The initial treatment of ovarian cancer usually involves a combination of surgery and chemotherapy. Surgery treatment generally involves removing both ovaries, the fallopian tubes, the uterus as well as nearby lymph nodes and a fold of fatty abdominal tissue (omentum) where ovarian cancer often spreads. The surgeon removes as much cancer as possible from the abdomen. Less extensive surgery may be possible if the ovarian cancer was diagnosed at a very early stage. For women with stage I ovarian cancer, surgery may involve removing one ovary and its fallopian tube. This procedure may preserve the ability to have children. After surgery, most patients are treated with chemotherapy to kill any remaining cancer cells. Chemotherapy drugs can be injected into a vein (intravenous) or directly into the abdominal cavity (intraperitoneal) or both. Chemotherapy may be used as the initial treatment even before surgery in some women with advanced ovarian cancer. In some cases intraperitoneal (IP) chemotherapy is recommended as treatment following the initial surgery. Combining IP chemotherapy with intravenous (IV) chemotherapy has shown to improve survival in some women with advanced ovarian cancer, though its use in clinical practice has been limited, according to findings from a new study. IP chemotherapy is delivered through an implanted subcutaneous port that drains into the cavity of the abdomen, allowing direct access for the drug to the peritoneal cavity, where ovarian cancer has spread. Its use, however, can cause more frequent and more severe side effects than IV chemotherapy, including abdominal pain, nausea, and vomiting.
Certain factors affect treatment options and prognosis (chance of recovery):
- The stage and grade of the cancer.
- The type and size of the tumor.
- Whether all of the tumor can be removed by surgery.
- Whether the patient has swelling of the abdomen.
- The patient’s age and general health.
- Whether the cancer has just been diagnosed or has recurred (come back).
Recurrent ovarian epithelial cancer, fallopian tube cancer, or primary peritoneal cancer is cancer that has recurred (come back) after it has been treated. Persistent cancer is cancer that does not go away with treatment. Treatment of recurrent ovarian epithelial cancer, fallopian tube cancer, and primary peritoneal cancer may include the following:
- Chemotherapy using one or more anticancer drugs, with or without surgery.
- Targeted therapy with novel agent either alone or combined with chemotherapy.
- A clinical trial of a new treatment.
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