Chemotherapy for ovarian cancer
Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. Cytotoxic means toxic to cells.
Ovarian cancer is usually very sensitive to chemotherapy, and in most women the cancer will become smaller and may disappear. Most women have chemotherapy for ovarian cancer as an outpatient. The chemotherapy drugs are usually given into a vein (intravenously).
Intravenous chemotherapy is given as a session of treatment, over several hours. This is followed by a rest period of a few weeks, which allows your body to recover from any side effects. Together, the treatment and the rest period are known as a cycle of chemotherapy. Most women have six cycles of chemotherapy, which is known as a course of treatment.
Chemotherapy after surgery
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Chemotherapy is most commonly given after surgery. It’s generally given once every three weeks. A complete course usually takes about 4-5 months.
Chemotherapy before surgery
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Some women are given chemotherapy both before and after surgery. In some situations this can help make surgery more successful.
In this case you’re usually given three cycles of chemotherapy before surgery and three after. After the first three cycles you have a CT scan to see how effective the chemotherapy has been. If it’s made surgery possible you’ll have an operation to remove the remaining tumour. After this you have three more cycles of chemotherapy to complete the course.
Sometimes if surgery still isn’t possible after three cycles of chemotherapy, a full course of six treatments is given. Another CT scan may then be done to check whether an operation is possible.
Chemotherapy as the main treatment
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If the cancer has spread to the liver, or outside of the abdomen, chemotherapy may be used as the main treatment. The aim is to try to control the cancer, reduce symptoms and help you feel better for longer.
The chemotherapy drug most commonly used to treat ovarian cancer is carboplatin.
It may be given on its own or in combination with the chemotherapy drug paclitaxel (Taxol®).
Other chemotherapy drugs sometimes used to treat ovarian cancer include:
We have information about these drugs.
Chemotherapy can cause side effects, but these can often be well-controlled with medicines.
Risk of infection
Chemotherapy can reduce the number of white blood cells, which help fight infection. If the number of your white blood cells is low, you’ll be more prone to infections. A low white blood cell count is called neutropenia.
Always contact the hospital immediately on the 24-hour contact number you’ve been given and speak to a nurse or doctor if:
you develop a high temperature, which may be over 37.5˚C (99.5˚F) or over 38˚C (100.4˚F), depending on the hospital’s policy - follow the advice you’ve been given by your chemotherapy team
you suddenly feel unwell, even with a normal temperature
you feel shivery and shaky
you have any symptoms of an infection such as a cold, a sore throat, a cough, passing urine frequently (a urine infection) or diarrhoea.
If necessary, you’ll be given antibiotics to treat any infection. You’ll have a blood test before each cycle of chemotherapy to make sure your white blood cells have recovered. Occasionally your treatment may need to be delayed if the number of your white blood cells is still low.
Bruising or bleeding
Chemotherapy can reduce the number of blood clotting cells called platelets in your blood. Let your doctor know if you have unexplained bruising or bleeding, such as nosebleeds, bleeding gums, blood spots or rashes on the skin.
Anaemia (low number of red blood cells)
You may become anaemic while having chemotherapy. This may make you feel tired and breathless. You may be given blood transfusions if you become anaemic.
Nausea and vomiting
Some chemotherapy drugs cause nausea and vomiting. Your doctor can prescribe anti-sickness (anti-emetic) drugs to prevent or greatly reduce nausea and vomiting.
If the sickness is not controlled or continues, tell your doctor, as they can prescribe other anti-sickness drugs that may work better for you.
Feeling tired is a common side effect of chemotherapy, especially towards the end of treatment and for some weeks after it’s over. It’s important to try to pace yourself and get as much rest as you need. Try to balance this with some gentle exercise, such as short walks, which will help build up your energy levels. If tiredness is making you feel sleepy, don’t drive.
Your doctor or specialist nurse can tell you if the chemotherapy drugs you’re having are likely to cause hair loss.
Carboplatin doesn’t usually cause hair loss, but if you’re treated with paclitaxel as well, you’ll usually begin to lose your hair 3-4 weeks after starting treatment. Hair usually falls out completely. You may also have thinning and loss of your eyelashes, eyebrows and other body hair.
You may be entitled to a free wig from the NHS. Your doctor or nurse will be able to arrange for you to see a wig specialist. You may prefer to wear a bandana, hat or scarf. We have more information about coping with hair loss, which discusses practical ways of dealing with hair loss and how to cope with the emotional effects.
Hair loss is almost always temporary and your hair will grow back over 3-6 months after chemotherapy has finished.
Numbness or tingling in hands or feet
Both carboplatin and paclitaxel can cause this side effect. You may have changes in sensation in your hands and feet. You may notice you have difficulty doing up buttons or other fiddly tasks. This is due to the effect of some chemotherapy drugs on nerves and is known as peripheral neuropathy.
Tell your doctor if you notice any changes in sensation in your hands or feet. It's important to report your symptoms to your doctor, as they may be controlled by slightly lowering the dose of the drug.
Peripheral neuropathy usually begins to improve slowly a few months after the treatment is finished. Sometimes symptoms can persist - talk to your doctor if this happens.
We have more information about peripheral neuropathy.
If you’re being treated with paclitaxel, you may notice some aches or pains in your muscles a few days after having the treatment. Muscle pain doesn't usually last long, and your doctor can prescribe mild painkillers to help.
Sore mouth and loss of appetite
Some chemotherapy drugs can make your mouth sore and cause small mouth ulcers. Regular mouthwashes are important, and your nurse will show you how to do these properly. If you don’t feel like eating, you could try replacing some meals with nutritious drinks or eating foods that are soft and moist.
Although these side effects may be difficult to cope with, most of them will disappear once your treatment is over.
We have more detailed information on all these side effects. We also have more information specific to chemotherapy treatment and its side effects.