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Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. The drugs work by disrupting the growth of cancer cells. Ovarian cancer is usually very sensitive to chemotherapy and in most women the tumours will become smaller and may disappear.
Chemotherapy drugs for ovarian cancer are usually given by injection into a vein (intravenously). Intravenous chemotherapy is given as a session of treatment, usually 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. The course of treatment is usually given over 4–5 months.
Chemotherapy is usually given to you as an outpatient, but sometimes it will be given as an inpatient, which will mean spending a few days in hospital.
Chemotherapy can also be given directly into the abdomen through a small tube. This is known as intraperitoneal chemotherapy. Research has shown that intraperitoneal chemotherapy, given alongside intravenous chemotherapy, can help to improve survival for a small number of women. However, it can also cause unpleasant side effects, such as pain, infection and digestive problems.
Intraperitoneal chemotherapy is not a standard treatment for ovarian cancer. Further trials are being carried out to see how helpful it is.
Women with borderline tumours, or those with low-grade or stage 1a ovarian cancer, will not need chemotherapy.
Chemotherapy is often recommended after surgery for women with ovarian cancer (particularly if the grade of the cancer is moderate or high).
Some women will be given chemotherapy as their initial or primary treatment. Usually 3–4 cycles of chemotherapy are given then a CT scan is carried out to see how effective the treatment has been. At this point a decision is made about whether it’s possible to carry out surgery on the remaining tumour. If surgery is carried out, a further 2–3 cycles of chemotherapy are usually given after the operation.
If the cancer has spread to the liver|, or beyond the abdomen, it may not be possible to remove it and so chemotherapy is the main treatment used. The aim of the chemotherapy is to try and shrink the cancer and improve symptoms and quality of life.
For some women with advanced cancer the chemotherapy will have little or no effect on the cancer and they will have the side effects of treatment but with little benefit. Even if chemotherapy isn’t given, it’s possible to control symptoms with a number of different medicines – this is known as supportive or palliative care.
Chemotherapy may also be used if the cancer comes back after treatment.
The most commonly used drug to treat ovarian cancer is carboplatin|, which may be given with paclitaxel (Taxol)|. Some other drugs that are less commonly used, or maybe used if the cancer comes back, are:
Chemotherapy can cause unpleasant side effects, but any that occur can often be well controlled with medicines.
Side effects may include:
You’ll find more detailed information on chemotherapy side effects| in our 'Chemotherapy' section. We also have information to help you manage the side effects| of cancer treatment in our 'Living with and after cancer' section.
Research trials are looking at whether giving a biological therapy called bevacizumab| at the same time as and after chemotherapy is more effective.
Bevacizumab works by stopping some cancers from developing new blood vessels. This reduces the cancer’s supply of oxygen and nutrients, which causes the tumour to shrink, or at least to stop growing.
So far, the results of these trials look promising.
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.