Chemotherapy for ovarian cancer
You may have chemotherapy on its own, or with surgery, to treat ovarian cancer, fallopian tube cancer or primary peritoneal cancer.
What is chemotherapy?
Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. It is one of the main treatments for cancer of the ovary, fallopian tube cancer or primary peritoneal cancer.
When chemotherapy is used for cancer of the ovary, fallopian tube or peritoneum
You usually have chemotherapy with surgery or sometimes on its own.
It can be given :
- after surgery – to reduce the risk of the cancer coming back (adjuvant chemotherapy)
- before surgery – to shrink the cancer to make the operation more effective (neo-adjuvant chemotherapy)
- to treat any cancer that cannot be removed during surgery
- as your main treatment – if your doctors think surgery is not the best treatment option for you, or if you are not well enough to have a big operation.
Chemotherapy after surgery
Chemotherapy starts when you have recovered from surgery. This is usually about 4 weeks after surgery. But it can be up to 12 weeks after.
If you have stage 1 ovarian cancer, you may not have chemotherapy. It can depend on the type, sub-stage and grade of the cancer. Your doctor can talk to you about this.
Chemotherapy before surgery
If you are having chemotherapy before surgery, you usually have it every 3 weeks. This is called a treatment cycle. You will have 3 treatment cycles.
After 3 treatment cycles, you will have a CT scan to check how well the chemotherapy has worked. Your doctors will tell you if the cancer has shrunk enough for you to have surgery. If you do not have surgery, you will have another 3 cycles of chemotherapy (6 cycles in total).
Chemotherapy during surgery (HIPEC)
You may have a chemotherapy drug called cisplatin during surgery. It is given through plastic tubes that go into the abdomen (tummy area). This is called hyperthermic intraperitoneal chemotherapy or HIPEC. The chemotherapy is heated and left inside the tummy for 90 minutes. It is drained before the surgery has finished, and the tubes are removed.
HIPEC can help control the cancer. The side effects can be different from chemotherapy given into a vein. Your cancer doctor can tell you more about this. You will usually have 3 more cycles of chemotherapy after you have recovered from surgery.
Related pages
Chemotherapy drugs used for cancer of the ovary, fallopian tube or peritoneum
You usually have a combination of the chemotherapy drugs carboplatin and paclitaxel.
You may have carboplatin on its own. This may be because you are not well enough to cope with the side effects of a paclitaxel and carboplatin combination. Carboplatin is sometimes given on its own for early stage ovarian cancer.
You may have chemotherapy with a targeted therapy drug called bevacizumab.
Other chemotherapy drugs used to treat ovarian cancer include:
- cisplatin
- docetaxel
- paclitaxel
- etoposide
- gemcitabine
- pegylated liposomal doxorubicin (sometimes called Caelyx®).
Treating ovarian cancer that comes back
If ovarian cancer comes back, chemotherapy can usually control it for a period of time. If your first treatment with carboplatin or cisplatin worked, you may have the same combination of drugs again. Or you may have other drugs such as pegylated liposomal doxorubicin or gemcitabine.
If the cancer comes back soon after chemotherapy treatment, you will have different chemotherapy drugs.
Having chemotherapy
You usually have chemotherapy as an outpatient in a hospital chemotherapy day unit. You usually have the drugs into a vein (intravenously).
How often you have chemotherapy
You have chemotherapy as 1 or more sessions of treatment. Each session takes a few hours. After the session, you will have a rest period of a few weeks. Together, a chemotherapy session and rest period is called a cycle.
The length of a cycle depends on the chemotherapy drugs you have. But most cycles are 1 to 4 weeks long. Your cancer doctor, specialist nurse or chemotherapy nurse will explain what to expect. Most courses of chemotherapy are 6 cycles.
If you are having bevacizumab with chemotherapy, you may continue having bevacizumab after chemotherapy has ended.
Related pages
Side effects of chemotherapy
Chemotherapy drugs may cause side effects. But these can usually be controlled with medicines and will usually go away after treatment has finished.
Not all drugs cause the same side effects for each person. Some people have very few side effects. Your cancer doctor or specialist nurse will explain what to expect.
Some general side effects of chemotherapy include:
- a higher risk of getting an infection
- more risk of bleeding or bruising
- feeling tired
- feeling sick (nausea)
- diarrhoea
- hair thinning or hair loss
We have more information about the side effects of chemotherapy.
About our information
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.
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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 informationproductionteam@macmillan.org.uk
Ovarian cancer: recognition and initial management. Clinical guideline [CG122] Published: 27 April 2011 Last updated: 02 October 2023 www.nice.org.uk/guidance/cg122 (accessed May 2024)
Ovarian cancer: identifying and managing familial and genetic risk. NICE guideline [NG241]. Published: 21 March 2024 www.nice.org.uk/guidance/ng241 (accessed May 2024)
A. González-Martín, P. Harter, A. Leary, D. Lorusso, R. E. Miller, B. Pothuri, I. Ray-Coquard, D. S. P. Tan, E. Bellet, A. Oaknin & J. A. Ledermann, on behalf of the ESMO Guidelines Committee. Newly diagnosed and relapsed epithelial ovarian cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Published August 17, 2023. www.annalsofoncology.org/article/S0923-7534(23)00797-4/fulltext (accessed May 2024)
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