Chemotherapy for ovarian cancer

Chemotherapy is the treatment of cancer with anti-cancer (cytotoxic) drugs. The aim is to destroy cancer cells while causing the least possible damage to normal, healthy cells.

Learn more about:

• When is chemotherapy used?
• Having chemotherapy
• Intraperitoneal chemotherapy
• Blood tests during chemotherapy
• Side effects of chemotherapy
• Video: What is chemotherapy?

When is chemotherapy used?

When you have chemotherapy depends on the stage of the cancer. It may be used at different times:

Before surgery – For stage 3 or 4 ovarian cancer, chemotherapy is sometimes given before surgery. This is known as neoadjuvant chemotherapy. The aim is to shrink the tumours to make them easier to remove.

After three cycles of chemotherapy, you will have a CT scan to check how the tumour has responded to the chemotherapy. Your doctor will then decide about having an operation. If you have surgery, you will have another three cycles of chemotherapy afterward. If you do not have surgery, you will continue with a further three cycles of chemotherapy.

After surgery – Chemotherapy is usually given 2–4 weeks after the surgery (adjuvant chemotherapy) as there may be some cancer cells still in the body. For ovarian cancer, the drugs are usually given in repeating cycles spread over 4–5 months, but this can vary depending on the stage of the cancer and your general health. Your treatment team will talk to you about your specific schedule. Some people may have chemotherapy with a targeted therapy drug.

Main treatment – Chemotherapy may be recommended as the main treatment if you are not well enough for a major operation or when the cancer cannot be surgically removed.

Having chemotherapy

Chemotherapy is usually given as a combination of two or more drugs, or sometimes as a single drug.

In most cases, the drugs are injected into a vein (intravenously). To reduce the need for repeated needles, you may receive chemotherapy through a small medical appliance or tube inserted beneath your skin. This may be called a port-a-cath or a peripherally inserted central catheter (PICC), or it may have another name.

You will usually have chemotherapy as an outpatient (also called a day patient), but some people need to stay in hospital overnight.

For more on this, see our general section on Chemotherapy.

Intraperitoneal chemotherapy

Occasionally, chemotherapy is given directly into the abdominal cavity – the space between the organs in the abdomen and the walls of the abdomen. This is known as intraperitoneal chemotherapy.

In this method, the drugs are delivered through a tube (catheter) that is put in place during surgery and removed once the course of chemotherapy is over.

Intraperitoneal chemotherapy is used only in specialised units in Australia.

It may be offered for stage 3 cancer with less than 1 cm of tumour remaining after surgery. Some studies have shown it may be more effective than giving chemotherapy through an intravenous drip.

Ask your medical oncologist for more information about this type of chemotherapy and the benefits and risks. Some studies are looking at giving heated intraperitoneal chemotherapy (HIPEC) immediately after surgery. This is thought to make the chemotherapy work better.

Blood tests during chemotherapy

You will have blood tests before each chemotherapy cycle, to check your body’s healthy cells have had time to recover. If your blood count has not recovered, which can be common, there maybe a delay before your next treatment.

In some cases, you may also have blood tests during treatment to check for the CA125 tumour marker:

• If your CA125 level was high before chemotherapy, it will be expected to fall as chemotherapy destroys the cancer cells.
• If the CA125 level stays the same or rises during chemotherapy, it may mean the cancer is not responding to treatment.
• If you did not have raised CA125 when you were diagnosed, this blood test won’t be used to monitor if the treatment is working.

→ READ MORE: Side effects of chemotherapy

Video: What is chemotherapy?

Watch this short video to learn more about chemotherapy.