Consider asking your doctor:

• What's the first course of treatment you would recommend?
• What do those treatments and the recovery process involve?
• What are the potential benefits, risks, and costs of those treatments?
• Are there other treatment approaches that I could use instead? How would those treatment approaches compare to your recommended treatment plan?

It's important not to minimize your priorities. You may be more likely to stick with your treatment plan if you feel more involved in the decision-making process.

'We really appreciate it when patients are very proactive about their care,' Boyd added.

Treatment for ovarian cancer can cause side effects. Some side effects are minor, while others may be more serious. Keep in mind, if your doctor recommends a treatment, they've judged that the potential benefits you could gain from the treatment outweigh the risk of side effects.

The range of side effects vary from one treatment approach to another. For example, potential side effects of surgery include:

• pain
• bleeding
• blood clots
• tissue or organ damage
• allergic reactions to anesthesia or other drugs used during surgery
• infections

Common side effects of chemotherapy include:

• nausea
• vomiting
• loss of appetite
• loss of hair
• mouth sores
• skin rashes
• fatigue

Before you start any treatment, check in with your doctor again with questions about side effects, such as:

• What potential side effects may I notice with this treatment?
• What steps can I take to reduce the risk of side effects?
• When should I contact you or seek emergency medical care for side effects?

Understanding the potential side effects of treatment can help you be prepared. If side effects develop, your doctor can recommend medications and complementary therapies to help you manage them.

'A lot of complementary therapies can be particularly helpful for side effects of standard chemotherapy,' said Boyd. 'We often suggest massage therapy, acupuncture, and Reiki therapy.'

At NYU Langone, Boyd explained that these options are often offered to patients simultaneously with their medical treatment. 'We usually have our licensed massage therapist on our treatment floor at any given time, so while you're getting your chemotherapy, you can be getting targeted massage and Reiki therapy at the same time.'

Finding emotional support is important when you're living with cancer and undergoing treatment. Asking friends and family members to be there for you and talking to them about your experiences may help you cope with the challenges of cancer.

It's also useful to let your loved ones know what you need and how they can help. Consider creating a list of ways your family and friends can show their support for you, such as:

• sending encouraging notes and setting up times to talk
• helping you with chores at home
• running errands for you
• preparing meals for you

You might also find it helpful to connect with professional support services and resources. To get the help you need, consider asking your doctor:

• Do you have any tips for managing the emotional challenges of living with cancer?
• Are there any support groups for people with ovarian cancer in my local area?
• Are there any books or online resources that you would recommend for me?

Let your doctor know if you experience frequent feelings of stress, grief, or anger. They may refer you to a mental health professional for counseling or other types of support.

Learning that you have ovarian cancer can be overwhelming, but current therapies offer hope. Boyd said that she tries to take some of the fear out of the diagnosis so that patients can focus on maintaining their health and quality of life.

Your doctor can help you understand possible treatment approaches and what may work best for you personally.

Boyd added, 'The amount of research we have, the amount of treatment options we have, the incredibly cutting-edge surgery we can do now, it really makes a huge difference.'