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Treatment decisions

Find out about how your doctor decides which treatment you need, the types of treatment you might have and treatment by stage.

Deciding which treatment you need

A team of doctors and other professionals discuss the best treatment and care for you. They are called a multidisciplinary team (MDT).

The team includes a surgeon who specialises in treating women's cancers (a gynaecological oncologist) and a medical cancer specialist (an oncologist). It should also include a gynaecological cancer specialist nurse.

The treatment you have depends on:

  • where your cancer is
  • how far it has grown or spread (the stage)
  • the type of cancer
  • how abnormal the cells look under a microscope (the grade)
  • your general health and level of fitness

Your doctor will discuss your treatment, its benefits and the possible side effects with you.

The main treatments

The main treatments for ovarian cancer are surgery and chemotherapy.

Almost all women with ovarian cancer will need surgery. The amount and type of surgery you have will depend on your stage and type of cancer.

For some women with very early stage ovarian cancer, surgery is the only treatment you need.

Most women with ovarian cancer are diagnosed with advanced disease and have a combination of surgery and chemotherapy. You may have chemotherapy after surgery, or both before and after surgery.

You may find that other women you meet with ovarian cancer are having different treatment from you. This may be because they have a different type of ovarian cancer, or their cancer is a different stage.

Don't be afraid to ask your doctor or nurse any questions you have about your treatment. It often helps to write down a list of questions you want to ask. You could also take a close friend or relative with you when you go to see the doctor - they can help you remember what was said.

The earlier your cancer is diagnosed, the easier it is to treat and possibly cure. Your treatment depends on the stage and type of your cancer, and your general health and fitness. Your doctors might suggest one type of treatment or a combination of treatments.

Treatment by stage

Treating stage 1 ovarian cancer

The main treatment for stage 1 ovarian cancer is surgery. Your doctor may suggest you have chemotherapy as well if there is a high risk of the cancer coming back.

Very early ovarian cancer

If you have a borderline ovarian tumour or a very early cancer (stage 1a) that is low grade, you may only need to have the affected ovary and fallopian tube removed. As the unaffected ovary and your womb are left behind, you may still be able to have children in the future.

Your surgeon will take samples (biopsies) from several areas within your abdomen and pelvis during surgery to fully stage your cancer. If there are cancer cells in any of these samples, you may need another operation to remove the rest of the cancer.

If you have had your menopause, or do not want to have any more children, your surgeon may advise that you have both ovaries and your womb taken out.

Women with a borderline tumour or very early cancer may not need any other treatment after surgery.

Early stage ovarian cancer

Surgery for early stage ovarian cancer (stage 1) aims to remove the cancer and fully stage the disease. Knowing the stage helps your doctor decide if you need treatment after surgery.

For most women with stage 1 ovarian cancer, you will have surgery to remove your:

  • ovaries
  • fallopian tubes
  • womb (including the cervix)

Your surgeon will also take biopsies from several areas within your abdomen and pelvis to check for cancer cells.

After surgery, your doctor may suggest you have chemotherapy if there is a high risk of the cancer coming back, such as if you have stage 1c or a high grade (grade 3) cancer. This is called adjuvant chemotherapy.

Stage 2, 3 and 4 ovarian cancers

Doctors class stage 2, 3 and 4 ovarian cancers as advanced cancer. This means the cancer has spread outside the ovary.

The main treatments for advanced ovarian cancer are surgery and chemotherapy. Some advanced cancers may be cured with these treatments. If your cancer can't be cured, treatment aims to control the cancer for as long as possible.

Getting a second opinion

Some people feel they would like to get an opinion from a second doctor before they decide about their treatment. If a surgeon who specialises in women's cancer (gynaecological oncologist) is treating you, you should also get an opinion from a cancer specialist (oncologist) about whether you need chemotherapy.

Most doctors are happy to refer you to another NHS specialist for a second opinion if you would find this helpful.

Note: A second opinion means just that. It does not mean that the second doctor will take over your care. Your treatment will usually still be managed by your original specialist.

If you want a second surgical opinion, you need to make sure that it is from someone who specialises in ovarian cancer surgery, and not a general gynaecologist.

Clinical trials to improve treatment

Your doctor might ask if you’d like to take part in a clinical trial. Doctors and researchers do trials to:

  • improve treatment
  • make existing treatments better
  • develop new treatments

Information and help

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About Cancer generously supported by Dangoor Education since 2010.