Your Comprehensive Guide to Chemotherapy for Ovarian Cancer

What is ovarian cancer?

Ovarian cancer is a leading cause of cancer-related deaths among women globally. Often diagnosed at an advanced stage due to a lack of early symptoms, ovarian cancer allows cancerous cells to grow within the abdominal cavity before spreading to other parts of the body. Treatment decisions, including chemotherapy, depend on the type and stage of ovarian cancer, as well as individual health needs. This article provides an in-depth look at chemotherapy for ovarian cancer, its methods, potential side effects, and other treatment options. 

For more information regarding ovarian cancer, click here.

Want to learn more about ovarian cancer treatment? Request for an appointment with our specialists at Thomson Medical for a personalised treatment plan.

When is chemotherapy used for ovarian cancer?

Chemotherapy is commonly the primary treatment for ovarian cancer. It can be administered:

1. Before surgery (neoadjuvant chemotherapy): To reduce tumour size and facilitate removal.

2. After surgery (adjuvant chemotherapy): To target residual cancer cells in the body.

Chemotherapy drugs can be administered via three routes:

1. Intravenous (IV): Drugs are injected into the bloodstream through a thin tube in the vein.

2. Oral: Medications are taken by mouth.

3. Intraperitoneal (IP): Drugs are delivered directly into the abdominal cavity through a catheter.

These methods help ensure that chemotherapy reaches cancer cells wherever they are located, enhancing the treatment’s overall effectiveness.

Types of chemotherapy for different ovarian cancer types

The chemotherapy approach for ovarian cancer depends on the specific type of cancer, as each type has unique characteristics and responds differently to various drugs. Here are a few types of chemotherapy approaches to consider, depending on the ovarian cancer subtype:

1. Epithelial ovarian cancer

   • Epithelial ovarian cancer, the most common type, is often treated with a combination of platinum-based drugs and taxanes:

     • Drug combination: Platinum compounds (carboplatin or cisplatin) are combined with taxanes (paclitaxel or docetaxel), administered intravenously.

     • Treatment cycles: Generally, 3 to 6 cycles are given, with each cycle involving scheduled doses followed by a rest period.

     • Intraperitoneal (IP) chemotherapy: For advanced cases, such as Stage III epithelial ovarian cancer, or for patients with successful tumour removal, IP chemotherapy may be added to IV chemotherapy. This approach places highly concentrated drugs directly in contact with abdominal cancer cells, which can enhance survival rates. However, it often leads to more intense side effects, such as nausea and abdominal discomfort.

2. Germ cell tumours

   • Germ cell tumours, a rarer type often affecting younger women, are typically very responsive to chemotherapy:

     • Preferred regimen: In the context of chemotherapy, a regimen refers to the specific drugs used, their dosages, the method of administration (such as intravenously or orally), and the timing or cycle in which they are given. The BEP regimen, consisting of bleomycin, etoposide, and cisplatin, is frequently used due to its effectiveness.

     • Alternative combinations: Some germ cell tumour subtypes may be treated with a gentler combination of carboplatin and etoposide, aiming to minimise toxicity while still being effective.

     • Treatment for recurrence: If initial treatments don’t fully eliminate the cancer or if it recurs, other drug combinations may be considered to target resistant cancer cells.

3. Ovarian stromal tumours

   • Ovarian stromal tumours are a rare form of ovarian cancer, often producing hormones and growing more slowly than other types:

     • Chemotherapy use: Chemotherapy is not the primary treatment but may be considered in advanced cases.

     • Drug combinations: When chemotherapy is used, combinations like carboplatin and paclitaxel or the BEP regimen may be applied.

Side effects of chemotherapy

Chemotherapy's effects vary depending on the drugs and dosages used. Common side effects include:

• Nausea and vomiting

• Abdominal discomfort

• Appetite and weight loss

• Hair loss

• Skin reactions on hands and feet

• Mouth sores

Bone marrow suppression is another significant effect, potentially causing:

• Anaemia: leading to fatigue

• Leucopenia: increasing infection risks

• Thrombocytopenia: causing easy bruising and bleeding

Most side effects subside after treatment, though some may be longer-lasting:

• Neuropathy (nerve damage): Causes tingling, numbness, and weakness.

• Nephropathy (kidney damage)

• Ototoxicity (hearing loss)

• Infertility

• Bone marrow damage: Rarely, this increases the risk of blood cancers like myelodysplastic syndrome or acute myeloid leukaemia.

You can always consult our gynaecologists to better understand what to expect and explore available supportive care options.

Additional treatments for ovarian cancer

Chemotherapy is often just one part of a comprehensive treatment plan for ovarian cancer. Depending on the cancer’s type, stage, and individual patient needs, additional treatments may be recommended to improve outcomes and target cancer cells more effectively. Here are some commonly used treatments:

1. Surgery

   • Surgery is typically the first line of treatment for ovarian cancer, especially in early stages. The main goals are:

     • Tumour removal: The surgeon aims to remove as much of the tumour as possible (debulking surgery), which may involve taking out one or both ovaries, the fallopian tubes, the uterus, and, in some cases, nearby tissues that may contain cancer cells.

