What is chemotherapy?

Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. It is one of the main treatments for ovaries cancer, 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

You usually have chemotherapy when you have recovered from your operation. You usually start it about 4 weeks after surgery. But it may start up to 12 weeks after.

Stage 1 ovarian cancer

If you have stage 1 ovarian cancer, you may also have chemotherapy after surgery. Your specialist doctor will talk to you about this. They may ask you to think about having chemotherapy if the cancer was either:

  • grade 3
  • stage 1c

We have more information about staging and grading of ovarian cancer.

Chemotherapy before surgery

If you have chemotherapy before surgery, you usually have it every 3 weeks for 3 treatment cycles.

After 3 treatment cycles, you will have a CT scan or MRI 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.

You will usually have 3 more cycles of chemotherapy after you have recovered from the operation. 

If you do not have surgery, you will still have another 3 cycles of chemotherapy. You will have 6 cycles in total.

Chemotherapy drugs used for cancer of the ovary, fallopian tube or peritoneum

You usually have chemotherapy drugs called carboplatin and paclitaxel (Taxol®).

You may have carboplatin on its own if:

  • you are not well enough to cope with the side effects of the 2 drugs
  • you have early-stage ovarian cancer. 

Sometimes you have chemotherapy and a targeted therapy drug called bevacizumab (Avastin®).

Other chemotherapy drugs you may have include:

How chemotherapy is given

You usually have chemotherapy in the chemotherapy day unit. This means you can go home after your treatment. The drugs are usually given 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 have a rest period of a few weeks. The chemotherapy session and rest period are called a cycle of treatment.

The length of a cycle depends on the chemotherapy drugs you have. But most cycles are 1 to 3 weeks. If you are having a single drug on its own, you may have it every 4 weeks. Your specialist doctor or nurse will explain what to expect. Most courses of chemotherapy have 6 cycles.

We have more information about having chemotherapy.

Treating ovarian cancer that comes back

If the cancer comes back, it can usually be controlled by more chemotherapy. If your first treatment with a platinum drug (carboplatin or cisplatin) worked well, you may have the same drug again. But you may have it with other drugs such as liposomal doxorubicin or gemcitabine.

If the cancer comes back soon after treatment has finished, you will have different drugs. For example, you may have liposomal doxorubicin by itself.

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 specialist doctor or 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
  • diarrhoea
  • hair thinning or hair loss.

We have more information about the side effects of chemotherapy.

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.