When doctors catch ovarian cancer early, standard treatments including surgery and chemotherapy often work. Most women diagnosed when their cancer is only in the ovaries or nearby lymph nodes survive for 5 years or more. That doesn’t mean they live only 5 years. Research typically doesn’t track cancer survival past 5 years.
The trouble is that doctors find about 6 in every 10 ovarian cancers after they have spread to more distant parts of the body. That’s because ovarian cancer often doesn’t show symptoms before it spreads. These advanced cancers are much harder for doctors to treat successfully. As a result, statistics show that less than half of women diagnosed with ovarian cancer live 5 years or more.
But, looking ahead, new research offers a lot of a hope. Ongoing research and treatment advances now give women with advanced ovarian cancers more options and the chance to live longer and better.
Treatment Advances in Ovarian Cancer
The FDA recently approved several new drugs to treat advanced ovarian cancers after they got strong results in clinical trials. Women now have new treatment options to slow more advanced ovarian cancers or keep the disease from coming back.
Anti-Angiogenics. These drugs starve tumors by blocking the blood vessels that feed them. In June 2018, the FDA approved one of these drugs, bevacizumab (Avastin), for women with advanced ovarian cancer.
PARP Inhibitors. Cancer cells survive and thrive because they can repair their own DNA when damage occurs. Drugs called PARP inhibitors make it harder for cancer cells to fix themselves. In the last 3 years, the FDA has approved four new uses of these drugs to treat ovarian cancer.
- Rucaparib (Rubraca) for maintenance treatment of recurrent ovarian cancer. Maintenance therapies can slow or keep an ovarian cancer from coming back after initial treatment.
- Olaparib (Lynparza) for women with advanced epithelial ovarian cancer that has a mutation in genes called BRCA.
- Olaparib plus bevacizumab for maintenance treatment in women with advanced ovarian cancers that have certain genetic traits.
- Niraparib (Zejula) for maintenance treatment to keep advanced epithelial ovarian cancers at bay after chemotherapy.
Immunotherapy. These treatments work by unleashing the body’s own immune system to fight cancer. They haven’t worked as well so far in ovarian cancers compared to other advanced cancers. But the immunotherapy drug pembrolizumab (Keytruda) is an option for certain advanced ovarian tumors that have lots of gene mutations. Those mutations make it easier for a person’s immune system to recognize a cancer as foreign and fight it.
Chemotherapy and surgery. In addition to new drugs, doctors are also studying ways to use surgery and chemo to get better results. For instance, some research explores whether a second surgery to remove a cancer that comes back can help women live longer. One recent study showed that this isn’t always helpful. But there may be some patients who could benefit from additional surgeries in addition to chemo. Research may help determine exactly who would and wouldn’t benefit from more surgery.
Recent research also shows that chemotherapy may lead to longer survival when doctors heat the drugs and apply them directly to cancer. Doctors sometimes call this HIPEC (heated intraperitoneal chemotherapy) or hot chemotherapy.
Early Detection and Prevention of Ovarian Cancer
The reason doctors often catch ovarian cancer too late is because it doesn’t usually have symptoms at first. When there are symptoms, they can look like other less serious conditions. Improvements in early detection and prevention could stop more ovarian cancers before they happen or catch them sooner, when doctors can more easily treat them.
Genetic tests can help to identify women at higher risk for ovarian cancer. But unfortunately, there is no reliable way to screen women to see if they already have ovarian cancer.
If you are at high risk for ovarian cancer or a doctor suspects you have it, they might suggest an ultrasound or a blood test to help find or rule it out. If you are at average risk, there’s no test that's recommended to catch ovarian cancer sooner. But research is in progress to develop better tests.
If doctors and genetic counselors find you have a much higher than average risk of ovarian cancer due to an inherited mutation, you might think about surgery to remove your ovaries and fallopian tubes to prevent ovarian cancer. But recent studies show that there are many factors to consider. The surgery may bring previously unknown risks. It also may not extend the lifespan of all women who choose it.
Clinical Trials for Ovarian Cancer
In addition to proven treatments, researchers are working to develop and test many new drugs and approaches to treat ovarian cancer. These include:
- Vaccines to boost the body’s immune system to fight the cancer
- Targeted treatments that attack specific traits in cancer cells that help them grow
- Antibody-drug combinations that also help the immune system fight cancer
- Gene therapy to put new genes into a cancer cell to kill the cell or slow its growth
Hundreds of active clinical trials are in progress to test new treatments and new ways to match cancers to existing treatments. Other trials focus on ways to better manage, detect, or prevent ovarian cancer. If you or someone you love wants to be part of ovarian cancer research, ask your doctor how you can get involved.