     • Staging and diagnosis: Surgery also allows doctors to assess the cancer’s stage and spread, helping to guide further treatment.

   • Surgery is often followed by chemotherapy or other therapies to target any remaining cancer cells.

2. Radiation therapy

   • Radiation therapy uses high-energy X-rays or particles to destroy cancer cells. While not commonly the primary treatment for ovarian cancer, it can be effective in specific cases:

     • External beam radiation: This is the most common type, where radiation is directed from a machine outside the body to target cancer cells in a precise location.

     • Internal radiation (brachytherapy): In rare cases, radioactive material may be placed directly inside the body near the cancer cells to provide a high dose of radiation to the tumour with minimal exposure to surrounding tissues.

   • Radiation therapy is sometimes used to relieve symptoms (palliative care) in advanced ovarian cancer, especially if the cancer has spread.

3. Hormone therapy

   • Hormone therapy is mainly used for ovarian stromal tumours, a rarer type of ovarian cancer that often produces hormones. This treatment works by:

     • Blocking hormone receptors: Hormone therapy drugs block the action of hormones like oestrogen that may promote cancer cell growth.

     • Reducing hormone production: Some drugs decrease the body’s hormone levels to slow down the tumour’s growth.

   • This approach is generally used for hormone-sensitive ovarian cancers and may be considered for patients who cannot undergo surgery or other aggressive treatments.

4. Targeted therapy

   • Targeted therapy focuses on specific molecules and mechanisms that cancer cells use to grow and survive. These treatments aim to interfere with cancer cell function without affecting normal cells, offering a more focused approach than traditional chemotherapy.

     • PARP inhibitors: Drugs like olaparib and niraparib inhibit PARP enzymes, which help repair DNA in cells. By blocking these enzymes, PARP inhibitors prevent cancer cells from repairing themselves, especially in patients with BRCA gene mutations.

     • Anti-angiogenesis drugs: Bevacizumab (Avastin) is a targeted therapy that inhibits the formation of blood vessels needed to supply nutrients to the tumor, effectively starving cancer cells.

5. Immunotherapy

   • Immunotherapy stimulates the body’s immune system to identify and destroy cancer cells. Although not yet standard for ovarian cancer, it is a growing area of research.

     • Immune checkpoint inhibitors: These drugs, such as pembrolizumab, block proteins that prevent immune cells from attacking cancer cells, allowing the immune system to recognize and fight the cancer.

     • Vaccine therapy: Experimental vaccines are being studied to boost the immune system’s response against ovarian cancer cells. Immunotherapy is primarily available through clinical trials and may be an option for patients with advanced-stage ovarian cancer or those who do not respond well to other treatments.

Chemotherapy is a vital part of ovarian cancer treatment, but understanding its uses, types, and side effects can help patients make informed choices. Depending on individual needs and cancer specifics, a combination of treatments, including surgery, radiation, and emerging therapies, may be recommended.

For tailored and comprehensive ovarian cancer care, consult with our specialists at Thomson Medical. Request for an appointment today to discuss the best treatment options for you.

FAQs

How long is chemotherapy for ovarian cancer?

Chemotherapy for ovarian cancer typically lasts 3 to 6 cycles, with each cycle lasting about 3 to 4 weeks. The entire treatment course may span 3 to 6 months. The exact duration depends on factors like the cancer stage, response to treatment, and the specific chemotherapy regimen used.

How long does each chemotherapy session take? 

Each chemotherapy session can vary in length depending on the specific drugs being administered, typically ranging from a few hours to an entire day. Your healthcare team will provide a schedule and estimated session time based on your treatment plan.

Are there foods or supplements I should avoid during chemotherapy?

Certain foods and supplements may interfere with chemotherapy’s effectiveness or increase side effects. It's essential to consult your healthcare provider before taking new supplements or significantly changing your diet during treatment.

Is chemotherapy painful?

Chemotherapy itself is not typically painful when administered. However, some side effects may cause discomfort, such as fatigue, nausea, mouth sores, or nerve pain. The experience varies from person to person, and healthcare providers can offer strategies to manage any discomfort effectively.

Does chemotherapy cause hair loss?

Hair loss is a common side effect of certain chemotherapy treatments, though not all chemotherapy drugs cause it. The extent of hair loss can vary from thinning to complete hair loss, depending on the specific medication, dosage, and treatment duration. Hair typically grows back after treatment ends.

What should I bring to my chemotherapy sessions? 

To stay comfortable, consider bringing water, snacks, a book or digital device, and a blanket. Many people also bring a family member or friend for support during the session.

Disclaimer: The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, please consult a specialist at Thomson Medical. Request for an appointment with Thomson Medical today.