Treating ovarian, fallopian tube or primary peritoneal cancer

Surgery, chemotherapy and targeted therapies are the main treatments for cancers that start in the:

Depending on the stage of the cancer, the aim of treatment may be to cure the cancer or to control it for as long as possible. Your specialist doctor and nurse will explain the aim of treatment to you.

Your treatment plan will depend on:

  • the type of cancer you have
  • its stage and grade
  • your general health
  • your personal preferences.

Your doctor and nurse will explain the possible advantages and disadvantages of each treatment and their side effects. You and your doctor can then decide on the best treatment for you.

Sometimes other treatments such as hormonal therapy or radiotherapy are used to improve symptoms. Your specialist doctor may also talk to you about taking part in a clinical trial to research new treatments.

Cancer treatments can cause early menopause and affect your fertility (ability to get pregnant). If you still want to be able to get pregnant, talk to your specialist doctor before treatment starts.

We understand that having treatment can be a difficult time for people. We are here to support you. If you want to talk, you can:

Treating borderline tumours

Most borderline tumours are found at an early stage and can often be cured with surgery. No further treatment is needed, and these tumours rarely come back.

Rarely, borderline tumours spread and behave more like a low-grade cancer. If this happens, you may not need more treatment. But you may have chemotherapy. The ovarian cancer charity Ovacome has more detailed information about borderline ovarian tumours.

Treating stage 1 cancer

Some stage 1 cancers in the ovary or fallopian tube can be cured with surgery alone. Depending on the stage and grade of the cancer, you may have surgery to remove only the affected ovary and fallopian tube. This means you can still get pregnant in the future.

If the cancer is stage 1c or high-grade, your doctor may advise you to have chemotherapy after surgery. This is to reduce the risk of the cancer coming back.

Treating stage 2 to 4 cancer

You will usually have surgery and chemotherapy or chemotherapy on its own. You may also have treatment with a targeted therapy drug.

Surgery

You usually have surgery to remove as much of the cancer as possible. If the cancer has spread to other areas in the pelvis, you may need more surgery. Sometimes you have chemotherapy before surgery to shrink the cancer and make it easier to remove.

Chemotherapy

You have chemotherapy to:

  • shrink the cancer before surgery
  • treat any remaining cancer cells that cannot be seen during surgery
  • shrink any cancer that could not be removed during surgery.

If you have chemotherapy before surgery, you will have a scan mid-way through the course of chemotherapy treatment. If the cancer has shrunk enough, you will have surgery before having more chemotherapy. If not, you will finish the whole course of chemotherapy.

Sometimes chemotherapy may be the only treatment you have. This is usually when it is not possible to remove the cancer or if you are not well enough for surgery.

Targeted therapy drugs

You may have targeted therapy drugs after chemotherapy to keep the cancer under control. Drugs called PARP inhibitors are often used. You take them as tablets for as long as they are working for you. This is called maintenance treatment. 

You may have a drug called bevacizumab (Avastin®) as a drip, along with chemotherapy or on its own. You may also have it with a PARP inhibitor drug.

Treating cancer that comes back

If ovarian cancer comes back, it can usually be treated again with more chemotherapy, targeted therapies and sometimes more surgery.

You may have several courses of chemotherapy and targeted treatments spaced over several years. This can help to keep the cancer under control and improve any symptoms.

Sometimes you can have hormonal therapy if you do not want further chemotherapy, or want to delay it.

Treating symptoms of advanced cancer

Sometimes ovarian cancer may cause some discomfort or pain. It may also cause fluid to gather in the tummy, and bowel problems. But these symptoms can be treated and controlled. For example, you may have radiotherapy to reduce pain or bleeding in the pelvis.

The main symptom of fluid in the tummy (ascites) is bloating and a swollen tummy. It may also make you feel breathless. Your doctor can drain the fluid away to make you feel more comfortable.

Your specialist doctor and nurse will help to make sure your symptoms are controlled. This is called supportive or palliative care. You may see a specialist palliative care doctor or nurse for expert help with your symptoms.

We have more information about coping with advanced cancer.

About our information

  • References

    Below is a sample of the sources used in our ovarian cancer information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

    Ledermann, Raja, Fotopoulou et al. Newly diagnosed and relapsed epithelial ovarian carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology, 2013; Volume 24, Supplement 6. Updated online 2020. Available from www.esmo.org/guidelines (accessed July 2021)

    Management of epithelial ovarian cancer. Scottish Intercollegiate Guidelines Network (SIGN). Nov 2013 revised 2018. Available from www.sign.ac.uk

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Chief Medical Editor, Professor Tim Iveson, Consultant Medical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

The language we use

We want everyone affected by cancer to feel our information is written for them.

We try to make sure our information is as clear as possible. We use plain English, avoid jargon, explain any medical words, use illustrations to explain text, and make sure important points are highlighted clearly.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected. Our aims are for our information to be as clear and relevant as possible for everyone.

You can read more about how we produce our information here.