Chemotherapy for Ovarian Cancer: Help Your Doctor Understand Your Preferences
Getting diagnosed with ovarian cancer is scary, but it is a treatable disease. However, there isn't a one-size-fits-all approach to ovarian cancer treatment. Talk to your oncologist to determine what will work best for you.
Because there is a lot of information to absorb, it may be overwhelming in the beginning. Write down your questions before your appointment (see our printable checklist) and ask the most pressing questions first so that you don't run out of time during your preliminary visit.
If an ovarian growth is suspected, an ultrasound of the ovaries is done. If any abnormality is detected, further testing will be done. Tests include blood studies, CT scans, barium enema X-rays, colonoscopy, MRI, and chest X-rays to help evaluate the extent of the cancer. Ultimately, the surgical opening of the abdomen (exploratory laparotomy) is necessary to confirm or rule out an ovarian cancer diagnosis.
Genetic testing may be useful for women who have a family history of ovarian, uterine (endometrial),...
Chemotherapy, which uses drugs to kill cancer cells, is usually recommended after surgery to treat most stages of ovarian cancer. Ovarian cancer is typically responsive to chemotherapy.
There are different ways to administer chemotherapy, such as by mouth or injections into the muscle. Chemotherapy for ovarian cancer is usually given intravenously (IV) -- into a vein -- or medications are injected through a catheter or port into your abdomen, called intraperitoneal chemotherapy (IP).
Ask your doctor whether you are a candidate for IP. Research shows that women who received both IV and IP chemotherapy are disease-free longer than women who received only IV chemotherapy (and have a higher survival rate), but they also experienced more severe side effects such as fatigue, pain, and low blood counts.
A central line, also called central venous catheter (CVC), may be administered prior to chemotherapy treatment. A CVC is a hollow tube that is placed in a large vein, and it can stay in the body for a much longer period of time. CVCs allow an easier route for IV medicines and require different levels of care. The type of CVC used is based on how long you will be getting treatment, how long it takes to infuse each dose of chemotherapy, your preferences, your doctor's preferences, the care required to maintain the CVC, and its cost. Talk to your doctor about the type of central line that he or she recommends for you.
Discussing Your Treatment Plan
You will likely receive a combination of chemotherapy drugs. Most oncologists in the U.S. consider combination chemotherapy more effective than a single drug in treating ovarian cancer.
The standard approach is to use a platinum compound, such as cisplatin or carboplatin, and a taxane, such as Taxol or Taxotere. For IV chemotherapy, most doctors favor carboplatin over cisplatin because it has fewer side effects and is just as effective. In addition, Taxol is favored over Taxotere due to a greater experience with Taxol.
Talk to your oncologist about the schedule that is most appropriate for your treatment. Different drugs have varying cycles, and the number of treatment cycles you have will depend on the stage of your disease. A cycle is a schedule that allows regular doses of a drug, followed by a rest period. For example, if you have advanced ovarian cancer, your oncologist may recommend a course of chemotherapy that involves six cycles, with each cycle given once every three weeks.