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Chemotherapy for Ovarian Cancer

Chemotherapy uses drugs to destroy ovarian cancer cells. The drugs enter the bloodstream and travel through the body to the cancer cells. Chemotherapy may be used:

  • Before surgery—to shrink the tumor and decrease the amount of tissue that needs to be removed
  • After surgery—to kill any remaining cancer cells and decrease risk of return
  • To help relieve symptoms of metastatic cancer and extend survival time

Chemotherapy may also be used in conjunction with other treatments like radiation therapy, other medications, or hormone blocking therapy.

Chemotherapy Drugs and Delivery

There are a variety of chemotherapy drugs. The choice and combination of drugs will be based on your particular cancer and reaction to drugs. Chemotherapy drugs for ovarian cancer may include:

  • Carboplatin
  • Cisplatin
  • Paclitaxel
  • Docetaxel
  • Gemcitabine
  • Doxorubicin
  • Topotecan
  • Epirubicin
  • Bevacizumab

Chemotherapy is usually given by IV, but some forms can be given by mouth as well. IV chemotherapy is delivered in cycles (usually 3-6) over a set period of time. For ovarian cancer, intraperitoneal chemotherapy may be used. Drugs are delivered through a catheter and directly into the abdominal cavity. The catheter port is inserted during laparoscopy and is anchored to a bone inside the abdomen. Drugs can be injected through the skin and into the port. Generally, this method of delivery allows for the use of stronger drugs.

A medical oncologist will determine how many cycles of chemotherapy are needed and what combination of drugs will work best.

Side Effects and Management

Though the drugs are targeted to cancer cells, they can affect healthy cells as well. The death of cancer cells and impact on healthy cells can cause a range of side effects. A medical oncologist will work to find the best drug combination and dosage to have the most impact on the cancer cells and minimal side effects on healthy tissue. Side effects or complications from chemotherapy may include:

  • Nausea and vomiting
  • Fatigue
  • Loss of appetite
  • Memory or cognitive problems
  • Low blood cell counts (red cells, white cells, or platelets) that can lead to infection or bleeding
  • Premature menopause —including symptoms and loss of fertility

A variety of treatments are available to help manage side effects including medication, lifestyle changes, and alternative treatments. In some cases, the chemotherapy regimen may be adjusted to reduce severe side effects. The earlier the side effects are addressed, the more likely they will be controlled with a minimum of discomfort.

REFERENCES:

Chemotherapy for advanced ovarian, fallopian tube and primary peritoneal carcinoma. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T900637/Chemotherapy-for-advanced-ovarian-fallopian-tube-and-primary-peritoneal-carcinoma. Updated August 17, 2017. Accessed January 29, 2018.

Chemotherapy for ovarian cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/ovarian-cancer/treating/chemotherapy.html. Updated February 4, 2016. Accessed January 29, 2018.

Ovarian cancer. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T900705/Ovarian-cancer. Updated November 17, 2017. Accessed January 29, 2018.

Ovarian cancer. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/gynecology-and-obstetrics/gynecologic-tumors/ovarian-cancer. Updated March 2017. Accessed January 29, 2018.

Treatment option overview. National Cancer Institute website. Available at: https://www.cancer.gov/types/ovarian/patient/ovarian-epithelial-treatment-pdq#section/_156. Updated October 13, 2017. Accessed January 29, 2018.

Last reviewed November 2018 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP  Last Updated: 1/29/2018