Decorative image

Treatment decisions

A team of health professionals decide what treatment you need. This depend on factors such as your cancer stage and grade. The most common treatments are surgery and chemotherapy.

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 gynaecological oncologist who specialises in women's cancer surgery, 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
  • chemotherapy

Some women with advanced ovarian cancer have targeted drug treatment, hormone treatment or radiotherapy.

Surgery

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

Chemotherapy

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. The drugs circulate throughout the body in your bloodstream.

Doctors most commonly use the chemotherapy drug carboplatin to treat ovarian cancer. You might have it on its own or with another chemotherapy drug called paclitaxel (Taxol).

Treatment by stage

Stage 1

Doctors usually class stage 1 cancer as early ovarian cancer. This means the cancer is still contained within the ovaries.

Surgery

Surgery is the main treatment. Your specialist surgeon (gynaecological oncologist) removes your cancer. They might need to remove your ovaries, fallopian tubes and womb (including the cervix). The surgeon examines the inside of your abdomen and your abdominal organs for signs of cancer.

For some low grade stage 1a cancers, it might be possible to just remove the affected ovary and fallopian tube, leaving behind the unaffected ovary and your womb. This means you might be able to become pregnant and have a baby afterwards. 

Chemotherapy

After surgery, your doctor might suggest you have chemotherapy if you have:

  • stage 1c ovarian cancer
  • high grade (grade 3) cancer

This is called adjuvant chemotherapy and aims to lower the risk of your cancer coming back.

 Stage 2, 3 and 4 ovarian cancers

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

The main treatments are surgery and chemotherapy.

Surgery

Most women with ovarian cancer have surgery to remove both ovaries, fallopian tubes and your womb (including the cervix).

If the cancer has spread to other areas in your pelvis or abdomen, your specialist surgeon (gynaecological oncologist) will aim to remove as much of the cancer as possible. Sometimes the surgeon has to remove part of the bowel if the cancer has spread there and is blocking the bowel. 

Chemotherapy

You might have:

  • chemotherapy after surgery – this is called debulking surgery with adjuvant chemotherapy
  • chemotherapy before and after surgery – this is called neoadjuvant chemotherapy and interval debulking surgery (IDS)  

You might not have surgery if you have very advanced cancer or you are not well enough. You might have chemotherapy on its own or combined with other treatments. 

Targeted cancer drugs

Some women with advanced ovarian cancer have targeted cancer drugs. These drugs change the way that cells work and help the body control the growth of cancer

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 make existing treatments better and develop new treatments.

Last reviewed: 
30 Jan 2019
  • The recognition and initial management of ovarian cancer.
    National Institute for Health and Care Excellence (NICE), April 2011

  • Management of epithelial ovarian cancer
    Scottish Intercollegiate Guidelines Network (SIGN), 2013

  • Newly Diagnosed and Relapsed Epithelial Ovarian Carcinoma: ESMO Clinical Practice Guidelines
    JA Ledermann and others
    Annals of Oncology, 2013. Volume 24, Supplement 6

  • Cancer and its management (7th edition)
    J Tobias and D Hochhauser
    Wiley-Blackwell, 2015

  • British gynaecological cancer Society (BGCS) Epithelial Ovarian / Fallopian Tube / Primary Peritoneal Cancer Guidelines: Recommendations for Practice
    C Fotopoulou and others
    European Journal of Obstetrics and Gynecology and Reproductive Biology, April 2017.  Vol. 213, p123–139

  • Cancer of the ovary, fallopian tube and peritoneum
    J Berek and others
    International Journal of Gynaecological Obstetrics 2018: Issue 143 Supplement 2 pages 59 - 78

Information and help

Dangoor sponsorship

About Cancer generously supported by Dangoor Education since 2010.