Ovarian Cancer Treatment

Most patients with ovarian cancer will undergo a combined treatment of surgery and medications, including chemotherapy and, in some cases, targeted therapy.

At Siteman Cancer Center, our team of Washington University gynecologic oncologists understand that every patient is unique. They will design a personalized treatment plan for you, taking into account, not only the type, stage, and even genetic profile of your cancer, but also your age, desires for future fertility, and your overall health.

Many patients at Siteman receive treatment through clinical trials, research studies evaluating new drugs and procedures. Trials give patients access to new therapies, some that may even lead to better outcomes than the current standard of care.  Siteman offers more clinical trials than any other facility in the region. Ask about clinical trials you can join, and mention any you think you could be a candidate for. Your physicians will have a conversation with you if they think a particular trial could be a good fit and welcome your input.

We understand that you probably have many questions and concerns as you go through treatment for ovarian cancer. There is no question too small or simple to ask. Your care team – your physicians, nurse practitioner, nurse coordinators, and other support personnel – will be with you every step of the way, ready to help.

Surgery for ovarian cancer

Most patients with ovarian cancer will undergo surgery to remove the tumor. This will likely include taking out the ovaries, fallopian tubes, uterus, cervix, omentum (an apron of fatty tissue that overlays our organs), and sometimes lymph nodes or pieces of bowel. If cancer has spread, diffusely, your surgeon will removal all visible tumor. This is called cytoreductive surgery.

Washington University gynecologic oncologists at Siteman excel at performing complex procedures that are not always available at community hospitals, including heated intra-peritoneal chemotherapy, or HIPEC.

Radiation therapy for ovarian cancer

Radiation therapy is not often used to treat ovarian cancer. However, in select cases, it can be beneficial.

At Siteman, our experienced Washington University radiation oncologists use advanced tools and techniques to target tumors while protecting surrounding tissues.

Chemotherapy for ovarian cancer

Chemotherapies are powerful medicines that kill cancer cells wherever they may be found in the body.

Ovarian cancer patients receive chemotherapy through an IV. The drugs can be delivered into the body through a port placed in the chest or in some cases, into the abdominal cavity, known as intraperitoneal chemotherapy. Each of these is a form of infusion.

Most patients tolerate chemotherapy well. If chemotherapy is recommended for you, your oncologist will discuss side effects with you. These include but not limited to fatigue, nausea, vomiting, and low blood counts, or reduced numbers of red blood cells and white blood cells in the blood stream.  Low blood counts can make you more susceptible to bleeding, bruising, and infections.

Patients may find that intraperitoneal chemotherapy causes more side effects than traditional chemotherapy. But this approach is rarely recommended for women with advanced stage ovarian cancer or primary peritoneal cancer as a way to keep the cancer from spreading beyond the abdomen.

At Siteman, we recognize that starting chemotherapy can be overwhelming. To help you through treatment, you will be assigned a dedicated nurse coordinator, who will spend additional one-on-one time with you and any support persons to make sure all of your questions and concerns are addressed. Your nurse coordinator will provide you with:

  • Educational material on common chemotherapy side effects
  • Prescriptions for medications that help prevent side effects before they occur
  • A schedule of all of your treatments

We will guide you through this process. If you have already started your treatments and have questions, or are starting to notice bothersome symptoms, be sure to speak to your care team so that we can optimize your care and better support you.

Researchers at Siteman are working to find new combinations of chemotherapies that are easier to tolerate and even more effective than the protocols currently in use.

Targeted therapy for ovarian cancer

Targeted therapies are medications that attack the mechanisms inside cancer cells that allow them to grow and multiply. Some patients with ovarian cancer will receive targeted therapies, often during or after trying conventional chemotherapies first.

If you are found to have a BRCA mutation, in particular, your physician may suggest targeted medications called PARP inhibitors that prevent cancer cells from making repairs to their DNA.

Ovarian cancer patients receive targeted therapies either as intravenous infusions or as pills.

Fertility preservation

One significant consequence of undergoing surgery to remove the ovaries is that patients are left unable to conceive a child. While such a course of treatment may be necessary to protect a patient’s life, Washington University oncologists at Siteman also recognize that it can be devastating for women who still hope to have children.

If you are a woman with ovarian cancer and facing a fertility-ending surgery or treatment, you still have options. Siteman offers a number of services and procedures that can enable patients to have a child, including egg banking and embryo . Experts begin with a 60-minute oncofertility assessment to learn more about your unique situation. It includes a consultation and review of routine blood work.