Ovarian cancer treatment usually involves a combination of surgery and chemotherapy. A minority of case require surgery only. Radiotherapy is rarely used in the modern management of ovarian cancer.
The objectives of ovarian cancer surgery are to stage the cancer (work out how far it has spread) and to remove the cancer completely. This is not always possible for example if the cancer involves a lot of the small bowel, but the surgeon always tries to remove as much cancer as can safely be removed. Sometimes surgery is necessary simply to reach a diagnosis if this has not already been made.
Usually the surgery requires a large up and down incision through the abdomen, but for some women, one of the recognized ways of removing apparently early-stage ovarian cancers is using laparoscopic (‘keyhole’) surgery. This type of surgery can greatly speed up the patient’s recovery from the operation.
Surgery usually involves removing the following:
- The womb, cervix, fallopian tubes and ovaries (a ‘full’ hysterectomy)
- the omentum (a piece of fatty tissue which hangs off the large bowel)
- lymph glands (involved in the immune system) in the pelvis and abdomen
In some cases other organs may need to be removed in order to get rid of all the visible tumour. These include parts of the large and small bowel, the spleen, the lining of the diaphragm and the appendix.
With ovarian cancer, the medical oncologist (doctor specialising in chemotherapy) will make the decision as to whether or not chemotherapy is needed. They will take into account various factors when making this decision including the stage of cancer, the grade of cancer (how abnormal the cancer cells look down the microscope), and how fit the patient is.
More recently, other types of drugs, called ‘biological agents’ have been developed to treat ovarian cancer. These drugs attack specific parts of the complex mechanisms that cancer cells use to grow. For example some biological agents stop tumours from growing blood vessels and this stops them getting enough oxygen to grow.
Another type of drug called a PARP-inhibitor has been developed recently and this is showing great promise in treating women with the inherited type of ovarian cancer.