Chemotherapy for ovarian cancer

Your doctor is most likely to suggest chemotherapy after surgery if your cancer is stage 1c or above. But you may have it for an earlier stage cancer that is high grade. You can also have chemotherapy for ovarian cancer that has come back (recurred) after you were first treated.

You are most likely to have chemotherapy for ovarian cancer through a drip into a vein.

Researchers have been looking into giving ovarian cancer chemotherapy straight into the abdomen. This is called intraperitoneal chemotherapy. Doctors hope it will be a useful way of treating ovarian cancer in the abdomen. But it is still experimental and you are only likely to be offered this type of treatment as part of a clinical trial.

A number of different treatment plans are used. When you are first diagnosed, you usually have chemotherapy using

• Carboplatin alone
• Carboplatin with another drug, paclitaxel (Taxol)

You may have this treatment before or after surgery for ovarian cancer. There is information about treatment with these drugs in this section.

Researchers are looking into using a number of chemotherapy drugs to see which work best at

• Stopping ovarian cancer from coming back after surgery
• Shrinking or slowing down advanced ovarian cancer

Your doctor may suggest you have treatment as part of a clinical trial to find better ways of stopping the cancer coming back or shrinking it. For more information about clinical trials in general, and ovarian cancer trials specifically, visit our searchable database on clinical trials in the UK.

If ovarian cancer comes back after your first surgery and chemotherapy, you may have different chemotherapy drugs from the first chemotherapy that you had. Treatment options include

• More platinum drug treatment (carboplatin or cisplatin), with paclitaxel (Taxol)
• Paclitaxel (Taxol) on its own
• Liposomal doxorubicin (Caelyx or Doxil)
• Topotecan (Hycamtin)

Doctors sometimes use other drugs such as etoposide or gemcitabine, either on their own or in combination with other chemotherapy drugs. The treatment cannot usually cure ovarian cancer that has come back.  But it can help to control it for months or sometimes years. There is information about treatment with these drugs in this section.

There are now other types of drugs that researchers are investigating for cancer of the ovary.  These are called biological therapies because they are either made from natural body substances or they block them.  There is information about research into biological therapies for ovarian cancer in this section of the website. There is also some research looking into hormone treatments for ovarian cancer.

If ovarian cancer spreads to other parts of the body this is called advanced or metastatic ovarian cancer and there is information about treating advanced ovarian cancer in this section.

There are various ways your doctor can find out how well your chemotherapy has worked. You may have

• CA125 blood tests
• CT scans or ultrasound scans

CA125 is a protein made by some ovarian cancer cells. It circulates in the blood stream. Your doctor will have measured your CA125 level before you started your treatment. If you had high levels, your doctor will expect the level to fall as the cancer cells are killed by the chemotherapy drugs. So you may have CA125 blood tests before each chemotherapy treatment or when your course of treatments is finished. This can show how well the treatment is working.

Note: Not all women with ovarian cancer have raised CA125 levels. If you did not have raised CA125 when you were first diagnosed, this blood test cannot be used to monitor your treatment or during follow up.

If you had a tumour that your doctor could measure on a scan, they may want to repeat the scan after your treatment to see if the tumour has shrunk.

If your cancer is still there after your chemotherapy has finished, more of the same chemotherapy is unlikely to get rid of it completely. It will almost certainly grow back, although it could be a long time before it begins to cause any symptoms. 

We don't know yet whether having more treatment immediately is helpful. So your specialist may just want to monitor how you are for the time being. Or your specialist may suggest an experimental treatment as part of a clinical trial. This might be a new type of chemotherapy into a vein, biological therapy or other types of experimental treatment. If you have symptoms, your doctor may suggest external radiotherapy as it may shrink tumours and reduce the symptoms.

There is more information about controlling symptoms of ovarian cancer and ovarian cancer research in this section.

We don't yet know much scientifically about how some nutritional or herbal supplements may interact with chemotherapy. Some could be harmful. It is very important to let your doctors know if you take any supplements. Or if you are prescribed them by alternative or complementary therapy practitioners.

Talk to your specialist about any other tablets or medicines you take while you are having active treatment. There is information about the safety of herbal, vitamin and diet supplements in the complementary therapies section.

Some studies seem to suggest that fish oil preparations may reduce the effectiveness of chemotherapy drugs. If you are taking or thinking of taking these supplements talk to your doctor to find out whether they could affect your treatment.

For more about chemotherapy look at the chemotherapy section. It explains the treatment in detail including

• What it involves
• How chemotherapy is planned and given
• General side effects
• Living with chemotherapy

If you would like more information about chemotherapy, contact our cancer information nurses. They would be happy to help.